Abstract
Lyme disease is a well-recognised human infection caused by certain Borrelia spp bacteria that are transmitted by the bite of some Ixodes spp ticks. While this infection is recognised as endemic in Europe, North America and Asia, it is not yet clear if the disease is present in Australia and some other countries. Nevertheless, there is considerable public and medical discussion on this topic, with polarised views ranging from “definitely in Australia” to “definitely not in Australia”. Although it is impossible to prove the negative (“not in Australia”) proposition, current expert opinion is that no confirmed Australian cases have yet been diagnosed. The Royal College of Pathologists of Australasia (RCPA) has recently (Feb 2014) issued a position paper entitled “Diagnostic Laboratory testing for Borreliosis (‘Lyme Disease’ or similar syndromes) in Australia and New Zealand”, which will be discussed in this presentation. It covers culture, molecular diagnosis and serological diagnosis, including a recommended Flow Diagram for undertaking the diagnosis of Lyme disease cases in Australia. In addition, data will be presented from the Australian Rickettsial Reference Laboratory on:-
Human cases investigated by 3 different forms of serology (enzyme immunoassay, micro-immunofluorescence and Western Blot)
and
Investigation of Australian ticks for the presence of Borrelia spp DNA by nucleic acid amplification.
At the time of writing (May 2014) no Australian human cases and no positive Australian ticks have been detected. However, this may change by the time of presentation (July 2014).