RESEARCH PAPER: Lyme Disease: A Counter Argument to the Australian Government's Denial
ISBN: 978-0-9923925-6-7
Researched & Written by Karen Smith 2010- 2012 : First Published Online July 2012
Researched & Written by Karen Smith 2010- 2012 : First Published Online July 2012
Apart from the Executive Summary, the information in this overview (and its complimentary report 'Lyme Disease / Borreliosis: An Overview of Lyme and Direction for further Research required in Australia' was published on the Lyme Australia Recognition and Awareness (LARA) website in July 2012, effectively being copyrighted at that time. The ISBN publishing date reflects the year of original online publication date (July 2012), rather than the date the information was released in a PDF format (2013).
The Executive Summary of the Counter-Argument is reproduced below. The entire Counter Argument in PDF format can be downloaded on the following link:
| Lyme Disease: A Counter Argument to the Australian Governments Denial.pdf |
A note for those that struggle reading long documents: I have received some comments from Lyme patients that whilst they would love to read the document, their neurological symptoms means that 25 pages is simply beyond their capability. To reduce some of those fears, while the document is 25 pages long, the body of the report is only 12 pages (6-17). The remaining pages include: Cover and Information Page, Executive Summary and Contents (Pge 1-5) and the References (Pge 18-25).
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If you prefer information in audio format:
The information provided with regards to the flaws in the counter argument is briefly covered in the you-tube video below. The video was originally made to explain the reasons I advocate for Lyme recognition and awareness and why I signed Australia up to be involved in the Worldwide Lyme Awareness Protests - an occasion which saw over a dozen events in Australia, and where over 25 countries around the world banded together to raise awareness of the problems associated with a lack of recognition and treatment for Lyme and other vector borne diseases. |
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Lyme Disease: A Counter Argument to the Australian Government’s Denial
Executive Summary
Lyme disease (LD) is a disease caused by an infection from the Borrelia species of bacteria. As there are numerous species of Borrelia underlying Lyme disease it is also known as Borreliosis and, in continents such as Europe and Asia where the species responsible for neurological symptoms are more common, Neuroborreliosis. In the initial stages Lyme may simply present with flu-like symptoms; however, as the duration of the infection increases, the disease may present as a more chronic and difficult to treat condition due to the bacteria disseminating throughout the body’s tissues and organs. In order to maximise the potential for early detection, treatment and full recovery, the recognition of the possibility of Lyme as a differential diagnosis is essential.
Lyme is the fastest growing vector borne disease in the world. In the United States of America (USA), the Centre for Disease Control (CDC) recently released figures of around 300,000 new cases of Lyme disease each year in America alone. Although there is no official collection of data, various sources reveal that the number of cases for the other continents, ie: Europe, Africa and Asia range from around 200,000 to 300,000 cases per year also. According to Australian Government Health departments, Australia is the one continent exempt from a disease that affects hundreds of thousands of people around the world each year. The ‘No Lyme in Australia’ stance is maintained, despite thousands of clinically suspected cases that date back as far as the 1980’s. This position stems from research that was conducted on ticks and animals collected from New South Wales (NSW) over twenty years ago.
This Counter-Argument examines the research from the Department of Medical Entomology (DME), Westmead Hospital, NSW that underlies the denial in Australia, the majority of which was published in a paper by Russell et al., (1994) Lyme disease: search for a causative agent in ticks in south-eastern Australia. As the research paper is also the basis of the information regarding Lyme disease on the DME website, information from this site is also briefly explored. The aim of this document is to highlight that the research methodology has a number of flaws. There will always be problems encountered within research; it is in learning from these difficulties that science and knowledge can progress. While most studies address the problems that arise and offer possible alternative viewpoints or conclusions, the disturbing factor in the DME’s investigations is that, despite being new to the field of Lyme research, the team at the DME assessed their own investigations as “expert” and ignored all other contradictory research that revealed there is a high probability that Lyme is in Australia.
In referring to Lyme disease, the DME website notes that the 1994 study was the result of “a multidisciplinary investigation” that began in 1988 to investigate the existence of Lyme disease in “coastal New South Wales”. The individual components - clinical and serological studies, reservoir host, and vector study – are explored in detail in this Counter-argument.
Clinical & Serological Studies: Despite over 1000 suspected cases of Lyme disease per year at that time, it was concluded that patients were not positive according to international test criteria. The clinical and serological section examines the blood tests performed, outlining the fact that they are not appropriate for Australian patients. The international criteria that the DME and Russell et al., reference is the US Centre for Disease Control (CDC) criteria established for surveillance purposes in the USA. The Western Blot (WB) criteria were developed in order to monitor the activity of the Borrelia burgdorferi sensu stricto species, the most common species of Borrelia underlying Lyme disease in the USA. There is alternative European WB criterion that is recommended for use outside of the USA where other species from the Borrelia sensu lato class, such as afzelii, garinii, and valaisiania are more prevalent than B. burgdorferi ss.
Due to known variations and the differences in the immunological response to various Borrelia species, the criteria for a positive WB test is vastly different in Europe. These differences have been known since the early 1990’s, although the literature on the diversity of Borrelia, and even the advice from the CDC that the USA criteria should not be used outside of America, seems to be totally ignored by the DME and Australian pathology laboratories. With the bird migratory pathways (it has been known since the 1980’s that migrating seabirds and the ticks they carry play a role in spreading Borrelia) and the knowledge that many animals in Australia were imported from Europe and Asia, it would be more appropriate to utilise the European guidelines with regard to what is considered a positive WB test for Lyme in Australia.
Reservoir Host Studies: Seventeen (17) animals were examined by the Westmead team. As various strains of Borrelia are found within organs, rather than restricted to the skin, ear punch biopsy of animals is insufficient. The identification of reservoir hosts within the environment is crucial to identifying the pathogens present. Indeed, Borrelia was found in the blood of Australian mammals, including rodents, cattle, kangaroos and bandicoots in a Commonwealth Scientific and Industrial Research Organisation (CSIRO) study by Mackerras in 1959. Curiously, this information is given little regard by the DME. A study involving 17 animals can only be described as extremely limited in scope.
The concluding statement on the DME Website is: “None of the mammal species identified as reservoir hosts in the northern hemisphere are present in Australia”. This is incorrect. The primary reservoir host for Borrelia in America is the white-footed mouse; it is a mammal, belonging to the Rodentia species of the Muridae family. While we do not have the white-footed mouse in Australia, over 20% of the mammal species belong to the Muridae, rat and mouse family. This includes the Australian Long-haired Rat, which in 1962 were the subject of a study in Richmond, north-west Queensland, in which a new species of Borrelia was identified and subsequently called Borrelia queenslandica.
The reservoir hosts section also briefly looks at four mammal species that have, in fact, been shown to be reservoir hosts in the northern hemisphere and have been introduced and are established in Australia. These include: Black Rats, Brown Rats, House Mouse, and European Hares. Many other mammal species are known reservoir hosts for Borrelia, including foxes, dogs, cats, horses and cattle. Other animal species such as birds, which include the European blackbird, Mallard duck and turkeys that have been introduced into Australia, are also known reservoir hosts of the Borrelia bacteria underlying Lyme disease.
Vector (Tick) Studies: The result of the research conducted on the ticks collected from the NSW coastline between 1990 and 1992 continues to be the primary basis for denial of Lyme disease in Australia today. Of the 12,000 ticks utilised in the study, over half were larvae, leaving less than 6,000 ticks that would have had a blood meal and have potentially been infected. No other study in the world uses tick larvae to ascertain the continent’s infection rates of Borrelia. While 6,000 ticks may seem a relatively large number, it is not so when considering infection rates of ticks from different environmental areas and locations can vary anywhere from zero to ninety percent. The ticks in this study were collected from a small ecological niche of the NSW coastline that accounts for less than one eighth of Australia’s entire coastline. The study ignored not only other ecological areas such as pasture or mountain areas in NSW, but also the seven other States and Territories of Australia.
This section on vector studies looks at the various methods used to ascertain infection within the ticks collected and argues that there were numerous problems contained within the methods used and conclusions drawn from the Russell et al, 1994 study. This counter-argument also presents the likelihood that what the study referred to as “spirochete-like objects” (SLO’s) were indeed spirochetes, rather than contaminants of the culture as was concluded. The tick species from which the SLO’s were cultured from included the Paralysis tick (Ixodes holocyclus), Wallaby tick (Haemaphysalis bancrofti), Bush/Scrub tick (Haemaphysalis longicornis) and Snake tick (Amblyomma morelia).
A few points as to why these findings should have encouraged further research, rather than simply dismissed the existence of Lyme include:
Executive Summary
Lyme disease (LD) is a disease caused by an infection from the Borrelia species of bacteria. As there are numerous species of Borrelia underlying Lyme disease it is also known as Borreliosis and, in continents such as Europe and Asia where the species responsible for neurological symptoms are more common, Neuroborreliosis. In the initial stages Lyme may simply present with flu-like symptoms; however, as the duration of the infection increases, the disease may present as a more chronic and difficult to treat condition due to the bacteria disseminating throughout the body’s tissues and organs. In order to maximise the potential for early detection, treatment and full recovery, the recognition of the possibility of Lyme as a differential diagnosis is essential.
Lyme is the fastest growing vector borne disease in the world. In the United States of America (USA), the Centre for Disease Control (CDC) recently released figures of around 300,000 new cases of Lyme disease each year in America alone. Although there is no official collection of data, various sources reveal that the number of cases for the other continents, ie: Europe, Africa and Asia range from around 200,000 to 300,000 cases per year also. According to Australian Government Health departments, Australia is the one continent exempt from a disease that affects hundreds of thousands of people around the world each year. The ‘No Lyme in Australia’ stance is maintained, despite thousands of clinically suspected cases that date back as far as the 1980’s. This position stems from research that was conducted on ticks and animals collected from New South Wales (NSW) over twenty years ago.
This Counter-Argument examines the research from the Department of Medical Entomology (DME), Westmead Hospital, NSW that underlies the denial in Australia, the majority of which was published in a paper by Russell et al., (1994) Lyme disease: search for a causative agent in ticks in south-eastern Australia. As the research paper is also the basis of the information regarding Lyme disease on the DME website, information from this site is also briefly explored. The aim of this document is to highlight that the research methodology has a number of flaws. There will always be problems encountered within research; it is in learning from these difficulties that science and knowledge can progress. While most studies address the problems that arise and offer possible alternative viewpoints or conclusions, the disturbing factor in the DME’s investigations is that, despite being new to the field of Lyme research, the team at the DME assessed their own investigations as “expert” and ignored all other contradictory research that revealed there is a high probability that Lyme is in Australia.
In referring to Lyme disease, the DME website notes that the 1994 study was the result of “a multidisciplinary investigation” that began in 1988 to investigate the existence of Lyme disease in “coastal New South Wales”. The individual components - clinical and serological studies, reservoir host, and vector study – are explored in detail in this Counter-argument.
Clinical & Serological Studies: Despite over 1000 suspected cases of Lyme disease per year at that time, it was concluded that patients were not positive according to international test criteria. The clinical and serological section examines the blood tests performed, outlining the fact that they are not appropriate for Australian patients. The international criteria that the DME and Russell et al., reference is the US Centre for Disease Control (CDC) criteria established for surveillance purposes in the USA. The Western Blot (WB) criteria were developed in order to monitor the activity of the Borrelia burgdorferi sensu stricto species, the most common species of Borrelia underlying Lyme disease in the USA. There is alternative European WB criterion that is recommended for use outside of the USA where other species from the Borrelia sensu lato class, such as afzelii, garinii, and valaisiania are more prevalent than B. burgdorferi ss.
Due to known variations and the differences in the immunological response to various Borrelia species, the criteria for a positive WB test is vastly different in Europe. These differences have been known since the early 1990’s, although the literature on the diversity of Borrelia, and even the advice from the CDC that the USA criteria should not be used outside of America, seems to be totally ignored by the DME and Australian pathology laboratories. With the bird migratory pathways (it has been known since the 1980’s that migrating seabirds and the ticks they carry play a role in spreading Borrelia) and the knowledge that many animals in Australia were imported from Europe and Asia, it would be more appropriate to utilise the European guidelines with regard to what is considered a positive WB test for Lyme in Australia.
Reservoir Host Studies: Seventeen (17) animals were examined by the Westmead team. As various strains of Borrelia are found within organs, rather than restricted to the skin, ear punch biopsy of animals is insufficient. The identification of reservoir hosts within the environment is crucial to identifying the pathogens present. Indeed, Borrelia was found in the blood of Australian mammals, including rodents, cattle, kangaroos and bandicoots in a Commonwealth Scientific and Industrial Research Organisation (CSIRO) study by Mackerras in 1959. Curiously, this information is given little regard by the DME. A study involving 17 animals can only be described as extremely limited in scope.
The concluding statement on the DME Website is: “None of the mammal species identified as reservoir hosts in the northern hemisphere are present in Australia”. This is incorrect. The primary reservoir host for Borrelia in America is the white-footed mouse; it is a mammal, belonging to the Rodentia species of the Muridae family. While we do not have the white-footed mouse in Australia, over 20% of the mammal species belong to the Muridae, rat and mouse family. This includes the Australian Long-haired Rat, which in 1962 were the subject of a study in Richmond, north-west Queensland, in which a new species of Borrelia was identified and subsequently called Borrelia queenslandica.
The reservoir hosts section also briefly looks at four mammal species that have, in fact, been shown to be reservoir hosts in the northern hemisphere and have been introduced and are established in Australia. These include: Black Rats, Brown Rats, House Mouse, and European Hares. Many other mammal species are known reservoir hosts for Borrelia, including foxes, dogs, cats, horses and cattle. Other animal species such as birds, which include the European blackbird, Mallard duck and turkeys that have been introduced into Australia, are also known reservoir hosts of the Borrelia bacteria underlying Lyme disease.
Vector (Tick) Studies: The result of the research conducted on the ticks collected from the NSW coastline between 1990 and 1992 continues to be the primary basis for denial of Lyme disease in Australia today. Of the 12,000 ticks utilised in the study, over half were larvae, leaving less than 6,000 ticks that would have had a blood meal and have potentially been infected. No other study in the world uses tick larvae to ascertain the continent’s infection rates of Borrelia. While 6,000 ticks may seem a relatively large number, it is not so when considering infection rates of ticks from different environmental areas and locations can vary anywhere from zero to ninety percent. The ticks in this study were collected from a small ecological niche of the NSW coastline that accounts for less than one eighth of Australia’s entire coastline. The study ignored not only other ecological areas such as pasture or mountain areas in NSW, but also the seven other States and Territories of Australia.
This section on vector studies looks at the various methods used to ascertain infection within the ticks collected and argues that there were numerous problems contained within the methods used and conclusions drawn from the Russell et al, 1994 study. This counter-argument also presents the likelihood that what the study referred to as “spirochete-like objects” (SLO’s) were indeed spirochetes, rather than contaminants of the culture as was concluded. The tick species from which the SLO’s were cultured from included the Paralysis tick (Ixodes holocyclus), Wallaby tick (Haemaphysalis bancrofti), Bush/Scrub tick (Haemaphysalis longicornis) and Snake tick (Amblyomma morelia).
A few points as to why these findings should have encouraged further research, rather than simply dismissed the existence of Lyme include:
- I. holocyclus - As well as SLO’s cultured from this species in this study, spirochetes were also cultured from I. holocyclus ticks collected from the Hunter Valley and Manning River district of NSW in research by Wills and Barry in 1991
- H. bancrofti - In Wills and Barry’s research, spirochetes were also cultured from the Haemaphysalis species. The H bancrofti tick not only attaches to wallabies, its hosts also include kangaroos. In 1959, Mackerras reported the presence of Borrelia in Australian animals, including kangaroos
- H . longicornis - is a vector of Borrelia in China. It is also the tick species infesting a herd of cattle in which positive serology for Borrelia was reported in a cow in Camden NSW in 1989
- A. morelia - Snakes are capable reservoir hosts of the Borrelia species B. lusitaniae. This is a species of Borrelia that might be expected along the coastline, as it is carried by migrating seabirds
- The Seabird tick (I. uriae) is a known vector of Borrelia, it is found world wide – including Australia
- While it was originally presumed that only a small number of tick species were capable vectors of Borrelia, it is now known that over two dozen species of ticks are involved in the Borrelia cycle. This includes various species of ticks from the Ixodidae family, including Ixode, Haemaphysalis and Amblyomma species
Copyright information: Apart from the Executive Summary, the information in this counterpoint argument (and its complimentary report “An overview of Lyme and direction for further research required in Australia”) was published on the Lyme Australia Recognition and Awareness (LARA) website (www.lymeaustralia.com) in July 2012, effectively being copyrighted at that time. The ISBN publishing date reflects the year of original online publication date (July 2012), rather than the date the research information was released in a PDF format (2013).
As noted in the copyright section of this website: The information is intended to be disseminated in order to promote awareness and further research of Lyme in Australia; though I do ask that the source (myself) of the information is referenced appropriately. Information may not be used, distributed, or reproduced for any commercial purpose. Thank you. Karen Smith, B Psych (Hons).
As noted in the copyright section of this website: The information is intended to be disseminated in order to promote awareness and further research of Lyme in Australia; though I do ask that the source (myself) of the information is referenced appropriately. Information may not be used, distributed, or reproduced for any commercial purpose. Thank you. Karen Smith, B Psych (Hons).
Please note: Due
to some spelling, grammatical and formatting errors unfortunately not noticed
until after the first PDF publication of this research in Nov 2013 (ISBN:
978-0-9923925-4-3), the original version has been corrected and replaced with
this 2nd and final version. While the changes did not alter the
content of the counter-argument, as there have been numerous downloads of the
original PDF report, a new ISBN (as noted top of this page) has been allocated
to this current version of the report in order to acknowledge these changes and
distinguish between the two released PDF versions.
