Lyme disease and sleep

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What does the new Australian study say about chronic Lyme disease in Australia?

Dr. Norman Swan 0:00

Hello and welcome to this week's Health Report with me, Norman Swan. Today, sleepless in cyberspace, losing sleep over your gut, a warning for shift workers about late-night snacks, and how a promising young broadcaster can be turned into a blithering idiot. But I want to start with an important paper in this week's Medical Journal of Australia. Said against what anecdotally is a growing number of people being told that their fatigue, mental fogginess, joint pains, and other symptoms are due to chronic Lyme disease, the paper concluded that there is in fact no Lyme disease in Australia. That is, apart from people who might have caught it on a trip overseas. Lyme disease is spread by tick bites from infected animals like deer in the northern hemisphere, where there are hundreds of thousands of cases each year.

Dr. Norman Swan 0:46

The symptoms are a rash at the sight of the bite, joint pains, headaches, and malaise, all treatable with antibiotics. People diagnosed with chronic Lyme disease in Australia are given long courses of often toxic antibiotics. So it's important to be sure that the diagnosis is real. Peter Colignon is an infectious disease physician at the Australian National University and was the lead author on the paper. Welcome to the Health Report.

Peter Colin Young 1:10

Thank you for having me.

Dr. Norman Swan 1:11

You're trying to prove a negative here, aren't you, Peter? It's a bit hard to do.

Peter Colin Young 1:14

Well, it is a bit hard. I mean, you can't absolutely say that there's no Lyme disease in Australia, but what we can say is that we've looked extensively for decades for the bacteria in ticks, in people, in animals, and we have not been able to find it uh and grow it, uh, nor reproducibly find the DNA. Now that's not to say that ticks may not carry whole lots of other viruses, bacteria or even fungi that might cause problems to people. And we actually know ticks carry things like Rukepsia, for instance, to give people typhus like uh illnesses, etcetera. But for the specific syndrome of chronic Lyme disease, we don't have evidence that that particular berylli that causes that bacteria is present in Australia.

Peter Colin Young 1:55

And that's particularly problematic because some people are almost demanding months of intravenous antibiotics with particularly an antibody called keftraxone that causes not only harm to themselves but harm to the rest of society. because of antibiotic resistance and in fact because of the economic costs of therapy that's inappropriate.

Dr. Norman Swan 2:14

But people say, well look, uh my doctor sent my tests off to the pathol the local pathology lab and it came back negative, but when my sample was sent off to Germany or the United States it came back positive, so the local pathologists are incompetent.

Peter Colin Young 2:28

Well, one of the things is people can have tests that are positive even here, antibody tests, but they have you know and notoriously can have some false positives. The ones that are important are the PCR tests, the ones that detect the nuclear material or culture. Um the ones that are in dispute are usually the PCR tests, the you know, finding the DNA uh make up. But the problem with that is even in Australia there's some laboratories that say they've found it, but It's not reproducible by outside bodies, it's not independently uh assessed, such as all the Medicare uh attributable law uh laboratories in Australia where you have an outside party like NATO or the College of Pathologists coming. And even the products that are produced in the labs in Australia

Peter Colin Young 3:08

are um you know not available for others to sequence and check it really is what they say it is. The ones that are overseas are even in a lot of ways less supervised than the ones in Australia. But it's the same problem. I remember um about a decade ago when a lot of people ha well and still have chronic fatigue that tests were being sent over for rickety and whole lot of things and again they were found oh y this was Rickettsia but nobody else could reproduce the same results. Now Again we have to hope an open mind. Sometimes people do can do things differently and we need to learn from that.