Australians in the affected community and their healthcare providers and supporters believe this illness is chronic Lyme disease or something similar. However, the concept of chronic Lyme disease is disputed and not accepted by most conventional medical practitioners, not only in Australia but around the world. The likelihood that Australia has an indigenous form of classical Lyme disease is questionable given a causative microorganism with a competent vector is yet to be found. Whether a form of tick-borne human borreliosis exists in Australia is yet to be determined.
The Australian Government recognises the existence of classical Lyme disease which is found in high rates in endemic areas (mainly the north east of the USA, some areas of Europe including the UK and some parts of Asia). Australians can be infected in these endemic areas and bring the infection to Australia. In the same way, visitors infected in endemic areas can also bring the infection to Australia. Because there is no person-to-person transmission of classical Lyme disease, the risk to Australia and Australians is low. The diagnosis and treatment for classical Lyme disease is readily available in Australia.
At the same time, the department is aware that Australian ticks are important vectors of human disease, e.g., rickettsial infections, Q fever and the newly described mammalian meat allergy.
The department will continue to encourage, identify and make known relevant Australian research on tick-borne disease.
To help support DSCATT patients, the Department of Health is providing funding for a number of projects and initiatives, including:
- The development of an evidence-based clinical pathway and multidisciplinary care model for patients presenting with DSCATT. The final DSCATT clinical pathway was published on the Department’s website in November 2020.
- The development of education and awareness materials to assist health professionals and the public to better understand tick-borne illness in Australia, and provide best practice advice regarding tick bite prevention and tick removal. Consultation with stakeholders about the processes involved was undertaken in December 2020. The draft education materials will be released for stakeholder consultation in a staged approach, with the first batch of materials to be released in February 2021. Key stakeholders will receive an email invitation to participate in the consultation process, and electronic copies of the draft education materials will be provided for review and feedback. Consultation will be open for six weeks and occur via an online survey tool. At the end of the consultation all stakeholder feedback will be collated and reviewed, and will be used to inform the finalisation of the materials.
- A tick survey to better understand which bacteria, viruses and other pathogens are carried by ticks in Australia and their impact on human health. The Commonwealth Scientific and Industrial Research Organisation has been engaged to progress this project. The project is due for completion in mid 2021.
- A case study biobank to gather and analyse samples from DSCATT patients for possible biomarkers. The Commonwealth Scientific and Industrial Research Organisation has been engaged to progress this project. The project is due for completion in mid 2021.
- A one-off grant to the Lyme Disease Association of Australia for the provision of patient advocacy and crisis counselling services for patients presenting with DSCATT.
The Australian Government remains committed to progressing these important projects and initiatives to support the best possible outcomes for patients presenting with DSCATT, and to better understand the aetiology of tick-borne diseases.
The Australian Government has developed the following position statements on Lyme disease in Australia and Debilitating Symptom Complexes Attributed to Ticks.
Even though the Chief Medical Officer’s Clinical Advisory Committee on Lyme Disease (CACLD) has ceased, the Australian Government Department of Health will maintain an interest in an Australian Lyme disease-like syndrome. This website will provide updates on the department’s work and relevant research findings on Australian Lyme disease-like syndrome.
DSCATT Clinical Pathway
In its response to the recommendations of the Senate Community Affairs References Committee Final Report: Inquiry into the growing evidence of an emerging tick-borne disease that causes a Lyme-like illness for many Australian patients, the Australian Government agreed to develop an evidence-based clinical pathway and multidisciplinary care model for patients presenting with DSCATT.
The Department contracted Allen and Clarke Policy and Regulatory Specialists to develop the DSCATT clinical pathway, in consultation with key stakeholders. The final clinical pathway was delivered to the Department in October 2020.
The clinical pathway supports clinicians’ decision-making on differential diagnosis and referral pathways for patients presenting with DSCATT. Patients will receive a comprehensive assessment of their symptoms, helping to ensure that their complex clinical presentations are appropriately diagnosed and managed.
The DSCATT clinical pathway has been informed by relevant literature and key documents. A comprehensive Literature Review detailing the evidence base used to underpin the development of the DSCATT clinical pathway was delivered to the Department in December 2020.
DSCATT Think Tank Report – 8 May 2019 Sydney
In its response to Recommendation 5 of the Senate Community Affairs References Committee Final Report: Inquiry into the growing evidence of an emerging tick-borne disease that causes a Lyme-like illness for many Australian patients, the Australian Government agreed to consult with key stakeholder groups to develop an evidence-based clinical pathway that can accommodate patient and medical needs.
The DSCATT Think Tank Report summarises the key discussion points and outcomes of a Think Tank held on 8 May 2019 to seek stakeholder input into the development the pathway.
DSCATT Forum Report – 27 July 2018 Sydney
On 27 July 2018, the Australian Government convened a patient group forum in Sydney to discuss the outcomes of the 18 April 2018 Melbourne forum and to provide patient groups with an opportunity to share their experiences and engage with the department on the next steps for managing DSCATT patients.
DSCATT Forum Report – 18 April 2018 Melbourne
On 18 April 2018, the Australian Government convened a forum in Melbourne to consider the outcomes of the Australian Government’s response to the Senate Community Affairs Reference Committee final report: Inquiry into the growing evidence of an emerging tick-borne disease that causes a Lyme-like illness for many Australians.
The Lyme Disease Association of Australia’s CEO, Sharon Whiteman, provided a statement at the DSCATT Forum held on 18 April 2018.
National Serology Reference Laboratory (NRL) Report
In June 2015 as part of the work of the Diagnostic Pathway Working Group of the Chief Medical Officer’s Clinical Advisory Committee (CACLD) on Lyme disease, the Australian Government Department of Health contracted with the National Serology Reference Laboratory (NRL) to undertake an evaluation of commercially available in vitro diagnostic devices (IVDs) used for the serological diagnosis of Lyme disease (the Project).
Statement from Australia’s Chief Medical Officer
Ministerial Statement - Australian Government response to the Senate Community Affairs References Committee final report: Inquiry into the growing evidence of an emerging tick-borne disease that causes a Lyme-like illness for many Australian patients
Australian Government response to the Senate Community Affairs References Committee final report: Inquiry into the growing evidence of an emerging tick-borne disease that causes a Lyme-like illness for many Australian patients
The Australian Senate has established an inquiry into a Lyme-like illness in Australia. The URL link for making a submission is: (www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Lyme-like_Illness).
Australian Government Response to the Senate – Community Affairs References Committee Interim Report on Health Inquiry into Lyme-like illness
Department of Health Media Statement
The Department of Health issued a media statement on Lyme Disease in Australia following several requests from the public and media outlets - a copy can be accessed below:
Recently Published Australian Research
- Molecular characterization of ‘Candidatus Borrelia tachyglossi’ (family Spirochaetaceae) in echidna ticks, Bothriocroton concolor Authors: Siew-May Loh, Amber Gillett, Una Ryan, Peter Irwin, Charlotte Oskam – April 2017. *
- Searching for Lyme borreliosis in Australia: results of a canine sentinel study Peter Irwin et al 13 March 2017. *
- Inhibition of the endosymbiont "Candidatus Midichloria mitochondrii" during 16S rRNA gene profiling reveals potential pathogens in Ixodes ticks from Australia. Peter Irwin et al, 25 June 2015. *
- Bacterial Profiling Reveals Novel “Ca.Neoehrlichia”, Ehrlichia, and Anaplasma Species in Australian Human-Biting Ticks” Peter Irwin et al 28 December 2015 *
- Novel Borrelia species detected in echidna ticks, Bothriocroton concolor, in Australia Peter Irwin et al 14 June 2016. *
Preventing and Treating Tick Bites
Chief Medical Officer's progress report on Lyme disease in Australia
Australian guideline on the diagnosis of overseas acquired Lyme Disease/Borreliosis
Progress Report against the CACLD Terms of Reference
The Progress Report from the Chief Medical Officer that details the activity achieved against each of the CACLD’s terms of reference can be accessed below.
The Department of Health contracted an expert in microbiology to conduct a Scoping Study to identify the research needs for an investigation into whether a causative tick borne microorganism for Lyme disease exists in Australia.
The Scoping Study can be accessed below.
Department of Health’s Response to the Scoping Study
In November 2013, the Department of Health sought public comment on the Scoping Study requesting that comments focus on the research programmes. Twenty-four submissions were received, along with eight expressions of support for the Lyme Disease Association of Australia’s submission and four letters from people describing their personal situations (36 submissions in total). The department considered each submission and has prepared a response to the Scoping Study.
The Department of Health’s response to the Scoping Study can be accessed below:
Consolidated List of Research Projects
The Department of Health, in consultation with the CACLD and other clinical experts has identified a number of research projects that would assist in clarifying the Australian Lyme disease-like syndrome.
The consolidated list of research projects can be assessed below:
Lyme Disease Treatment Round Table
The Department of Health hosted the Lyme Disease Treatment Round Table Meeting on Tuesday 27 May 2014. The outcomes can be accessed below:
Advice provided by the CACLD, recommendations from the Scoping Study, and outcomes from the Lyme Disease Round Table Meeting have revealed potential research projects that would assist in clarifying the Australian Lyme disease-like syndrome.
The majority of Australian Government health and medical research funding is administered by the National Health and Medical Research Council (NHMRC). The Australian Research Council (ARC) has funded some Special Research Initiatives in the health and medical areas however the ARC does not generally fund medical research. The ARC Medical Research Policy is available on the ARC web site. Researchers may also seek other avenues for funding including the higher education sector, business sector or the private non-profit sector. The Department of Health is not a research funding agency.
National Health and Medical Research Council
The Project Grant scheme is the NHMRC's main avenue of support for individuals and small teams of researchers undertaking biomedical, clinical, public health or health services research in Australian universities, medical schools, hospitals or other research institutions. The Project Grants scheme aims to fund research leading to improved health of all Australians. To achieve this aim the scheme provides support for projects with the following attributes:
- Investigator initiated research across all fields of research, from basic research through to research in clinical and community settings, relevant to health; and
- single investigators or small teams of researchers (up to 10 investigators) and early career researchers (new investigators).
All applications undergo a competitive peer-review process and project grant rounds usually start in December each year. Further information is available on the NHMRC website.
Australian Research Council
The ARC funds research and researchers under the National Competitive Grants Program (NCGP). As part of its commitment to nurturing the creative abilities and skills of Australia's most promising researchers, the NCGP provides:
- support for the highest-quality research leading to the discovery of new ideas and the advancement of knowledge
- financial assistance towards facilities and equipment that researchers need to be internationally competitive
- support for the training and skills development of the next generation of researchers
- incentives for Australia’s most talented researchers to work in partnership with leading researchers throughout the national innovation system and internationally, and to form alliances with Australian industry
Advice to Clinicians
The provision of linked information does not constitute departmental endorsement.