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77265
star this property registered interest false more like this
star this property date less than 2014-07-10more like thismore than 2014-07-10
star this property answering body
Department of Health more like this
unstar this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Lyme Disease remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government whether, in December 2011, the Clinical Pathology Accreditation Service was made aware of modifications by the Health Protection Agency’s Lyme Borreliosis Unit to the Trinity Biotech immunoblot kit to be used for testing human cerebrospinal fluid. more like this
star this property tabling member printed
The Countess of Mar more like this
star this property uin HL999 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2014-07-24more like thismore than 2014-07-24
star this property answer text <p>The former Health Protection Agency's Lyme Borreliosis Unit (HPA LBU) was accredited by Clinical Pathology Accreditation who had access to, and was able to review, all the standard operating procedures of the unit.</p><p> </p><p>The Trinity Biotech Lyme Western Blot is a qualitative in vitro assay for the detection of Immunoglobulin (IgG or IgM) antibodies in human samples against specific antigens/proteins of <em>Borrelia afzelii, Borrelia garinii and Borrelia burgdorferi</em>. The Trinity Biotech Lyme Western Blot is intended as a confirmatory assay for use in testing human samples which have been previously found to be positive or equivocal using an Enzyme Immunoassay and Immunofluroescent Assay or other appropriate screening method. Positive second-tier results are supportive evidence of infection with <em>B. burgdorferi</em>. The diagnosis of Lyme disease should be made based on history and symptoms (such as erythema migrans), and other laboratory data, in addition to the presence of antibodies to <em>B. burgdorferi</em>. The Trinity Biotech blot has been in use since 2007 by the former HPA’s LBU for testing cerebrospinal fluid (CSF) and proved very reliable. This technique has also been in use widely across Europe during this period as a diagnostic test using CSF as a sample to support the diagnosis of neuroborreliosis.</p>
star this property answering member printed Earl Howe more like this
star this property question first answered
less than 2014-07-24T12:32:59.6647091Zmore like thismore than 2014-07-24T12:32:59.6647091Z
star this property answering member
2000
star this property label Biography information for Earl Howe more like this
star this property tabling member
1861
star this property label Biography information for The Countess of Mar more like this
77264
star this property registered interest false more like this
star this property date less than 2014-07-10more like thismore than 2014-07-10
star this property answering body
Department of Health more like this
unstar this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Lyme Disease remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government when the testing of the cerebrospinal fluid of patients suspected of having Lyme disease using the Trinity Biotech kit at the Health Protection Agency’s Lyme Borreliosis Unit began; how many patients' samples were tested in that way; and how many patients were recorded as being positive over that period of time. more like this
star this property tabling member printed
The Countess of Mar more like this
star this property uin HL998 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2014-07-24more like thismore than 2014-07-24
star this property answer text <p>The Trinity Biotech blot has been in use since 2007 by the former Health Protection Agency's Lyme Borreliosis Unit for testing cerebrospinal fluid (CSF) and proved very reliable. It has also been used in this way by other laboratories in Europe. However, CSF antibodies will not be present if there is no evidence of any other antibodies in the serum. Data is not collected centrally on specific samples from patients as the final diagnosis is made by the clinician on the basis of the test results and the clinical presentation.</p> more like this
star this property answering member printed Earl Howe more like this
star this property question first answered
less than 2014-07-24T12:31:17.2846277Zmore like thismore than 2014-07-24T12:31:17.2846277Z
star this property answering member
2000
star this property label Biography information for Earl Howe more like this
star this property tabling member
1861
star this property label Biography information for The Countess of Mar more like this
448149
star this property registered interest false more like this
star this property date less than 2016-01-27more like thismore than 2016-01-27
star this property answering body
Department of Health more like this
unstar this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Lyme Disease remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what is their estimate of how long it would take for research-led treatment to eradicate Lyme disease from the UK if resource provision were no issue. more like this
star this property tabling member printed
Lord Mawhinney more like this
star this property uin HL5539 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2016-02-09more like thismore than 2016-02-09
star this property answer text <p>It is not practical to eradicate Lyme disease in the United Kingdom through treatment of human cases, therefore no cost estimate has been made. The disease is endemic in much of the small mammal and bird population in the UK, and is spread to humans by the bite of infected ticks which have fed on these animals. The number of human cases can be reduced by raising public awareness of how to avoid tick bites, and by environmental measures in public places to reduce the long grass and scrub which harbour ticks.</p><p> </p><p>The number of laboratory confirmed cases of Lyme disease in England and Wales varies annually, in 2013 there were 878 and in 2014 there were 730, but the majority of diagnoses are made clinically by general practitioners and those figures are not recorded. Patients with late or complicated Lyme disease may be diagnosed in a variety of specialist clinics, and the numbers are not recorded. Based on the clinical information supplied with the laboratory request, only a small proportion of the annual number of cases fall into this category.</p><p> </p><p>The Health Protection Research Unit of the University of Liverpool in partnership with Public Health England (PHE) has funding from the National Institute of Health Research for research into Lyme disease, covering diagnostics and biomarkers and public awareness. PHE is working on clinically linked studies for diagnostics with the Czech Republic, as no single centre in the UK has sufficient patients for a suitable study; funding for this work is not yet in place. PHE undertakes limited studies on ticks and Lyme disease in the UK. The Research Councils fund some additional work on ticks and the environment.</p>
star this property answering member printed Lord Prior of Brampton more like this
star this property grouped question UIN
HL5540 more like this
HL5541 more like this
HL5542 more like this
star this property question first answered
remove maximum value filtermore like thismore than 2016-02-09T15:50:46.73Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property tabling member
121
star this property label Biography information for Lord Mawhinney more like this
173567
star this property registered interest false more like this
star this property date less than 2015-01-14more like thismore than 2015-01-14
star this property answering body
Department for Environment, Food and Rural Affairs more like this
unstar this property answering dept id 13 more like this
star this property answering dept short name Environment, Food and Rural Affairs more like this
star this property answering dept sort name Environment, Food and Rural Affairs more like this
unstar this property hansard heading Lyme Disease remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what assessment they have made of the extent of Lyme disease in the United Kingdom in (1) sheep, (2) other farm animals, (3) domestic animals, and (4) wild animals; and what action they are taking to reduce the number of infected animals. more like this
star this property tabling member printed
Lord Greaves more like this
star this property uin HL4127 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-01-28more like thismore than 2015-01-28
star this property answer text <p>Defra has made no formal assessment of the extent of Lyme disease in the United Kingdom in livestock, domestic or wild animals. However a number of surveillance studies have shown that the main carriers of the <em>Borrelia</em> organism that causes Lyme disease in people and dogs are small wild mammals (for example mice and voles) and ground nesting birds. Other studies have looked at the role of cattle, sheep and deer as hosts for the intermediate tick host, although these species do not maintain infection with the organism. No action is taken to reduce the number of infected wild animals. Action to reduce the number of infected wild animals could only be taken at disproportionate cost.</p><p> </p><p> </p><p> </p><p>Control of the disease in people is focussed on public awareness of the importance of preventing tick bites. Factsheets on tick bite risk and prevention are produced by Public Health England and Lyme Disease Action, with further information for patients published by NHS Choices. Veterinary advice on the prevention of infection in dogs is widely available through private practitioners and a vaccine for dogs is now licensed.</p><p> </p><p> </p><p> </p><p> </p>
star this property answering member printed Lord De Mauley more like this
star this property question first answered
less than 2015-01-28T17:30:08.833Zmore like thismore than 2015-01-28T17:30:08.833Z
star this property answering member
2202
star this property label Biography information for Lord De Mauley more like this
star this property tabling member
2569
star this property label Biography information for Lord Greaves more like this
173566
star this property registered interest false more like this
star this property date less than 2015-01-14more like thismore than 2015-01-14
star this property answering body
Department of Health more like this
unstar this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Lyme Disease remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what assessment they have made of the quality and availability of tests for Lyme disease and related diseases in (1) the United Kingdom, (2) the rest of the European Union, and (3) North America. more like this
star this property tabling member printed
Lord Greaves more like this
star this property uin HL4126 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-01-26more like thismore than 2015-01-26
star this property answer text <p>Public Health England (PHE) actively reviews test methodologies for Lyme disease based on peer reviewed reports and on evaluation of possible alternative test kits within the laboratory. As part of this work, staff from the Rare and Imported Pathogens Laboratory (RIPL) have attended international conferences, including those organised by pressure groups proposing alternative testing systems to those used in state laboratories, and met with private and state laboratory service providers in Europe and the United States.</p><p> </p><p> </p><p> </p><p>RIPL offers a telephone advice line to clinicians with problem cases, and also works with the patient charity Lyme Disease Action to address the needs of individual patients. RIPL also participates in a European external quality assessment programme, and cross-compares results with Raigmore Hospital in Scotland.</p><p> </p><p> </p><p> </p><p>All diagnostic tests for infectious diseases are less sensitive in the very early stages of disease, and the results of a laboratory test have to be interpreted in this light and in conjunction with the patient’s presentation. Whilst the current tests are not perfect, none of the alternatives have yet proven superior to accepted methodologies. Any novel methods to test for Lyme disease are kept under review.</p><p> </p>
star this property answering member printed Earl Howe more like this
star this property question first answered
less than 2015-01-26T15:07:51.67Zmore like thismore than 2015-01-26T15:07:51.67Z
star this property answering member
2000
star this property label Biography information for Earl Howe more like this
star this property tabling member
2569
star this property label Biography information for Lord Greaves more like this
173565
star this property registered interest false more like this
star this property date less than 2015-01-14more like thismore than 2015-01-14
star this property answering body
Department of Health more like this
unstar this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Lyme Disease remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what information, advice and training is provided to doctors and nurses on the symptoms and treatment of Lyme disease; what advice is provided to general practitioners on the reference to specialists of patients exhibiting symptoms of Lyme disease; and which centres provide specialist treatment for that disease. more like this
star this property tabling member printed
Lord Greaves more like this
star this property uin HL4125 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-01-28more like thismore than 2015-01-28
star this property answer text <p>Public Health England (PHE) and the National Health Service have detailed information on the recognition, diagnosis, treatment and management of Lyme disease. PHE has also written a guide on how to refer patients for specialist advice, which is attached. The National Institute for Health and Care Excellence also has an online guide for general practitioners (GP) and other health professionals.</p><p> </p><p> </p><p> </p><p>PHE issues a letter to all GPs on an annual basis at the beginning of the tick season describing Lyme disease and highlighting the need to be aware and to recognise the condition. The majority of cases are managed by GPs without reference to specialists, but problem cases can be referred to neurology, rheumatology, cardiology and infectious disease clinics depending on the local provision and of services and patient’s symptoms. In addition to the attached guidance, <em>Suggested referral pathway for patients with symptoms related to Lyme disease</em>, PHE offers a telephone helpline for GPs and consultants to discuss particular cases. PHE works closely with the patient group Lyme Disease Action, who will also represent individuals who have trouble obtaining specialist advice, and can thus help in suggesting potential routes of referral.</p><p> </p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p>
star this property answering member printed Baroness Jolly more like this
star this property question first answered
less than 2015-01-28T14:04:57.627Zmore like thismore than 2015-01-28T14:04:57.627Z
star this property answering member
4203
star this property label Biography information for Baroness Jolly more like this
star this property attachment
1
star this property file name Lyme disease referral pathway Jan 2015.pdf more like this
star this property title Lyme Disease Referral Pathway more like this
star this property tabling member
2569
star this property label Biography information for Lord Greaves more like this
173564
star this property registered interest false more like this
star this property date less than 2015-01-14more like thismore than 2015-01-14
star this property answering body
Department of Health more like this
unstar this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Lyme Disease remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what is the recorded number of occurrences of Lyme disease in the United Kingdom in each of the past 10 years; whether they have estimated the extent of under-reporting; and what assessment they have made of the number of cases of Lyme disease in (1) the United States, and (2) other member countries of the European Union, in the latest year for which they have information. more like this
star this property tabling member printed
Lord Greaves more like this
star this property uin HL4124 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-01-26more like thismore than 2015-01-26
star this property answer text <p>The recorded number of occurrences of Lyme disease in the United Kingdom from 2004-2012 is shown in the following table:</p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>Year of report</p></td><td><p>2004</p></td><td><p>2005</p></td><td><p>2006</p></td><td><p>2007</p></td><td><p>2008</p></td><td><p>2009</p></td><td><p>2010</p></td><td><p>2011</p></td><td><p>2012</p></td></tr><tr><td><p> </p><p>Lyme disease cases in UK</p><p> </p></td><td><p>586</p></td><td><p>693</p></td><td><p>940</p></td><td><p>1,027</p></td><td><p>1,098</p></td><td><p>1,093</p></td><td><p>1,213</p></td><td><p>1,189</p></td><td><p>1,163</p></td></tr></tbody></table><p> </p><p> </p><p> </p><p>Data from 2013 is not currently available.</p><p> </p><p> </p><p> </p><p>It is estimated that between 1,000 and 2,000 additional cases of Lyme disease may occur each year in England and Wales.</p><p> </p><p> </p><p> </p><p>The recorded number of occurrences of Lyme disease in the United States in each of the past 10 years is shown in the following table:</p><p> </p><p> </p><p> </p><table><tbody><tr><td><p> </p></td><td><p>2004</p></td><td><p>2005</p></td><td><p>2006</p></td><td><p>2007</p></td><td><p>2008</p></td><td><p>2009</p></td><td><p>2010</p></td><td><p>2011</p></td><td><p>2012</p></td><td><p>2013</p></td></tr><tr><td><p>TOTAL USA</p></td><td><p>19,804</p></td><td><p>23,305</p></td><td><p>19,931</p></td><td><p>27,444</p></td><td><p>28,921</p></td><td><p>29,959</p></td><td><p>22,561</p></td><td><p>24,364</p></td><td><p>22,014</p></td><td><p>27,203</p></td></tr></tbody></table><p> </p><p><em>Source:</em> CDC <a href="http://www.cdc.gov/lyme/stats/index.html" target="_blank">http://www.cdc.gov/lyme/stats/index.html</a></p><p> </p><p> </p><p> </p><p><em>Notes:</em></p><p> </p><p>The recorded number of occurrences of Lyme disease are not systematically reported. A paper in 2009 provided an estimate of 65,000 cases (Hubalek 2009 <a href="http://www.ncbi.nlm.nih.gov/pubmed/19367096" target="_blank">http://www.ncbi.nlm.nih.gov/pubmed/19367096</a>)</p><p> </p><p> </p><p> </p><p>Data on the number of occurrences of Lyme disease in other European Union member states is not held.</p><p> </p>
star this property answering member printed Earl Howe more like this
star this property question first answered
less than 2015-01-26T15:02:12.363Zmore like thismore than 2015-01-26T15:02:12.363Z
star this property answering member
2000
star this property label Biography information for Earl Howe more like this
star this property tabling member
2569
star this property label Biography information for Lord Greaves more like this
173563
star this property registered interest false more like this
star this property date less than 2015-01-14more like thismore than 2015-01-14
star this property answering body
Department of Health more like this
unstar this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Lyme Disease remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what assessment they have made of the rate and extent of the spread of Lyme disease in (1) the United Kingdom, (2) other parts of the European Union, and (3) other parts of the world. more like this
star this property tabling member printed
Lord Greaves more like this
star this property uin HL4123 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-01-26more like thismore than 2015-01-26
star this property answer text <p>Public Health England monitors laboratory-confirmed Lyme disease (also known as Lyme borreliosis) in England and Wales, devolved administrations of Scotland and Northern Ireland have separate local arrangements in place.</p><p> </p><p> </p><p> </p><p>The rate of laboratory-confirmed Lyme borreliosis and its regional distribution in England and Wales has not changed significantly in recent years, data for 2013 will be published shortly.</p><p> </p><p> </p><p> </p><p>Assessment of Lyme borreliosis in other European Union (EU) countries is co-ordinated by the European Centre for Disease Prevention and Control (ECDC). Reporting systems and criteria are not standardised throughout EU countries and this data is not routinely collected by ECDC. Therefore as an assessment of Lyme borreliosis using routinely collected data across the EU is not available.</p><p> </p><p> </p><p> </p><p>Reporting of Lyme borreliosis worldwide is co-ordinated by the World Health Organization (WHO) based on the heterogeneous reporting systems and criteria adopted by individual countries.</p><p> </p>
star this property answering member printed Earl Howe more like this
star this property question first answered
less than 2015-01-26T13:01:20.117Zmore like thismore than 2015-01-26T13:01:20.117Z
star this property answering member
2000
star this property label Biography information for Earl Howe more like this
star this property tabling member
2569
star this property label Biography information for Lord Greaves more like this
421251
star this property registered interest false more like this
star this property date less than 2015-10-14more like thismore than 2015-10-14
star this property answering body
Department of Health more like this
unstar this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Lyme Disease remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what action they are taking to raise awareness of the challenge of Lyme disease in the light of suggestions that the problem has spread to urban environments. more like this
star this property tabling member printed
Lord Condon more like this
star this property uin HL2622 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-10-28more like thismore than 2015-10-28
star this property answer text <p>Public Health England (PHE), alongside various stakeholders including local authorities, undertakes a number of local and national initiatives to raise public awareness of the risks posed by ticks and the illnesses they may carry. The National Institute of Health and Care Excellence and Lyme Disease Action have produced guidance, which is attached, and training modules for general practitioners (GPs), and PHE has a helpline for doctors, as well as running GP training days.</p> more like this
star this property answering member printed Lord Prior of Brampton more like this
star this property question first answered
less than 2015-10-28T12:23:18.567Zmore like thismore than 2015-10-28T12:23:18.567Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name HL2622.pdf more like this
star this property title Lyme Disease Guidance more like this
star this property tabling member
2171
star this property label Biography information for Lord Condon more like this
79197
star this property registered interest false more like this
star this property date less than 2014-07-21more like thismore than 2014-07-21
star this property answering body
Department of Health more like this
unstar this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Lyme Disease remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government, further to the Written Answer by Earl Howe on 25 June 2012 (WA 21–2), whether they consider that the use of the CE-marked Trinity Biotech EU Lyme western blot test, when used with cerebrospinal fluid, would constitute "use of an in-house test" as defined by the Medical and Healthcare Products Regulatory Agency guidance. more like this
star this property tabling member printed
The Countess of Mar more like this
star this property uin HL1358 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2014-07-29more like thismore than 2014-07-29
star this property answer text <p>Use of a sample type not indicated by the manufacturer would be considered to be off label use of the device. This off label use is not regulated by the Medicines and Healthcare products Regulatory Agency and would be the responsibility of the laboratory.</p> more like this
star this property answering member printed Earl Howe more like this
star this property question first answered
less than 2014-07-29T13:16:10.1285003Zmore like thismore than 2014-07-29T13:16:10.1285003Z
star this property answering member
2000
star this property label Biography information for Earl Howe more like this
star this property tabling member
1861
star this property label Biography information for The Countess of Mar more like this