Question asked by
To ask Her Majesty’s Government what assessment they have made of
the appearance in England of a tick-borne encephalitis virus, and
what plans they have to include advice about such a virus
alongside that given on the tick-borne Borreliosis bacteria and
associated Lyme disease.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care ()
(Con)
My Lords, the risk from tick-borne encephalitis virus is assessed
as very low for the general public and low for those visiting,
living and working in areas where infected ticks have been found.
Lyme disease is the most common tick-borne infection in the
United Kingdom. Tick awareness campaigns are planned for early
2020, ahead of the seasonal increase in tick activity in the UK,
and will include information on tick-borne encephalitis and Lyme
disease.
(LD)
My Lords, the history of Lyme disease, a bacterial infection
called Borreliosis, has been riddled over many years with
mistakes of understanding, recognition, testing, diagnosis and
treatment. Tick-borne encephalitis—a viral infection—has now
reached the UK for the first time, having been steadily spreading
westwards across Europe for several years. What are the
Government doing to make sure that the mistakes that have been
made—and are still being made—on Lyme disease are not made on
TBE, and in particular that new instances of TBE are not mistaken
for Lyme?
The noble Lord is right to raise this issue. We have been making
sure that action is taken quickly. Tick bite avoidance is a key
message in this area and is the same for TBEV as for Lyme
disease. PHE has worked with local authorities and key
stakeholders in the relevant areas, informing them about TBE and
the tick toolkit documents and guidance, so that they can remind
the public, their staff and visitors to be tick aware. Specific
awareness campaigns will come forward in spring 2020. The
material for these will include information on Lyme disease and
TBE. In addition, there will be research programmes on TBE, to
ensure that we in the UK are as aware as we can be about it. To
be clear, there has been only one probable case of TBE infection
diagnosed—a European visitor bitten by a tick in the UK. At the
moment, this is a very low risk to anyone in the UK and a low
risk to those in the areas.
(CB)
My Lords, I do not want to be alarmist but the discovery of
tick-borne encephalitis virus in the UK is worrying. The tick
vectors of this viral infection are widespread throughout the UK
and are maintained on a variety of animal hosts, including wild
deer, which are now extremely common in lowland as well as upland
areas. The number of clinical cases in Europe has been steadily
increasing and, while it is true that something like two-thirds
of cases are non-clinical, as many as up to 10% of those affected
may suffer severe neurological sequelae, especially children
and—noble Lords may like to know—the elderly. I ask the noble
Lord: will the Government reintroduce the mandatory tick
treatment of pets imported into the UK under the pet travel
scheme? Is the noble Lord satisfied that we are doing all we can
in the UK, in terms of research and preventive actions with
regard to biosecurity, to safeguard animal and human health in
this era of climate change and globalisation?
I thank the noble Lord for that question, although I generally
identify as a noble Baroness. We are continuing surveillance
studies for TBEV in ticks and wildlife, and we plan to monitor
its prevalence, distribution, maintenance and spread in the UK to
ensure oversight of the situation. We have based our
understanding of the risk assessment on recent experience in the
Netherlands, where TBEV was recently identified. The estimated
risk there of Lyme disease from a tick bite is 1:50, while the
estimated risk of TBEV from a tick bite is 1:500,000. As regards
us doing enough work, we have a national contingency plan written
to deal with vector-borne diseases and understanding the effect
of climate change, which gives us a sense of the challenges that
we face.
(Con)
My Lords, will my noble friend recognise the work of the national
Encephalitis Society, which is based in Malton in North
Yorkshire, of which I have the honour to be a vice-president?
Will she update the House on what work has been undertaken to
help doctors identify the difference between meningitis and
encephalitis so that the swiftest possible treatment can be
given? My husband was one of those who suffered encephalitis in
his 20s; many are less fortunate and do not make the recovery
that he made.
The noble Baroness is absolutely right, and I am happy to
recognise the organisation that she mentioned. In the first
place, the tick toolkit and the work of PHE is in place to raise
awareness, and work goes into providing advice to professionals
so that early diagnosis is possible.
(Lab)
My Lords, one of the problems with Lyme disease is that the
symptoms that it causes mimic a whole range of different viral
infections, many of which are much more common. Does the Minister
feel that the Government are doing enough to raise awareness of
Lyme disease among general practitioners, and is she satisfied
that the screening tests—I think that they cost around £60 a
time—are sufficient?
The noble Lord is quite right, and he understands this a lot
better than I do. NICE published guidelines for health
professionals in 2018 in an effort to ensure prompt diagnosis of
Lyme disease. Obviously if it is recognised promptly and treated
with antibiotics, acute Lyme disease is usually resolved without
further complications. I will take away the question about the
cost of the test to consider whether that has been a barrier; we
have no evidence about that at this time.
(LD)
My Lords, raising awareness is critical, and many are completely
unaware of the risk when they go out for a walk. What actions
will the Government take to ensure that organisations such as
national parks, national forests and the National Trust have a
part to play?
We will run tick awareness campaigns in the spring. Material for
these campaigns will include information about Lyme disease and
TBE. They will be run in all areas identified as at risk as part
of the surveillance campaign.
(CB)
My Lords, how much research is the UK doing with other European
countries, which may know much more about these conditions?
As part of our surveillance work and the work of PHE, there is
constant contact between the UK and other public health bodies
across Europe to understand not only the risks but the most
effective interventions. Two specific studies are looking at
evidence of past TBEV infection in people and to understand the
best interventions among the general population.
