Dr Dobie is one of the foremost Australian experts in the diagnosis and treatment of Lyme disease. He has treated approximately 500 cases of Lyme disease and gave evidence at the recent Senate inquiry into Lyme-like illness in Australia.
Dr Dobie is a member of ILADS, the pre-eminent international organisation of doctors who treat Lyme disease, and is secretary of the Australian Chronic Infectious and Inflammatory Disease Society (ACIIDS), an organisation of Australian doctors with an interest in tick-borne diseases. He has attended many international conferences on Lyme disease.
Lyme disease is an infection caused by a bacterium called Borrelia. Humans acquire this illness primarily from a tick bite.
Lyme disease is most common in the north-east of the USA and in Eastern Europe, but there are confirmed cases on every continent.
Lyme disease is named after the town of Lyme, in Connecticut, USA, where the illness was first recognised.
Lyme disease is controversial in Australia. Most Australian doctors are under the impression hat there is no Lyme disease in Australia, but there is now strong evidence that Lyme disease can be acquired from a tick bite in Australia. It is likely that there are many thousands of undiagnosed cases of Lyme disease in Australia.
The main reason for the controversy is that the species of Borrelia that causes Lyme disease in the USA has not been found in Australian ticks. It is thought that the Australian form of Lyme disease is probably caused by a different species of Borrelia.
Many people are developing a chronic debilitating illness after a tick bite in Australia. The symptoms of this illness are similar to Lyme disease as seen in the USA, and the illness responds to the same treatment as is used for Lyme disease in the USA.
When this illness is acquired from a tick bite in Australia Dr Dobie prefers to describe the illness as “borreliosis” or “Australian Lyme-like illness”.
Early symptoms of Lyme disease, occurring in the first two or three weeks after a tick bite, can include a skin rash (known as a “bull’s–eye” rash), flu-like symptoms, joint pains, swollen lymph nodes, fever and headache.
If left untreated Lyme disease can develop into a chronic infection with a wide variety of symptoms affecting every organ system, including the heart and brain. Symptoms of chronic Lyme disease (otherwise known as persistent borreliosis) can include fatigue, muscle and joint pain, headaches, cognitive impairment with poor memory and concentration, sleep disturbance, limb weakness, numbness or pins and needles in the limbs, sensitivity to bright light, muscle twitching, tinnitus, palpitations, dizziness, swollen glands, anxiety and depression.
The symptoms of chronic Lyme disease can be similar to the symptoms of many other illnesses such a multiple sclerosis, rheumatoid arthritis, lupus, ALS, Parkinson’s disease and Alzheimer’s disease.
Lyme disease is diagnosed primarily on the basis of a patient’s symptoms, as the infection does not always show up on blood tests. All patients with suspected Lyme disease should however have a blood test. Urine tests are also often used.
The blood test done for Lyme disease by most Australian pathology laboratories, known as the ELISA test, is not sensitive enough to detect most cases of this illness. Testing for Lyme disease should be done at specialised laboratories. There are only two laboratories in Australia that do the correct testing for Lyme disease. Blood specimens can also be sent to laboratories in the USA and Germany.
Most patients with Lyme disease have what is known as “co-infections”. This is because ticks often carry other infections in addition to the Borrelia bacteria that cause Lyme disease. These “co-infections” include Babesia, Bartonella, Rickettsia, Ehrlichia and Mycoplasma. Testing for co-infections should also be performed.
The primary treatment for Lyme disease is antibiotics. The duration of antibiotic treatment depends on the severity of the patient’s symptoms and how long the patient has been suffering from the illness. Antibiotics are usually given orally but occasionally intravenous antibiotics are required. Dr Dobie always prescribes probiotics to help minimise the side-effects of antibiotics.
Dr Dobie always gives dietary advice to patients suffering from Lyme disease and prescribes nutritional supplements in addition to antibiotics.
A range of other treatments including herbal medicines and various treatments available at overseas clinics can be useful in some cases of Lyme disease.
Herbal treatments for Lyme disease are generally less effective that antibiotics, but Dr Dobie prescribes herbal treatments if a patient does not wish to take antibiotics or is unable to take antibiotics because of gut problems or an allergy to antibiotics.
Most patients with Lyme disease require treatment for co-infections as well as treatment for Borrelia.
Patients who have had Lyme disease less than five years generally respond well to antibiotics treatment but if someone has suffered from the illness from 20 or 30 years it is more difficult to treat.