Court grants Lyme disease autopsy

KATE BENSON HEALTH July 20, 2010

A SYDNEY woman has been awarded a Supreme Court injunction to have her dead husband tested for a disease the Health Department says does not exist in Australia.

Mualla Akinci's husband, Karl McManus, died last Wednesday - three years after he was bitten by a tick she says carried Lyme disease, a bacterial infection which, if left untreated, can cause profound neurological damage.

Mr McManus, 43, from Turramurra, was bitten on the left side of his chest during filming for the television show Home and Away in bushland in Waratah Park, northern Sydney. Within six weeks he lost mobility in one of the fingers on his left hand. That quickly spread to paralysis in his left arm and across to his right arm.

Mr McManus was diagnosed with multifocal neuropathy after testing negative for Lyme disease, but Ms Akinci, a pharmacist, insisted he be tested again at clinics in the US and Germany. Both tests returned positive for Lyme disease.

She argues that Australian tests are inadequate because pathologists looks for antibodies in the blood, rather than for proteins in specific bacteria within tissue.

''Lyme doesn't usually live in the blood. It lives in tissues unless someone's system is flushed with it so it stands to reason that every test will come back negative,'' Ms Akinci said.

The Health Department maintains that no case has been transmitted in Australia and the organisms that cause it - three species of the genus borrelia - are not carried here by wildlife, livestock or their parasites.

The NSW Health Minister, Carmel Tebbutt, said in May there was not enough evidence to support the existence of ticks carrying the borrelia organism.

''Until there is solid evidence to indicate that locally acquired Lyme disease is a significant public health matter in Australia, specific measures to educate the general public or clinicians are difficult to justify,'' she said.

But Tim Roberts, of Newcastle University's school of environmental and life sciences, said that it was becoming more difficult for the government to deny the problem.

''Westmead Hospital [where most testing is performed] categorically says there are no Lyme organisms in Australia, but a significant number of people certainly look like they have the signs and symptoms,'' Associate Professor Roberts said.

His view is supported by Peter Mayne, a GP from Laurieton who says he has 12 patients with the disease. Western blot testing, the standard used in Australia for 25 years, missed most cases because patients on antibiotics did not have antibodies to the disease, he said.

''It is a very, very difficult diagnosis to make in a lab. But I believe it does exist and there are many doctors who agree.''

Last week, hours after Mr McManus died by choking from his paralysed tongue, Ms Akinci sought to have an autopsy performed on his body but was told by Glebe Morgue a backlog of more than 46 bodies meant that was impossible.

''I was also told he had died from natural causes so an autopsy wasn't needed,'' she said.

Ms Akinci then applied to the Supreme Court and was granted permission to have the autopsy done at Royal North Shore Hospital. Preliminary results are expected tomorrow.

''He wanted answers, I want answers,'' she said.

WARNING SIGNS

- Flu-like symptoms that appear a few days to a few weeks after the bite.

- A red rash, called erythema migrans, which grows daily and looks like a bullseye with multiple rings.

- Fatigue, low-grade fevers, night sweats, sore throat, swollen glands and stiff neck.

- Memory loss, headache, depression, sleep disturbance and irritability.

- Facial numbness, pain and tingling.

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