Management Of Individuals Without Symptoms Following A Tick Bite
Diagnostic testing is not recommended for individuals who do not develop any symptoms suggestive of Lyme disease after a tick bite.
Some commercial companies offer services to test removed ticks for the presence of the bacteria that cause Lyme disease. UKHSA does not provide such tick-testing services. The results of such tests should not be used to inform diagnosis or treatment. A positive result does not mean that the infected tick will have passed on the bacteria there are many factors that determine whether Lyme disease results from the bite of an infected tick. A negative result may not be technically valid and could give false assurance, as it does not exclude the possibility that another tick elsewhere on the body has been missed by the patient.
UKHSA runs a tick surveillance scheme and is happy to receive ticks for species identification and to monitor tick distribution.
Why It Is Done
A Lyme disease test is done to diagnose Lyme disease in people who have symptoms of Lyme disease. Symptoms may include:
- An expanding red rash with a pale center. This is sometimes called a “bull’s-eye” rash.
- Extreme tiredness.
- Headache and stiff neck.
- Muscle and joint pain.
Symptoms of chronic Lyme disease infection include joint pain, stiffness, and problems with the heart, brain, or nerves.
Testing is most accurate when you have risk factors for Lyme disease or symptoms of the disease.
Question 2 How Is The Diagnosis Of Lyme Disease Made
Diagnosis of Lyme disease is made through clinical assessment or clinical assessment supported by laboratory testing. The presence of an erythema migrans rash is diagnostic of Lyme disease without laboratory investigation.1,2
Patients who do not develop a rash but have symptoms suggesting Lyme disease, and have been to areas with a high risk of tick exposure, may undergo laboratory testing to help identify the cause of symptoms.1,2 For more information, see the Quest Diagnostics Clinical Focus Tick-borne Diseases: Laboratory Support of Diagnosis and Management available here.
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How You Get Lyme Disease
If a tick bites an animal carrying the bacteria that cause Lyme disease, the tick can become infected. The tick can then transfer the bacteria to a human by biting them.
Ticks don’t jump or fly. They climb on to your clothes or skin if you brush against something they’re on. They then bite into the skin and start to feed on your blood.
Generally, you’re more likely to become infected if the tick is attached to your skin for more than 24 hours. Ticks are very small and their bites are not painful, so you may not realise you have one attached to your skin.
Negative Elisa On Serum
Early clinical Lyme disease in the form of erythema migrans with an associated history of a tick bite should be treated empirically. There is no need for testing unless there are further symptoms.
A negative ELISA result in the early stages of Lyme disease does not exclude infection. If acute Lyme disease is suspected but serology results are negative, we recommend that the test is repeated in 4 to 6 weeks with a fresh sample to look for seroconversion.
In patients with long term symptoms a negative ELISA test usually excludes Lyme disease as a cause of these symptoms. Information on differential diagnosis for patients with persistent symptoms and negative Lyme disease serology results is available.
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Can Lyme Disease Be Detected By A Blood Test
In a word: yes!
A blood test does not only detect Lyme disease it is the most accurate and preferred test for diagnosing the disease. If a patient with Lyme disease shows signs that the central nervous system has been affected by the disease, western blot testing on the cerebrospinal fluid can be performed. If ordering from Walk-In Lab, a doctors note is not needed. Just pick your Lyme disease test and place your order online.
What Does The Lyme Multiplex Assay Measure
The Lyme Multiplex assay quantifies antibodies directed against specific proteins on the surface of B. burgdorferi at three different stages of the bacterial life cycle. This antibody profile can indicate whether an animal has been recently infected or is chronically infected with B. burgdorferi. It can also be used to monitor protective antibodies after vaccination.
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Where Is Lyme Disease Found
In the United States, Lyme disease has been reported in every state, but over 95% of cases are from the Northeastern, Mid-Atlantic, and upper Midwestern states, with a small number of cases reported along the West Coast, especially Northern California. In Canada, Lyme-positive dogs are found mostly in southern Ontario and southern Manitoba, with a small number of cases in southern Quebec and the Maritime provinces.
Does Treatment Immediately After A Tick Bite Negate Signs Of Early Infection
Not every tick carries B. burgdorferi. The infection rate of ticks also varies with geographic region. Therefore, treatment should not be performed based on a tick bite alone. If the tick was found on the animal it can be sent in for B. burgdorferi PCR. PCR for Anaplasma can be performed simultaneously if requested. If the tick was infected, early treatment can be considered. However, a tick must feed for at least 24 hours on an animal or human for B. burgdorferi transmission to occur. Only a serological test will confirm whether transmission of B. burgdorferi occurred and the animal was infected. Antibodies can be detected in infected animals as early as 3-4 weeks after infection. Lyme Multiplex testing is recommended after that time. Treatment can be initiated immediately afterwards if antibody levels are positive. Treatment during this early infection phase is generally very effective.
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How To Remove A Tick
Diagnosis Testing And Treatment
You may have heard that the blood test for Lyme disease is correctly positive only 65% of the time or less. This is misleading information. As with serologic tests for other infectious diseases, the accuracy of the test depends upon how long youve been infected. During the first few weeks of infection, such as when a patient has an erythema migrans rash, the test is expected to be negative.
Several weeks after infection, FDA cleared tests have very good sensitivity.
It is possible for someone who was infected with Lyme disease to test negative because:
If you are pregnant and suspect you have contracted Lyme disease, contact your physician immediately.
* Silver HM. Lyme disease during pregnancy. Infect Dis Clin North Am. 1997 Mar 11:93-7.
The most common co-infections that occur with Lyme disease are anaplasmosis and babesiosis. In general:
References:
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Focus Group Data Collection And Analysis
The initial target study population included primary care and emergency and urgent healthcare providers practicing in a small-town community endemic to Lyme disease with emerging incidence of additional TBDs. Invitation emails for focus group participation were sent to practice managers and medical directors for medical practices employing members of the study target population. Researchers coordinated with these key contacts within the practices to schedule in-person focus groups at a date and time convenient to the participating providers. Focus groups were scheduled in late fall 2018 and early spring 2019. Participants included both prescribing and non-prescribing providers.
Academic project team members developed guided focus group questions covering current knowledge, perceived challenges, and needed resources on tick-borne illness, which were reviewed by physician and health department team members prior to finalization . Focus groups were hosted at each participating practices office location and time-appropriate meals were offered to participants. After receiving verbal informed consent from participants, a project team member trained in qualitative interviewing techniques led a group discussion based on the guided questions. All focus groups were audio-recorded and transcribed verbatim for analysis. No names or other personally identifiable information were recorded in the transcripts, including the business names of the participating clinics.
Investigation Of Suspected Lyme Disease
Erythema migrans is a clinical diagnosis and does not require confirmation by laboratory testing. Lyme disease is not a notifiable disease so there is no statutory requirement to notify clinically suspected cases to the local Health Protection Team.
The 2018 NICE Lyme disease guideline provides detailed advice about when a diagnosis of Lyme disease should be suspected and about which tests to use and when.
The NICE Lyme disease guideline also contains a useful summary diagram of the routine serological testing recommendations for Lyme disease.
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What Are The Symptoms Of Lyme Disease
Dogs can display several forms of Lyme disease, but the most common symptoms are lameness, swollen lymph nodes, joint swelling, fatigue, and loss of appetite. In addition, serious kidney complications have been associated with Lyme disease in dogs.
Clinical signs of Lyme disease in horses include shifting-leg lameness, generalized stiffness, hypersensitivity to touch, weight loss, and poor performance. Sometimes, the bacteria can infect the central nervous system, leading to neurologic symptoms.
Do Antibodies To B Burgdorferi Determine Active Infection
In untreated animals, antibodies to OspC and/or OspF are indicators of infection with B. burgdorferi. Many infected animals dont show clinical signs and maintain constant antibody levels to the pathogen. It is believed that many animals can control the persistent infection. However, increasing antibody values indicate re-activation of or re-infection with the pathogen.
In treated animals, antibody levels decrease slowly and are usually still detectable for several months if treatment was successful.
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How Is Lyme Disease Diagnosed
Though several types of tests do exist for the diagnosis of Lyme disease, the best tests for a Lyme disease diagnosis are blood tests, also known as serological tests. These tests are indirect, meaning they dont detect the infecting bacteria or its antigens but rather the antibodies an infected persons body produces in response to these antigens.
What Is Lyme Disease
This bacterial infection is spread through the bite of a young deer tick or black-legged tick. These eight-legged creatures, about the size of a poppy seed, can be found in wooded and grassy areas throughout the United States, especially in New England and the Rocky Mountains.
Because these ticks are so small, most people donât realize when theyâre bitten. But the longer a tick stays attached to you, the more likely it is to transmit Borrelia burgdorferi , if the tick is a carrier.
If not found and treated, Lyme disease can lead to problems with your joints, heart, and nervous system. It can even affect your memory.
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What Happens During Lyme Disease Testing
Lyme disease testing is usually done on a sample of blood. In certain cases, a cerebrospinal fluid test may be done.
For a Lyme disease blood test:A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For a CSF test:You may need a cerebrospinal fluid test if your symptoms could mean that Lyme disease is affecting your nervous system, such as a stiff neck or numb hands or feet. Providers may order a CSF test if the results of your blood test show you likely have Lyme disease or if the results are uncertain.
To get a sample of your cerebrospinal fluid, a provider will do a procedure called a lumbar puncture, also known as a spinal tap. During the procedure:
The Chance Of Getting Lyme Disease
Not all ticks in England carry the bacteria that causes Lyme disease.
But itâs still important to be aware of ticks and to safely remove them as soon as possible, just in case.
Ticks that may cause Lyme disease are found all over the UK, but high-risk places include grassy and wooded areas in southern and northern England and the Scottish Highlands.
Ticks are tiny spider-like creatures that live in woods, areas with long grass, and sometimes in urban parks and gardens. Theyâre found all over the UK.
Ticks do not jump or fly. They attach to the skin of animals or humans that brush past them.
Once a tick bites into the skin, it feeds on blood for a few days before dropping off.
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How To Mail Your Tick:
We test Blacklegged Deer and Western Deer ticks in all sorts of conditions both nymphs and adults. Simply place your order and follow the instructions that will be emailed to you upon successful placement of the order.
Simply place the tick in a tightly sealed Zip-Lock bag with the order number written on the bag with permanent marker, then mail it to us here in Loudoun County, Virginia!Additional information on exactly how and where to mail the ticks to, will be emailed to you once you have placed your order.
IMPORTANT! Since COVID-19, we have been working with a very limited staff and on average receive anywhere between 20 to 50 or more ticks daily. Any ticks that we receive that do NOT have an Order/Lab Number on the bag or container housing the tick will be Discarded or returned to sender.
IMPORTANT NOTE:
Sample Types For Lyme Disease Testing
For routine Lyme disease serological testing, you must send a serum sample .
For testing for neurological Lyme disease, you must send paired CSF and serum samples taken on the same day. If possible, please provide CSF cell count and total albumin, IgG and IgM values. If albumin, IgG and IgM measurements are not available, RIPL will make arrangements for these measurements at additional cost.
PCR testing is available. We recommend that specialists call RIPL to discuss appropriate sample types for PCR. These may include joint fluid, biopsy tissue, CSF and EDTA plasma. Please submit biopsies as fresh tissue in a sterile container, ideally with a drop of sterile saline to prevent the tissue drying out.
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Polymerase Chain Reaction May Help In Some Situations
Molecular assays are not part of the standard evaluation and should be used only in conjunction with serologic testing. These tests have high specificity but lack consistent sensitivity.
That said, PCR testing may be useful:
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In early infection, before antibody responses develop
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In reinfection, when serologic tests are not reliable because the antibodies persist for many years after an infection in many patients
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In endemic areas where serologic testing has high false-positive rates due to high baseline population seropositivity for anti-Borrelia antibodies caused by subclinical infection.
PCR assays that target plasmid-borne genes encoding outer surface proteins A and C and VisE are more sensitive than those that detect chromosomal 16s ribosomal ribonucleic acid genes, as plasmid-rich blebs are shed in larger concentrations than chromosomal DNA during active infection. However, these plasmid-contained genes persist in body tissues and fluids even after the infection is cleared, and their detection may not necessarily correlate with ongoing disease. Detection of chromosomal 16s rRNA genes is a better predictor of true organism viability.
The disadvantage of PCR is that a positive result does not always mean active infection, as the DNA of the dead microbe persists for several months even after successful treatment.
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Looking For Fast And Affordable Healthcare Options Try Urgent Care Instead Of Minute Clinics
A number of pharmacies and superstores across the country now offer walk-in minute clinics to their visitors, such as CVSs Minute Clinic. Between Emergency Rooms, Minute Clinics, Primary Care Centers, and Urgent Care Centers, its easy to confuse the difference between these various medical care destinations. At AFC Urgent Care Beverly, weve striven to offer the most comprehensive and highest quality medical services since day one. Better than most minute clinics in our area!
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The Igenex Lyme Immunoblot Solves These Problems
IGeneX has developed a serological test that increases specificity without sacrificing sensitivity that has changed how to test for Lyme disease. It uses specifically created recombinant proteins from multiple species and strains of Lyme borreliae and reduces inconsistencies in reading and interpreting the test bands.
More species detected The Lyme ImmunoBlot tests for more species of Lyme borreliae than the traditional ELISA and Western blot tests, reducing the risks of false negatives due to the inability to detect antibodies to a certain strain or species of Lb. The test includes all Borrelia-specific antigens relevant in North America and Europe, not just B. burgdorferi B31 or 297.
The result is a single test that replaces at least 8 Western blots.
More accurate testing The ImmunoBlot uses specific recombinant proteins that are sprayed in precise amounts onto specific locations on the membrane strip, allowing for greater control of the quantity and location of the antigens. This makes reading the bands much more accurate and consistent.
Earlier detection The ImmunoBlot can detect infections at multiple stages of illness, letting you catch infections earlier.
The IgM and IgG ImmunoBlots superior specificity and sensitivity make them the best Lyme disease test available.