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Best Way To Diagnose Lyme Disease

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What Do I Do If I Find A Tick On My Skin

What’s the Best Test for Lyme Disease?

Dont panic. Use fine-tipped tweezers to grasp the tick as close to the skins surface as possible. Pull up with steady, even pressure. Be careful not to squeeze or twist the tick body. Sometimes parts of the tick remain in the skin. You can leave them alone or carefully remove them the same way you would a splinter. Do not use heat , petroleum jelly, or other methods to try to make the tick back out on its own. These methods are not effective.

Wash the area where the tick was attached thoroughly with soap and water. Keep an eye on the area for a few weeks and note any changes. Call your doctor if you develop a rash around the area where the tick was attached. Be sure to tell your doctor that you were bitten by a tick and when it happened.

The Most Common Lyme Disease Blood Tests

The two most common diagnostic tests for Lyme disease are the enzyme-linked immunosorbent assay and the Western blot. These Lyme disease tests allow physicians to visualize the reaction between antibodies in an infected persons blood to specific antigens or parts of the bacteria that cause Lyme disease.

In the case of the Western blot, for example, antigens are separated by size and then transferred onto a membrane strip. When an antibody reacts with an antigen on the strip, that band will turn dark purple. For test results to be positive, a specific combination of bands on the membrane strip must be present.

Future Possibilities For Diagnostic Tools

NIAID-supported scientists have identified genome sequences for multiple strains of B. burgdorferi. Greater advances in diagnostics are anticipated as genetic information is combined with advances in microarray technology, imaging, and proteomics. These growing fields of science are expected to lead to improved diagnostic tools as well as provide new insights on the pathogenesis of Lyme disease. Examples of tools being developed with NIAID support include use of metabolomics to characterize new biomarkers of infection, next generation T-cell based measurements, and novel antigens for improved measurement of effective treatment.

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First Comes Igm Then Igg

The pathogenesis and the different stages of infection should inform laboratory testing in Lyme disease.

It is estimated that only 5% of infected ticks that bite people actually transmit their spirochetes to the human host. However, once infected, the patients innate immune system mounts a response that results in the classic erythema migrans rash at the bite site. A rash develops in only about 85% of patients who are infected and can appear at any time between 3 and 30 days, but most commonly after 7 days. Hence, a rash occurring within the first few hours of tick contact is not erythema migrans and does not indicate infection, but rather an early reaction to tick salivary antigens.

Antibody levels remain below the detection limits of currently available serologic tests in the first 7 days after exposure. Immunoglobulin M antibody titers peak between 8 and 14 days after tick contact, but IgM antibodies may never develop if the patient is started on early appropriate antimicrobial therapy.

If the infection is not treated, the spirochete may disseminate through the blood from the bite site to different tissues. Both cell-mediated and antibody-mediated immunity swing into action to kill the spirochetes at this stage. The IgM antibody response occurs in 1 to 2 weeks, followed by a robust IgG response in 2 to 4 weeks.

Because IgM can also cross-react with antigens other than those associated with B burgdorferi, the IgM test is less specific than the IgG test for Lyme disease.

Two Standards Of Care For Lyme Disease Treatment

Lyme Disease Early Symptoms In Humans

There is significant controversy in science, medicine, and public policy regarding Lyme disease. Two medical societies hold widely divergent views on the best approach to diagnosing and treating Lyme disease. The conflict makes it difficult for patients to be properly diagnosed and receive treatment.

One medical society, the Infectious Diseases Society of America , regards Lyme disease as hard to catch and easy to cure with a short course of antibiotics. IDSA claims that spirochetal infection cannot persist in the body after a short course of antibiotics. The group also denies the existence of chronic Lyme disease.

In contrast, the International Lyme and Associated Diseases Society , regards Lyme disease as often difficult to diagnose and treat, resulting in persistent infection in many patients. ILADS recommends individualized treatment based on the severity of symptoms, the presence of tick-borne coinfections and patient response to treatment.

LDo believes that patients and their doctors should make Lyme disease treatment decisions together. This requires that patients be given sufficient information about the risks and benefits of different treatment options. Then, patient and health care provider can collaborate to reach an informed decision, based on the patients circumstances, beliefs and preferences.

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Do Your Research And Get Referrals

You can learn a lot just by researching doctors and reading patient reviews online. You can also connect with other patients through local and online support groups for various tick-borne diseases. Asking other patients to recommend or share their own experiences with different doctors can be particularly helpful when youre trying to locate and learn about physicians who specialize in various tick-borne illnesses.

The following sites can connect you to online support-group forums or help you identify different tick-borne support groups in the United States:

The Earlier In The Course Of Tick Borne Disease That The Treatment Is Started The Better For The Patient And The Worse For The Microbes

Early detection, however, can be difficult. Lyme IS the most prevalent tick borne disease in the states and it is increasing in incidence year to year. Yet the Center for Disease Control estimates only 10% of the cases of Lyme disease are reported annually. This is because only 50% to 68% of patients have a clear bulls-eye rash. Only 26% ever see the tick that gives them Lyme disease. Most people do not know that a flu in the late spring, summer or early fall can be a sign of Lyme disease. Most doctors do not know that Lyme exists anywhere but the northeast part of the United States. So early treatment is a challenge. I try during tick season in Northern California to have short appointments to check out a tick bite or erythema migrans rash, in order to effect early treatment.

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Final Words About Neurological Lyme Disease Treatment

Neurological Lyme Disease can be extremely debilitating, and frightening for patients.

It is important to recognise the symptoms so treatment can be sought as early as possible.

The treatment of Neurological Lyme Disease commonly begins with antibiotics, but there are also effective natural treatments.

A nutritional program that aims to boost the patients immune system is essential, as well as herbs, supplements, and lifestyle changes.

It is important that each patient receives a personalized Neurological Lyme Disease Treatment Plan as the stages of the disease vary across patients with different body systems being affected.

Do you have any experience with diagnosing and treating neurological lyme disease?

Leave us a comment below, we would love to hear from you.

REFERENCES:

  • Hildenbrand, P., et al. Lyme Neuroborreliosis: Manifestations of a Rapidly Emerging Zoonosis. American Journal of Neuroradiology, American Journal of Neuroradiology, 1 June 2009, ajnr.org/content/30/6/1079/.
  • Halperin, and John J. Lyme Disease: Neurology, Neurobiology, and Behavior | Clinical Infectious Diseases | Oxford Academic. OUP Academic, Oxford University Press, 25 Feb. 2014, oup.com/cid/article/58/9/1267/2895273.
  • Grab, D J, et al. Borrelia Burgdorferi, Host-Derived Proteases, and the Blood-Brain Barrier. Infection and Immunity., U.S. National Library of Medicine, Feb. 2005, ncbi.nlm.nih.gov/pubmed/15664945.
  • Current Research On New Approaches

    Lyme Disease: Best Test for Diagnosis

    NIAID actively supports research on Lyme disease diagnostics. Small businesses and public/private partnerships often submit applications for new research projects. NIAID grantees also work directly with CDC scientists to evaluate and compare the effectiveness of currently used diagnostic methods.

    Working with CDC, NIAID plays a major role in encouraging the development of new approaches to improve Lyme disease diagnosis in people with tick-borne co-infections such as anaplasmosis or babesiosis. New diagnostic tests are also needed to distinguish between people with B. burgdorferi infection and those whose immune responses stemming solely from past Lyme disease vaccination. Although Lyme disease vaccines for humans are no longer available in the United States, the discontinued LYMErix vaccine used between 1998 and 2002 was based on a specific part of B. burgdorferi called outer surface protein A . In response to the vaccines, immunized individuals developed antibodies for OspA. Because the conventional ELISA measures OspA antibodies to determine if someone has Lyme disease, the test does not provide accurate results for immunized individuals. People who received the vaccination will test positive whether or not they are actually infected with B. burgdorferi.

    NIAID is supporting research on a variety of approaches to improve the diagnosis of Lyme disease:

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    Why Antibiotics Have Limited Use For Chronic Lyme

    Borrelia clears the blood quickly and uses its corkscrew shape to penetrate deeply into tissues where it is protected from antibiotics and the immune system. It can penetrate into cells, give up the corkscrew shape, and live inside of cells, thus gaining protection from the immune system and antibiotics. If confronted with a full antibiotic assault, it rolls up into dormant cyst and rides out the storm until the antibiotics are gone.

    Antibiotics work best on highly threatening microbes that grow very rapidly and congregate densely in localized areas in the body . Borrelia grows very slowly in the body and only occurs in very low concentrations in tissues.

    Borrelia is a master at blending in with the trillions of other microbes that make up the human microbiome . Overwhelming the host is not its mission it simply needs to scavenge enough resources to survive. Borrelias stealthy ability to lay low makes diagnosis and treatment a real challenge.

    Borrelia never occurs alone. There are many stealthy microbes mycoplasma, chlamydia, Bartonella, Epstein-Barr virus , cytomegalovirus , and others that can occupy space in the microbiome. Sometimes they occur as coinfections with the tick bite, but they can already be present in the microbiome, without causing symptoms, when infection with Borrelia occurs.

    Is There An Effective Treatment For Lyme Disease

    Dr. Dane was introduced to a new treatment for Lyme disease in 2017. It was not an antibiotic, nor was it an herbal remedy. It was a mineral compound produced in liquid form that could be turned into a gaseous state and nebulized. The product essentially acts as a fumigator and blasts the body with a blend of minerals that kills the spirochetes and improves immune function. Skeptical at first, Dr. Dane tracked eight patients over the course of a year that she had treated for the neurological effects of Lyme disease. Much to her amazement, seven of those patients were clear of Lyme just over a year later. Symptom relief varied from completely gone to 50% better. However, some effects of CLD cannot be reversed.

    The mineral product is called Lyme-N, and, like many aspects of Lyme disease, its effectiveness is controversial. But this is the only treatment Dr. Dane has seen eradicate the spirochetes associated with CLD.

    Dr. Dane has witnessed many patients put their trust in her after becoming frustrated with more traditional Lyme disease treatments at other medical facilities. The Carolina Brain Centers way of treating patients is built upon the tenets of functional neurology, which use a combination of medical technology and brain therapy to produce healing where possible and the easing of symptoms in other cases.

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    What Are The Best Tests For Lyme Disease

    At the Carolina Brain Center, we recommend two tests. One is DNA Connexions, a urine test. The other is MacTech Imaging, a saliva test.

    The DNA Connexions test identifies co-infections common to Lyme disease. MacTech Imaging picks up where the DNA Connexions test leaves off by giving doctors an idea of a patients overall microbial load. Each saliva sample is scanned for spirochetes and then given a graded score.

    These two unique tests allow us to proceed confidently with treatment. Post-treatment analysis informs doctors as to whether a patient is clear.

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    Can Persistent Cases Be Predicted

    How to know whether you have Lyme disease

    A bigger question, which was not examined in the current paper, is whether these autoantibodies may identify a subset of patients who will develop persistent symptoms of Lyme disease after treatment. Up to 20 percent of patients can develop persistent symptoms after Lyme disease. Diagnosis of these patients is currently only by clinical symptoms, making it likely that patients with different causes of their symptoms are grouped together. And treatment trials in patients with persistent Lyme disease are unlikely to show benefit if that occurs.

    Antiphospholipid antibodies are commonly seen in autoimmune diseases like lupus, and are associated with blood clots and persistent inflammation that causes other disease conditions, says Hu. Many of the persistent symptoms in patients who continue to have symptoms after being diagnosed with Lyme disease are similar to those autoimmune diseases.

    If there ends up being a link between having persistent Lyme symptoms and these autoantibodies, this would be the first test that could be used to distinguish a group of patients who have persistent Lyme disease, he says. It would allow us to test specific new therapies targeted to a defined mechanism.

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    Lyme Disease In Europe And Asia

    Lyme disease can also occur in Europe and Asia, where Borrelia garinii and Borrelia afzelii are most commonly found.

    Ticks infected with a Lyme disease bacterium can be found in woodlands across the European continent from northern Turkey to northern Sweden. However, Lyme disease is considered endemic in central Europe, where the following countries have the highest tick infection rates: Austria, Czech Republic, southern Germany,Switzerland, Slovakia, and Slovenia. In Europe, Lyme disease is primarily transmitted by the castor bean tick.

    Lyme disease has been reported throughout Asia, as well, such as in Russia, Mongolia, northern China, Japan, and Koreaâ âthough infection from a Lyme disease bacterium appears to be relatively uncommon in these areas. In Asia, Lyme disease is transmitted by the taiga tick .

    Is There A Blood Test For Lyme Disease

    If your doctor suspects that you have Lyme disease, they may order two blood tests. These will look for signs that your body is trying to fight it off. The results are most precise a few weeks after youâve been infected.

    These tests are:

    ELISA test. This test canât check for the bacteria that causes Lyme disease. It can only look for your immune systemâs response to it.

    Once Borrelia burgdorferi gets into your blood, your body begins to make special proteins called antibodies to fight it off. The ELISA test checks for those antibodies.

    Although itâs the most common way to check for Lyme disease, the ELISA test isnât perfect. It can sometimes give false âpositiveâ results. On the other hand, if you have it done too soon after youâve been infected, your body may not have developed enough antibodies for the test to detect them. This will give you a ânegativeâ result even though you do have Lyme disease.

    Western blot test. Whether your ELISA test comes back positive or negative, your doctor will need to do this blood test, too.

    A Western blot uses electricity to split certain proteins in your blood into patterns. This is then compared to the pattern of people known to have Lyme disease.

    At least five band matches means that you have Lyme disease. Still, not all labs have the same standards. Thereâs a chance that you could get a âpositiveâ result from one and a ânegativeâ result from another.

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    How Do You Diagnose The Later Stages Of Lyme Disease

    Disseminated Lyme disease, due to unsuccessful or delayed treatment, can become disabling. The bacteria can leave the skin where it was initially inoculated by the tick and travel through the bloodstream to numerous systems of the body, primarily joints, heart, brain, muscles and the nervous system.

    Late disseminated Lyme disease has a wide range of presentations including joint pain, extreme fatigue, neuromuscular pain, cardiac problems, headaches, and other central nervous system dysfunction. There are some distinguishable signs of later stage Lyme disease including facial palsy in the second stage, and swollen knees in the third stage that are somewhat specific for Lyme disease, but not absolutely, because there are other causes of Bells Palsy and swollen knees.

    Diagnosis can be confirmed by serology blood tests which measure the antibodies that are formed by the immune system in response to the Lyme disease bacterial infection. Collection of cerebrospinal fluid by lumbar puncture may be indicated in neurologic cases that may involve the central nervous system.

    Are Antibiotics Always Effective For Lyme Disease

    Understanding the Persistent Symptoms in Lyme Disease | Johns Hopkins Medicine

    While antibiotics are certainly beneficial in combatting Lyme disease in its earliest stages, they are usually not well-suited to patients plagued with chronic Lyme and debilitating symptoms.

    In fact, antibiotics that target Borrelia burgdorferi bacterium early on may not be equipped to address complications of chronic Lyme disease including co-infections and the formation of biofilm.

    Whats more, when inappropriately-used, antibiotics can actually weaken the immune system and lead to resistance.

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    Lyme Disease Frequently Asked Questions

    If you have not done so already, remove the tick with fine-tipped tweezers.

    The chances that you might get Lyme disease from a single tick bite depend on the type of tick, where you acquired it, and how long it was attached to you. Many types of ticks bite people in the U.S., but only blacklegged ticks transmit the bacteria that cause Lyme disease. Furthermore, only blacklegged ticks in the highly endemic areas of the northeastern and north central U.S. are commonly infected. Finally, blacklegged ticks need to be attached for at least 24 hours before they can transmit Lyme disease. This is why its so important to remove them promptly and to check your body daily for ticks if you live in an endemic area.

    If you develop illness within a few weeks of a tick bite, see your health care provider right away. Common symptoms of Lyme disease include a rash, fever, body aches, facial paralysis, and arthritis. Ticks can also transmit other diseases, so its important to be alert for any illness that follows a tick bite.

    References:

    Moody KD, Barthold SW, 1991. Relative infectivity of Borrelia burgdorferi in Lewis rats by various routes of inoculation.external iconAm J Trop Med Hyg 44: 135-9.

    There are no reports of Lyme disease being spread to infants through breast milk. If you are diagnosed with Lyme disease and are also breastfeeding, make sure that your doctor knows this so that he or she can prescribe an antibiotic thats safe for use when breastfeeding.

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