What Is Lyme Disease
Lyme disease is a bacterial infection that is caused by tick bites. It causes rash and, if left untreated, can lead to more serious problems.
B. burgdorferi is carried by the black-legged tick, also known as deer tick, although not all species of ticks carry these bacteria. Nymphs, which are small immature ticks roughly the size of a pinhead, pick up bacteria when they feed on small B. burgdorferiinfected animals such as mice. They can then transmit Lyme disease when they bite humans.
Is There A Lyme Disease Test Kit
Blood collection kits are available for at-home Lyme disease testing. Lyme disease test kits can cost as less as $20 and as much as $100 or more. Using a Lyme disease test kit is as simple as pricking your finger and smearing or collecting the blood onto the kit for testing.
However, testing for Lyme disease in a more controlled environment such as a lab or clinic is preferable as qualified healthcare professionals are likely to perform a more reliable test.
Waddell L. A., et al. . The accuracy of diagnostic tests for Lyme disease in humans, a systematic review and meta-analysis of North American research. PLoS One. 2016 11: e0168613. Retrieved from
Lyme Disease Test Western Blot
Labs performing a Western blot use electricity to separate proteins called antigens into bands. The read-out from the Western blot looks like a bar code. The lab compares the pattern produced by running the test with your blood to a template pattern representing known cases of Lyme disease. If your blot has bands in the right places, and the right number of bands, it is positive.
The CDC requires 5 out of 10 bands for a positive test result. However, because some bands on the Western blot are more significant than others your doctor may decide you have Lyme disease even if your Western blot does not have the number of bands or specific bands recommended by the CDC. Different laboratories use different methods and criteria for interpreting the test, so you can have a positive test result from one lab and a negative test result from another.
For a comprehensive explanation of the western blot test, download Understanding Western Blot Lyme disease test.
The chart below will help you understand how to interpret the western blot test.
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Cvs Opens 13 Additional Covid
CVS is opening 13 additional COVID-19 drive-thru test sites across the state on Friday. One is at the CVS Pharmacy in East Lyme. Photo courtesy of CVS.
HARTFORD CVS opened 13 new COVID-19 test sites Friday at select CVS Pharmacy drive-thru locations in Connecticut. One of the test sites is in East Lyme at the CVS Pharmacy at 15 Chesterfield Road. These test sites come in addition to the 12 locations the company previously opened in the state on May 15, making a total of 25 sites across the state.
These new sites will utilize self-swab tests and will be available to individuals meeting Centers for Disease Control and Prevention criteria, in addition to age guidelines.
Patients must register in advance at CVS.com to schedule an appointment. Upon arriving for their appointment, patients must stay in their cars and will be directed to the pharmacy drive-thru window, where they will be provided with a test kit and given instructions.
A CVS Pharmacy team member will observe the self-swab process to ensure it is done properly. Tests will be sent to an independent, third-party lab for processing and the results will be available in approximately three days.
The other 12 new CVS Health test sites in Connecticut that will open tomorrow include:
The 12 previously announced CVS Health test sites that opened May 15 include:
For additional information from CVS Health, visit www.cvs.com/minuteclinic/
Completion Of Lyme Disease Test Request Form
Diagnostic samples must be submitted with a completed RIPLLyme disease test request form . Please use a single request form for each patient even when sending several samples.
Please provide details of the sample type, patients symptoms and onset date, tick bite or exposure history and, if relevant, travel and treatment history. Symptom onset date is particularly important for interpretation of laboratory results.
When sending CSF, please provide the cell count and total albumin, IgG and IgM levels for the CSF and serum pair, if available.
Ideally the clinician who sees the patient should print out and complete the appropriate request form . Send the request to the local laboratory with the clinical sample along with a local laboratory request form, whether this is paper or electronic.
The local laboratory should complete the senders information on the request form and then forward the completed form and sample to RIPL. Before sending samples, clinicians are advised to liaise with their local laboratory because local arrangements may vary.
If only immunoblot confirmation is required because the local laboratory has already obtained a positive Lyme screening test result on the serum sample being submitted, tick the Line blot confirmation only box and write the positive screening test result below.
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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.
Molecular Testing For Detection Of Borrelia Species Bacterial Dna
PCR is available for Borrelia species DNA detection but is of limited value in routine testing for Lyme disease because the organism is only present in blood during the early stages of the disease and is predominantly restricted to the affected tissues.
Diagnostic molecular testing for Borrelia species DNA is available on request for relevant specimen types. Please call RIPL to discuss individual cases.
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Th Medical Group News And Updates
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What Does An At
Once ordered, an at-home Lyme disease test kit is delivered to your home, where you can collect the sample privately and comfortably. The kit will include the instructions, the sample collector, and the box to return the sample.
Once the results are ready, you will receive them in your email or through the companys online portal, or they will be sent to your doctors office.
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Lyme Disease Blood Test Results Fully Explained
The Lyme disease blood test is used to discover if someone who has the symptoms of a Borrelia burgdorferi infection actually has the bacteria in their bloodstream. Recent infections are much easier to detect and an IgM and IgG blood test will often be ordered as complimentary information gathering tools. This blood test does not always detect the presence of the disease, so patients that have persistent symptoms after having the test may be re-tested in a few weeks.
If any of these tests come back as positive, then other samples will be used to track the stage of the disease to determine if it has reached the chronic infection stage. At this point, a medical provider will order a Western blot test to confirm the presence of Lyme disease.
Are There Any Risks To Lyme Disease Tests
There is very little risk to having a blood test or a lumbar puncture. If you had a blood test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly. If you had a lumbar puncture, you may have pain or tenderness in your back where the needle was inserted. You may also get a headache after the procedure.
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How To Avoid Tick Bites
To reduce the chance of being bitten:
- cover your skin while walking outdoors and tuck your trousers into your socks
- use insect repellent on your clothes and skin products containing DEET are best
- stay on clear paths whenever possible
- wear light-coloured clothing so ticks are easier to see and brush off
How Is It Diagnosed
If youâve been outside in an area where ticks are known to live, you should tell your doctor. Theyâll also want to know about the symptoms youâre having. These details are crucial to making a diagnosis of Lyme disease.
Early symptoms that usually occur within the first month after a tick bite can include:
- Rash at the site of the tick bite that may look like a âbullâs-eyeâ
- Racing heart
- Problems with your short-term memory
Symptoms that come and go are common with Lyme disease. They will also depend on the stage of the disease.
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Cvs Minute Clinic Lyme Disease Test
An at-home Lyme disease test will typically be a blood finger prick test.
If you have been exposed to the bacteria Borrelia that leads to the infection of Lyme disease, your body will have created two antibodies to fight it off. The test will look for the presence of both types of antibodies, known as immunoglobulin M and immunoglobulin G .
You will receive your test kit along with account information so that you can get your test results as soon as they are ready. Follow the manufacturers instructions exactly as they are described.
Each test has different instructions, so its very important that you read the kits detailed information before getting started.
Can Lyme Disease Be Detected By A Blood Test
Lyme disease can be detected by tests that look for antibodies in the blood or in the fluid from the joints or spine. However, antibodies can take 4-6 weeks to be detected in a blood test after becoming infected.
Borrelia burgdorferi is the bacterium that causes Lyme disease, and there are two tests that can detect whether you have developed antibodies in response to it:
- Enzyme-linked immunosorbent assay : Detects antibodies against B. burgdorferi and is the most commonly used test.
- Although this test may not give a positive result in the early stages of Lyme disease, doctors may make a diagnosis if the rash is distinctive enough in patients who reside in Lyme disease-infested areas.
- However, this test is seldom used as the main basis for diagnosis because it can sometimes produce false-positive results.
In the first few weeks of infection, especially when a patient has a rash of erythema migrans, diagnostic test results will be negative. Some people who take a course of antibiotics in the early stages of the disease may have a negative blood test result because the concentration of antibodies are too low.
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The Chance Of Getting Lyme Disease
Not all ticks in England carry the bacteria that causes Lyme disease.
But it’s 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. They’re 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.
Ongoing Symptoms Of Lyme Disease
A few people who are diagnosed and treated for Lyme disease continue to have symptoms, like tiredness, aches and loss of energy, that can last for years.
These symptoms are often compared to fibromyalgia and chronic fatigue syndrome.
It’s not clear why this happens to some people and not others. This means there’s also no agreed treatment.
Speak to a doctor if your symptoms come back, or do not improve, after treatment with antibiotics.
The doctor may be able to offer you further support if needed, such as:
- referral for a care needs assessment
- telling your employer, school or higher education institution that you require a gradual return to activities
- communicating with children and families’ social care
Page last reviewed: 05 July 2021 Next review due: 05 July 2024
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Detection Of Bacterial Antigens
Antigen-capture assays provide one means of direct detection. Bacteria often shed or secrete antigens that can be detected in body fluids. For example, legionellosis, cryptococcosis, aspergillosis, and dimorphic fungal infections can be diagnosed using antigen tests applied to urine, blood, bronchoalveolar lavages, or cerebrospinal fluid. A direct test for Lyme disease is needed, but a sensitive and specific antigen-capture assay has been elusive. Even if the antigen is known to be present in a sample, past attempts to develop an antigen-capture assay had poor specificity, low sensitivity, and uncertainty about the choice of the capture antigen target .
The specificity and sensitivity of an antigen-detection assay is largely a function of the choice of the capture and reporter antigenic targets, as well as the affinity of the antibody used to capture or detect it . Depending on the duration of the infection, the B. burgdorferi antigenic repertoire changes. In addition, because of the high sequence variability between B. burgdorferi strains, identification of conserved antigenic epitopes that span all strains at all times has been challenging across genospecies. One can select 1 or more appropriate target antigens for any genospecies. Even OspC, known for its variability, has at least 2 well-conserved epitope targets found across the various serotypes.
New developments to stabilize proteins in samples prior to analysis may be suitable for several assays .
What Happens During Lyme Disease Testing
Lyme disease testing is usually done with your blood or cerebrospinal fluid.
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.
If you have symptoms of Lyme disease affecting your nervous system, such as neck stiffness and numbness in hands or feet, you may need a test of cerebrospinal fluid . CSF is a clear liquid found in your brain and spinal cord. During this test, your CSF will be collected through a procedure called a lumbar puncture, also known as a spinal tap. During the procedure:
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Lyme Disease Diagnostics Research
There is a great need to develop rapid, point-of-care tests to determine whether people are infected with Borrelia burgdorferi, the bacterium that causes Lyme disease. NIAID is committed to improving Lyme disease diagnostics by supporting innovative research projects.
Priorities include finding potential targetssubstances that new diagnostic tools might measure in patient samplesand improving the sensitivity and specificity of currently available diagnostic tests, thereby leading to more accurate results.
Investigation Of Suspected Neurological Lyme Disease
The diagnosis of neurological Lyme disease can only be confirmed by examination of the CSF and a paired serum. A definite diagnosis is based on the presence of a pleocytosis in the CSF, demonstration of intrathecal synthesis of specific antibodies to Borrelia species in CSF by comparison to serum and the presence of neurological symptoms. It is not possible to confirm intrathecal synthesis and hence definite neurological Lyme disease without a paired serum .
In 2018 RIPL is introducing a service for the detection of intrathecal synthesis of Borrelia-specific antibodies which is summarised in this flow diagram.
Clinicians may ask for guidance on laboratory testing of CSF from RIPL if required.
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Borrelia Species Pcr Results
Borrelia species DNA may occasionally be detected in the blood by PCR, but a negative PCR test is of no value in excluding localised Lyme disease.
The overall sensitivity of PCR on a skin biopsy of an EM or ACA rash is around 50% and is limited by the chance of a single biopsy hitting a site with a significant number of organisms.
In neurological Lyme disease involving the CNS, up to 10% of cases may be PCR positive on a CSF sample a negative PCR result does not exclude the diagnosis.
Synovial fluid may be positive by PCR in up to 50% of cases. A negative result does not exclude the diagnosis.
Traditional Lyme Disease Tests Are Not Specific Enough
Lyme disease is caused by the spiral-shaped bacteria Borrelia. There are multiple species and strains of Lyme borreliae . Therefore, tests must be targeted to these multiple species and strains in order to be able to detect them. If a patient is infected with a species or strain of Lyme borreliae that their test cant detect, they will get a false-negative test result and thus risk missing their diagnosis. This can be costly and dangerous.
Many ELISA and Western blot Lyme disease tests are only equipped to detect one strain of one species of Borrelia: Borrelia burgdorferi B31 . This means that those tests are missing infections caused by other strains and/or species of Lyme borreliae.
In one internal study designed to test the validity of the IGeneX ImmunoBlot against traditional Western blot tests, a total of 132 patients were tested by both Lyme Western blots and Lyme IB. 43 patients were seropositive on the ImmunoBlot, and 14 were positive on standard Western blots prepared from a mixture of two species for Bb ss B31 and 297. Thus 29 of the 43 patients tested negative on Western blots i.e., the Western blot totally missed their infections with strains other than Bb ss B31 and 297.
With such limited tests, patients infected with non-B31 species and strains e.g., B. mayonii, B. californiensis, or European species are at risk of receiving false negatives and missing the chance to treat their diseases.
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