Serological Testing Of Serum For The Diagnosis Of Lyme Disease
The most commonly used tests look for antibodies to the Borrelia species that cause Lyme disease in the UK and Europe, but they also detect infections from strains of Borrelia from the US.
The antibody response takes several weeks to reach a detectable level, so antibody tests in the first few weeks of infection may be negative. If the first sample was taken within 4 weeks from the start of symptoms and is negative and there is a clinical suspicion of Lyme disease, then retesting in 4 to 6 weeks may be useful.
It is very rare for patients to have negative antibody tests in longstanding infections. Borrelia antibodies persist indefinitely in some patients and this does not indicate continuing disease or a need for re-treatment.
Serological testing for Lyme disease in the UK and much of the world follows a two-step approach using commonly available antibody screening tests as a first stage, followed by immuno-blotting of samples that give positive or indeterminate results in the screening tests.
Sensitive screening tests are used at the first stage of testing but have the disadvantage of occasionally detecting other diseases and producing false positive results. RIPL uses the C6 Lyme ELISA for screening
Samples giving positive or indeterminate preliminary screening test results are then tested in a more specific system to confirm the presence of Borrelia-specific antibodies. RIPL uses the Borrelia ViraChip® IgG, IgM test for this purpose
What Are The Symptoms Of Lyme Disease
Early stage : The most common early symptom is a rash where the tick was attached. It often, but not always, starts as a small red area that spreads outward, clearing up in the center so it looks like a donut. Flu-like symptoms, such as fever, headache, stiff neck, sore and aching muscles and joints, fatigue and swollen glands may also occur. Even though these symptoms may go away by themselves, without medical treatment, some people will get the rash again in other places on their bodies, and many will experience more serious problems. Treatment during the early stage prevents later, more serious problems.
Later stages : If untreated, people with Lyme disease can develop late-stage symptoms even if they never had a rash. The joints, nervous system and heart are most commonly affected.
- About 60% of people with untreated Lyme disease get arthritis in their knees, elbows and/or wrists. The arthritis can move from joint to joint and become chronic.
- Many people who dont get treatment develop nervous system problems. These problems include meningitis , facial weakness or other problems with nerves of the head, and weakness or pain in the hands, arms, feet and/or legs. These symptoms can last for months, often shifting between mild and severe.
- The heart also can be affected in Lyme disease, with slowing down of the heart rate and fainting. The effect on the heart can be early or late.
Access To Lyme Disease Testing Services
This guidance on the laboratory diagnosis of Lyme disease is intended for healthcare professionals in the UK. Patients concerned about possible Lyme infection should consult an appropriate healthcare professional, for example their GP, in the first instance.
Health professionals wishing to discuss a possible case or ascertain local arrangements for testing should contact a local Infection specialist .
NHS testing for Lyme disease is available through local service providers and the Rare and Imported Pathogens Laboratory at PHE Porton where ISO15189 accredited confirmatory testing is also provided. RIPL is also introducing a testing service for neurological Lyme disease.
RIPL provides medical and laboratory specialist services to the NHS and other healthcare providers, covering advice and diagnosis of a wide range of unusual bacterial and viral infections, including Lyme disease.
RIPL continuously updates its methods and will make further information on Lyme disease diagnostic testing available as it arises.
You May Like: Diagnostic Procedures For Lyme Disease
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!
Fast Quality Care From Mediq Urgent Care
Our goal is to bring peace of mind to the people of our community. So, if youre located in the Piedmont Triad, stop by one of our clinics today! Thanks to our convenient locations and our extended evening and weekend hours, MEDIQ Urgent is the ideal solution for your lyme disease testing needs.
We accept most major insurance plans, making it easy to be seen at our office. And, if you dont have insurance, we offer straight-forward costs. to see our worry-free pricing chart and get a better idea of what you would pay out-of-pocket on the day of your visit.
Visit us at MEDIQ Urgent Care in Greensboro or Winston-Salem today! Just walk in, or check in online below to save time. Want to make your first visit move a bit more quickly? Download our registration form and bring the completed copy with you to our office.
Also Check: How Long For Lyme Test Results
High Endemicity Screening Of A Child
A healthy child from an area of high endemicity receives an annual physical. The mother notes that the child enjoys playing in the backyard, which is adjacent to a heavily wooded area.
Serologic testing should not be ordered because the child is asymptomatic. A false-positive test result would expose the child unnecessarily to the risks of treatment. In this scenario, the probability that a positive test represents true infection is less than 25 percent.
Theme : Difficulty In Diagnosis
Clinicians described multiple challenges in the diagnostic process for TBDs. Clinicians from each of the three participating practices felt that differential diagnoses for TBDs were complicated by the nonspecific symptoms associated with these diseases. Clinicians had a self-professed lack of awareness of TBDs outside of Lyme disease, noting that they were unfamiliar with the signs, symptoms, and appropriate serologic testing needed to diagnose non-Lyme TBDs, as well as the prevalence of these TBDs in their local communities.
Focus group participants reported confidence in diagnosing Lyme disease and developing treatment plans when serologic test results and/or empiric assessment of the patient was conclusive, particularly when the erythema migrans lesion, or rash, was present. However, interpreting test results for Lyme disease was more difficult in scenarios where patients had nonspecific symptoms in the absence of the characteristic EM rash. At least one participant from each focus group described patients associating nonspecific symptoms, such as fatigue, with Lyme disease specifically and expressed uncertainty around interpreting serology results for Lyme disease. This juxtaposition of nonspecific symptoms and unclear diagnostic testing results proved challenging for clinicians making decisions on how to treat and diagnose their patients for Lyme disease.
Read Also: Does Lyme Disease Stay With You Forever
Serological Testing Of Csf For The Diagnosis Of Neurological Lyme Disease
Serological testing for neurological Lyme disease is based on demonstrating intrathecal synthesis of Borrelia-specific antibodies in CSF. For laboratory testing for neurological Lyme disease, separate IgG and IgM ViraChip® serology assays are performed on CSF and paired serum and the results compared.
CSF samples must be tested in parallel with a contemporaneous serum sample and protein and immunoglobulin levels compared between the two sample types to produce a meaningful result.
For necessary sample types and volumes see Sample types for Lyme disease testing
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.
Recommended Reading: Can Any Tick Carry Lyme Disease
Positive C6 Elisa On Serum
RIPL will automatically proceed to do IgM and IgG immunoblot tests after a positive or indeterminate ELISA test and will provide an overall interpretation of the ELISA and immunoblot in the light of the clinical details provided on the request form.
Please provide clinical details to allow the interpretation of serological results. These are needed for interpretation because antibody levels from a protective humoral immune response to Borrelia species may persist indefinitely in patients who have had Lyme disease in the past. After successful treatment of Lyme disease antibody concentrations may slowly fall over time.
Borrelia species are notifiable organisms. The numbers of positive results from laboratory confirmed cases in RIPL are reported to PHE and analysed for inclusion in PHE Health Protection Reports as part of Lyme disease epidemiology and surveillance.
You May Like: Bed And Breakfast Old Lyme Ct
Diagnosis & Treatment Of Lyme Disease
The current initial test is a blood test that checks for antibodies formed in reaction to the disease. This is called the Enzyme-linked immunosorbent assay test. This test sometimes produces a false positive in the first few weeks. The Western blot test is typically done to confirm the diagnosis.
It can be especially difficult to detect Lyme disease in the first month of infection, which is why its essential to make a note of all of your symptoms before you visit our North Haven, CT clinic. If the disease is caught in the early stage of development, then its more likely to be treated effectively. If the disease isnt treated as soon as possible then it can cause additional problems. Some of these can be irreversible.
Protect Yourself From Tick Bites
- Avoid Wooded Areas and High Grass
- Walk in Center of Trails
- Wear long sleeves and pants when working with brush or in other common area of ticks
- Use repellents that contain 20-30% DEET
- Use products that contain 0.5% permethrin on clothing.
- Examine clothes, backpacks and pets after coming back from any outdoor activity
You May Like: Chance Of Lyme Disease From Deer Tick
Serology And Dna Testing
There are two main types of Lyme testing. The first one tests the bodys reaction to the bacteria. You can do this by detecting whether antibodies are being created against that particular microbe. Secondly, you can check for the presence particles of the DNA of the bacteria.
There are other types of testing available, but the above are the two main types, namely, serology or antibody testing and, DNA or PCR testing.
Both these types of tests are designed to detect acute Lyme disease.
In the initial stages of infection, the bacteria is still in the blood, and it is relatively easy to find it. Later on however when the bacteria have moved away from the blood and invaded the tissue, then it becomes harder to detect.
This latter scenario highlights one of the problems with testing for Lyme in that many people who are initially infected with Lyme often do not have an acute reaction.
Many people begin to exhibit symptoms much later after their immune system begins to deteriorate, and by then the bacteria is deeply embedded in tissue.
So whether you are going to find the bacteria depends on firstly if the concentration of microbes in tissue is high enough to give a reaction and secondly if the immune system is reacting to it.
In acute Lyme, research shows that current testing has a pickup rate of 95%. On the flip side, in chronic Lyme, scientists do not know the pickup rate. They do not know if it a 30% pickup rate or 80%.
Read Also: Whatâs The Cure For Lyme Disease
Serving Lynn Peabody & Salem For Urgent Care Needs
We go beyond broken bones and x-rays, offering everything from flu shots, physicals and COVID & STD Testing. Were dedicated to quality care and patient satisfaction, so that you can live life uninterrupted. Best of all, you can walk into AFC Urgent Care to see a doctor on your own schedule.
Our healthcare providers offer extended weekday hours to patients in and around Peabody, Salem, Lynn, Marblehead and Clifton. Were also open on the weekend. Theres no need to make an appointment walk-ins are always welcome. A visit to AFC is only a fraction of the cost of an emergency room trip, making it the smart alternative to the ER in non-life-threatening situations.
Read Also: Beach Houses For Sale In Old Lyme Ct
Don’t Miss: Can Lyme Disease Cause Leg Weakness
Where To Check For Ticks
Ticks prefer the warm moist areas of the body due to the ample blood supply in those areas.
If you or your child have been playing outdoors in the garden or in a woodsy area, make sure to check the armpits, legs, neck, and hair for signs of a tick bite.
- Mercy-GoHealth Urgent Care in Arkansas, Springfield, St. Louis & Oklahoma
- Novant Health-GoHealth Urgent Care in North Carolina
What Can I Do To Lower My Chances Of Getting Lyme Disease Or Any Other Disease From Ticks
Prevention begins with you! Take steps to reduce your chances of being bitten by any tick. Ticks are most active during warm weather, generally late spring through fall. However, ticks can be out any time that temperatures are above freezing. Ticks cling to vegetation and are most numerous in brushy, wooded or grassy habitats. When you are outside in an area likely to have ticks , follow these simple steps to protect yourself and your loved ones:
Don’t Miss: How Do You Get Tested For Lyme Disease
You Do Not Usually Need Tests To Show That You Have Lyme Disease
In most cases, theres a clear sign of Lyme diseasea painless, spreading rash that often grows to look like a bulls eye. If you have this rash, and you recently had a tick bite or were in an area known for Lyme disease, you dont need a test. Instead, your doctor can just start treating you with antibiotics, as appropriate.
Recommended Reading: What Is The Test For Lyme Disease Called
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 âbullâs-eyeâ 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.
Don’t Miss: Lyme Disease And Chronic Fatigue
What Abnormal Results Mean
A positive ELISA result is abnormal. This means antibodies were seen in your blood sample. But, this does not confirm a diagnosis of Lyme disease. A positive ELISA result must be followed up with a Western blot test. Only a positive Western blot test can confirm the diagnosis of Lyme disease.
For many people, the ELISA test remains positive, even after they have been treated for Lyme disease and no longer have symptoms.
A positive ELISA test may also occur with certain diseases not related to Lyme disease, such as rheumatoid arthritis.
Also Check: Lyme Disease Blood Test Cost
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:
In early infection, before antibody responses develop
In reinfection, when serologic tests are not reliable because the antibodies persist for many years after an infection in many patients
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.
Recommended Reading: What Does A Lyme Tick Look Like
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.