The Elisa And Western Blot Are Not Sensitive Enough
Another major limiting factor of the traditional ELISA and Western blot is the quality. These tests tend to use lysed BB cultures, and therefore, depending on the culture conditions, some antigens are over-expressed, and some are under-expressed. This, in turn, can affect the ability to detect antibodies from patients blood.
Whats more, if a patient tests too early after a tick bite, his or her body may not have produced enough antibodies to show up on a test with suboptimal sensitivity.
Most Accurate: Dna Connexions
Test looks for Borrelia burgdorferi, in addition to 10 other common vector-borne pathogens
Does not accept insurance
No assistance after testing results are received
DNA ConneXions is a company known in the scientific community for its detailed analysis of lab results. This at-home Lyme disease test, for example, is superior to the others because it tests for all 10 vector-borne pathogens, while others only test the most common two or three.
DNA ConneXions earned our most accurate distinction because of its detailed Lyme disease test, as well as its impressive laboratory with a biosafety level 2 lab with a CLIA license. This means the company knows its stuff and is able to help people with accurate testing.
After DNA ConneXions receives your urine sample, it will review your sample, and email you your results within two to three weeks. It is unclear how much support the company offers after you receive your results, so it would be wise to schedule an appointment with your primary care doctor. This is to ensure that your body heals entirely if your Lyme disease test is positive.
This is the most expensive kit on this list, costing about $650 for the full Lyme panel. As of now, it will not work with insurance companies or accept HSA. The DNA ConneXions lab, however, is one of the most trusted laboratories worldwide.
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 company’s online portal, or they will be sent to your doctors office.
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Can I Be Assured That The Type Of Lyme Disease Testing Carried Out In Ireland Is Accurate
Yes. Irish laboratories operate to a very high standard of quality. Laboratories in Ireland follow the testing guidelines of the US Centres for Disease Control and prevention , Infectious Disease Society of America , European Federation of Neurological Societies and British Infection Association . These guidelines provide information on which of the currently available laboratory tests have enough evidence to accurately diagnose Lyme disease.
It is important that patients who are concerned about Lyme disease seek help and receive a firm diagnosis in Ireland to ensure continued medical care. It is important to ensure that your symptoms and lab results are considered together to make sure your diagnosis is as correct as possible.
Enzyme Immune Assay Testing:
This test detects antibodies to the different kinds of bacteria that are known to cause symptoms of Lyme disease. Different strains of Borrelia are found in the USA and Europe but the tests are designed to detect all of the Borrelia that cause symptoms.
The EIA is the first test performed as it is designed to be very sensitive . If the EIA test is negative for Lyme disease, this can be relied upon to exclude Lyme disease in the patient, especially if the sample is taken when symptoms have been present for several weeks.
The disadvantage of the EIA is because it is very sensitive it can give false positive results. This means that the EIA test is reacting with something else present in the blood sample which is not related to Lyme disease. False positive EIA results can happen when there are infections with other bacteria or viruses, or in certain inflammatory /automimmune conditions. This is why a positive EIA test should be confirmed by a second test the Western Blot.
In Ireland, 2.5% of over 4,800 people who were tested by the National Virus Reference Laboratory in a single year had a positive Lyme test result. In Europe, between 3- 5% of the general population show evidence of infection with Borrelia bacteria at some point in their lifetime while a study in Ireland previously found that the background rate of infection in the Irish population was 3.4%.
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So When Do You Need Blood Tests For Lyme Disease
In some cases, you can have Lyme disease without the rash. Or you may not see the rash before it goes away on its own.
In these cases, your doctor should ask you about your medical history and do a thorough physical exam. Your doctor should look for these signs that you might have Lyme disease:
- You were in an area with ticks and Lyme disease.
- You also have fever or redness, warmth, and swelling in one or a few joints at a time usually the knees, shoulders, or wrists.
Other symptoms can occur later on. Talk to your doctor about testing and treatment choices.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
When Should You Call Your Doctor
- A tick is attached to your body and you are unable to remove the entire tick.
- You have a circular red rash that expands over the course of several days, especially if you know you were recently exposed to ticks. You may also have flu-like symptoms, such as fatigue, headache, stiff neck, fever, chills, or body aches.
- You feel very tired or have joint pain , irregular heartbeats, severe headache, or neck pain.
- You are pregnant or nursing and you think you may have been exposed to ticks.
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Symptoms Of Lyme Disease
Lyme disease can come with various symptoms. Most notable of these is the characteristic erythema migrans or bulls-eye rash, which occurs in about 70% of infected people. This often begins as a red area near the tick bite. As it expands in size, it often clears in the middle and develops a red ring .
Although the rash is a hallmark symptom of Lyme disease, it may look different from person to person. Itâs usually not painful or itchy and tends to appear on the thighs, groin, trunk, and armpit.
In addition to erythema migrans, people who are infected with Lyme disease may also experience:
- Fatigue, including severe fatigue later on during the infection
- Weakness or numbness in arms or legs
- Joint pain which may come and go suddenly and move from one joint to another
- Vision changes
Culture Isolation And Direct Detection Of Organisms In Tissue
Culture isolation of B. burgdorferi sensu lato from clinical specimens remains the gold standard for diagnosis and is most commonly attempted with skin biopsy or cutaneous lavage specimens from EM lesions and blood from patients with early-disseminated disease. Positive culture rates of nearly 90% for secondary EM lesions, 50% for primary EM lesions, and 48% for large-volume blood or plasma specimens from patients with early LD have been reported . Isolation of B. burgdorferi sensu lato from other sites, such as cerebrospinal fluid and synovial fluid, is uncommon the low recovery rate probably reflects the small number of viable organisms present in those anatomic locations.
Culture of B. burgdorferi sensu lato involves incubating a specimen in Barbour-Stoenner-Kelly medium and detecting the presence of characteristic spirochetes by dark-field microscopy or by fluorescent microscopy with acridine orange or a specific fluorescent antibody . Some microbiologists consider Borrelia culture to be too expensive and tedious to be practical for many clinical laboratories. In reality, isolation of B. burgdorferi sensu lato is no more difficult and is probably easier than recovering and identifying other fastidious microorganisms such as Legionella or Mycobacteria spp. from clinical specimens. BSK is commercially available, and the only specialized equipment required is a fluorescent microscope or a light microscope equipped with a dark-field condenser.
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What Happens After A Tick Bite
Ticks can attach and feed in any part of the human body. The bite is painless. Because they are very tiny nymph bites are often overlooked. Borrelia are transmitted from the midgut of the infected tick to the attached skin when attachment lasts for 3648 hours.
Several things can happen after being bitten by an infected tick.
- The body’s defence mechanisms can overwhelm and eliminate the infecting bacteria.
- The bacteria can remain localised at the site of the bite and cause a localised skin infection.
- The bacteria may disseminate via the blood and lymphatic system to other organs and cause a multisysteminflammatory disease.
Choosing A Lyme Disease Test
Often the diagnosis of Lyme disease depends upon the physicians readiness to listen and ask questions and on the mutual exchange of information, beginning with the initial doctor-patient interview.
Often the diagnosis of Lyme disease depends upon the physicians readiness to listen.
Lyme disease should be diagnosed clinically, without reliance on testing. However, all too often, physicians will ignore clinical presentations if laboratory tests are negative. Yet there are numerous scientific articles documenting false negatives and low sensitivity of such tests.
There can be several reasons for the inaccurate results. The sensitivity of the tests varies greatly depending upon how long an individual has been infected and on the type of clinical manifestations. If a patient has received antibiotics in the early stage of the disease, antibody levels may be too low to be detected or nonexistent. Antibodies to Borrelia burgdorferi do not appear in the blood until several weeks after the tick bite. The Lyme bacteria are not always present in the blood. The person could have been infected with a strain of Bb that is not covered in testing.
That said, laboratory tests can be used to support the diagnosis. Because of the varied presentations and necessity of relying on a patients symptoms, several tests may be helpful.
The ELISA and Western blot are the most common tests used to diagnose Lyme disease. Both tests measure antibodies to Bb, the bacterium that causes Lyme disease.
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How Much Does A Lyme Disease Test Cost
The cost of a Lyme disease test depends on what type of test is performed an ELISA test or a combination of ELISA and western blot tests.
Averagely, the cost for an ELISA test for Lyme disease is in the vicinity of $120 or more. If you include a confirmation western blot test, it can attract an additional $130 or more. More details on pricing can be referenced on our website.
Although an ELISA test might come back negative, it is best to combine it with a western blot test because not everyone shows the rash or bulls eye symptoms of Lyme disease.
After a successful diagnosis and treatment, it is equally important to do a follow-up test for Lyme disease years later to be sure that any similar flu-like symptoms are something else and not the same disease reoccurring.
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
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Should You Get A Test For Lyme Disease
If Lyme disease is treated soon after a tick bite, the outlook is great. Most cases of Lyme disease respond to a 2- to 4-week round of antibiotics.
If Lyme disease goes untreated, it can be more difficult to eliminate. For some, it can lead to inflammation of the joints, heart, and nervous system. Progression of the disease, and its severity, can vary from person to person.
Lyme disease is staged in categories: acute, early disseminated, and late disseminated. Later stages of Lyme disease may involve multiple systems in the body.
The most common sign of Lyme disease is an erythema migrans, or bulls-eye rash. The rash often appears after a delay of 3 to 30 days after the tick bite, according to the
Research from 2014 suggests that the bulls-eye rash may last for 3 to 4 weeks. About 80 percent of people with Lyme disease have a single erythema migrans rash. But the bacteria can spread and lead to multiple rashes, indicating disseminated Lyme disease.
While a rash is the most common symptom of Lyme disease, it isnt the only one.
With disseminated Lyme disease, symptoms can also include neurologic conditions, such as cranial nerve palsy and meningitis that mimics aseptic meningitis. Heart inflammation can also be a sign of Lyme disease.
If youre experiencing any of these signs or symptoms, an at-home test may help you identify Lyme disease. With the click of a button, a test can be shipped to your front door.
To select the best tests, we look at studies and user reviews.
How Are Dogs Tested For Lyme Disease
Diagnosis is made by a combination of history, physical signs, and diagnostics. For dogs, the two blood tests for diagnosing Lyme disease are called the C6 Test and Quant C6 test. Veterinarians perform both.
The C6 test detects antibodies against a protein called C6. Presence of the antibodies suggests an active Lyme infection. The C6 antibodies can be detected three to five weeks after an infected tick bites a dog and may be found in the bloodstream even before the dog shows signs of illness.
The next step is to do a Quant C6 test. This, along with urinalysis will help determine if antibiotic treatment is necessary.
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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.
What If Lyme Disease Goes Untreated
If Lyme disease goes untreated, it can affect other systems in the body. According to the , common symptoms of later stage Lyme disease include:
- severe headaches and neck stiffness
- additional erythema migrans rashes on other areas of the body
- facial palsy, which is a loss of muscle tone or droop on one or both sides of the face
- arthritis with severe joint pain and swelling, particularly in the knees and other large joints
- intermittent pain in tendons, muscles, joints, and bones
- heart palpitations or an irregular heartbeat
- episodes of dizziness or shortness of breath
- inflammation of the brain and spinal cord
- nerve pain
- shooting pains, numbness, or tingling in the hands or feet
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The Problem With Cdc Surveillance Criteria In Lyme Disease Testing
The problem of testing for Lyme Disease starts with the fact that CDC surveillance criteria, that are commonly used in diagnosis, were never meant to be used as a diagnostic test.
In-stead, they were created by epidemiologists to track the disease.
In order to receive a diagnosis of Lyme Disease, the patient must receive a positive ELISA or IFA test result followed by a positive Western Blot test result.
As the ELISA and IFA are often not sensitive enough to detect the disease and therefore produce a false negative result, this system is flawed from the start.
What Are The Symptoms Of Lyme Disease
Lyme Disease is a bacterial infection that results from a tick bite. The symptoms vary, and you can feel sick for months because of it. Some of the most common symptoms of Lyme disease are flu-like symptoms such as fever, chills, and headache. A rash can also occur in 70 to 80 percent of infections. If left untreated, the symptoms can worsen into facial palsy, dizziness, heart palpitations, and more.
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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.