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.
How To Prevent Lyme Disease In Humans
There are things you can do to reduce your chance of getting the disease, including:
- avoiding areas where infected ticks live, such as long grass and woodland
- regularly checking your skin and your childrens skin for ticks after being outdoors
- wearing long-sleeved shirts and long trousers tucked into your socks to prevent ticks from touching your skin
- taking a shower or bath after being outdoors in an area prone to ticks
- using insect repellent – look for products containing DEET, as these are the most effective
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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Lyme Disease Laboratory Tests Available At Ripl
The primary service provided by RIPL is serological testing using well-characterised and validated screening and confirmatory tests in accordance with the NICE Lyme disease guideline.
RIPL participates in regular external quality assurance exercises as an independent measure of its performance.
Details of prices and turnaround times for Lyme testing are provided in Appendix 1 of the RIPL user manual.
Treatment For Other Forms Of Lyme Disease
People with other forms of disseminated Lyme disease may require longer courses of antibiotics or intravenous treatment with antibiotics such as ceftriaxone. For more information about treating other forms of Lyme disease, see:
The National Institutes of Health has funded several studies on the treatment of Lyme disease that show most people recover within a few weeks of completing a course of oral antibiotics when treated soon after symptom onset. In a small percentage of cases, symptoms such as fatigue and myalgia can last for more than 6 months. This condition is known as post-treatment Lyme disease syndrome , although it is also sometimes called chronic Lyme disease. For details on research into chronic Lyme disease and long-term treatment trials sponsored by NIH, visit the visit the National Institutes of Health Lyme Disease web siteexternal icon.
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Metabolomics For Early Detection
A new approach to detecting early Lyme disease is metabolomics: quantifying small molecule metabolites in blood. The body reacts to infection by changing its metabolism and this is reflected in changes in blood levels of amino acids, sugars, fats, and nucleotides . From the success of this approach, it seems safe to say that our metabolism is a sensitive indicator of specific infections. Research from Claudia Molins, PhD, and others at the CDC has demonstrated that by profiling metabolites in blood they can detect almost 90 percent of early Lyme disease within three weeks of infection. They correctly identified Lyme disease in samples that were negative with the standard double antibody testing approach . This approach may also be useful in distinguishing other tick-borne diseases from Lyme disease, for example STARI, which is prevalent in much of the eastern US .
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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
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What To Think About
- It may be hard to tell if you have Lyme disease. False-positive and false-negative Lyme disease test results are common. Many people do not make antibodies to Lyme disease bacteria for up to 8 weeks after being infected.
- Doctors often do not rely on test results alone when recommending treatment for a person who may have Lyme disease. Treatment is often based on a person’s symptoms, the time of year, having a tick bite, and other risk factors for Lyme disease.
How Do You Test A Tick For Lyme Disease
How do you test a tick for lyme diseaseTick Bite: What to Do Ticks bites can make people sick. Below are some steps that you can take after a tick bite to reduce your chances of getting sick and how to get treatment promptly if you do get sick. Remove the tick as soon as possible. 1. Use fine-tipped tweezers to grasp the tick as close to the skin as you can. 2.
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What If Your Lyme Disease Test Is Positive
Its important to note that a positive result doesnt mean you have a diagnosis of Lyme disease. The tests will show that antibodies are present in your blood, but a physician will need to order another type of test before you get an official diagnosis.
If someone gets a positive at-home test, definitely see your doctor, says Dr. Puja Uppal, a board certified family medicine physician and the chief medical officer at Think Healthy.
A physician will likely order both an enzyme-linked immunosorbent assay and a Western blot test, which check for antibodies specific to Borrelia burgdorferi. They will consider the results of both these tests, along with your symptoms, to make an accurate diagnosis.
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 centre. 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.
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Persistent Lyme Disease Symptoms Arent Helped By Long
Microbiologist Elli Theel, who directs the Infectious Diseases Serology Laboratory at Mayo Clinic, calls the 2015 study incredibly promising. The sensitivity they showed just in early Lyme disease patients was very high, the highest Ive actually seen, she said.
In an upcoming publication, the researchers also showed that metabolomics can differentiate Lyme from a similar tick-borne disease called southern tick-associated rash illness . The disease causes similar symptoms as Lyme, including a bullseye rash, and occurs in overlapping geographic regions. Currently there is no laboratory test to diagnose STARI, and little is known about how the disease progresses and how to treat it, something Molins hopes will change with better testing.
Serologic Tests Are The Gold Standard
Prompt diagnosis is important, as early Lyme disease is easily treatable without any future sequelae.
Tests for Lyme disease can be divided into direct methods, which detect the spirochete itself by culture or by polymerase chain reaction , and indirect methods, which detect antibodies . Direct tests lack sensitivity for Lyme disease hence, serologic tests remain the gold standard. Currently recommended is a standard 2-tier testing strategy using an enzyme-linked immunosorbent assay followed by Western blot for confirmation.
Diagnostic testing methods in Lyme disease
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Limitations Of Serologic Tests For Lyme Disease
Currently available serologic tests have inherent limitations:
Antibodies against B burgdorferi take at least 1 week to develop
The background rate of seropositivity in endemic areas can be up to 4%, affecting the utility of a positive test result
Serologic tests cannot be used as tests of cure because antibodies can persist for months to years even after appropriate antimicrobial therapy and cure of disease thus, a positive serologic result could represent active infection or remote exposure
Antibodies can cross-react with related bacteria, including other borrelial or treponemal spirochetes
False-positive serologic test results can also occur in association with other medical conditions such as polyclonal gammopathies and systemic lupus erythematosus.
Lyme Websites Books And Organizations
Private and governmental organizations provide help for people with Lyme disease and PTLDS, their caregivers, and medical professionals, including referrals to support groups and doctors, summaries of the latest research, and practical tips for Lyme prevention.
The American Lyme Disease Foundation is a private foundation providing science-based educational resources for patients and physicians.
The Bay Area Lyme Foundation funds research on Lyme disease and offers information about symptoms, prevention tips, and how to remove a tick properly.
The Centers for Disease Control and Prevention is a government agency responsible for health security in the US. It carries out research focusing on disease prevention and tick control, and it also provides recent and historical data on Lyme occurrence.
Conquering Lyme Disease: Science Bridges the Great Divide, a book by Jennifer Sotsky, MD, and Brian Fallon, MD, MPH, the director of the Lyme and Tick-Borne Diseases Research Center at Columbia University Medical Center, is an invaluable resource for Lyme patients and practitioners.
The Global Lyme Alliance is a nonprofit dedicated to fighting tick-borne diseases by supporting education, research, and awareness. It provides referrals to Lyme-literate health care providers, to support groups, and to peer mentors.
Familydoctor.org provides general advice from the American Academy of Family Physicians.
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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.
Lyme Disease Diagnosis And Laboratory Testing
Lyme disease is diagnosed based on the presence of symptoms, a physical exam, the possibility of exposure to infected ticks and, if necessary, laboratory testing. If your health care provider suspects Lyme disease, you may be asked to provide a blood sample for testing.
Public health and laboratory experts in Canada, the United States and worldwide support the 2-step testing used in Alberta as the best laboratory method for supporting the diagnosis of Lyme disease. These high standards help protect individuals from misleading false-positive results and unnecessary treatments.
In Alberta, laboratory testing for the first step is done by the Provincial Laboratory for Public Health. The second verification step is done by the National Microbiology Laboratory in Winnipeg to reduce the chances of false-positive results.
The Alberta government advises against the use of laboratory testing offered by some private laboratories outside of Canada. Some of these laboratories use non-standardized testing methods. These methods may report a higher number of false-positive results.
False positives can result in misdiagnosis that can lead to a delay in finding the actual cause of an individuals illness, as well as unnecessary, expensive and sometimes harmful treatments.
A 2014 study found that one alternate United States laboratory had incorrectly diagnosed Lyme disease in up to 57% of healthy people who did not have Lyme disease.
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Advantages Of The Equine Lyme Multiplex Assay
The Equine Lyme Multiplex Assay is available only at the Animal Health Diagnostic Center at Cornell University. It combines the results obtained by previous ELISA and Western blot testing and exceeds the information obtained by tests that are based on a single antigen of B. burgdorferi such as C6. The Lyme Multiplex Assay provides information whether the horse got infected with B. burgdorferi and when the infection occurred. The test results are fully quantitative and appropriate to follow-up on treatment success or response to vaccination. The advantages of the Lyme Multiplex Assay compared to other Lyme tests are:
The Lyme Multiplex Assay result provides advanced information beyond any of the currently available Lyme disease testing methods. Lyme Multiplex Assay testing allows a better definition of the horses current infection status and assists in determining treatment options and prognosis. The infection status can also be determined most vaccinated horses. Interpretation varies slightly depending on the vaccine used.
Who Gets Lyme Disease
Anyone bitten by an infected deer tick can get Lyme disease. Most U.S. cases of Lyme disease happen in Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin. But Lyme disease is found in other parts of the U.S., Europe, Asia, and Australia too.
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Is Treatment 100% Effective
Scientists are divided on this topic. Some studies suggest that that even long-term antibiotics may not completely clear infection dogs may get sick again at some point after antibiotic treatment is stopped. Other studies suggest that complete clearance of infection is possible with antibiotic treatment. Further research is required to answer this question.
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Her ordeal is a common one every year, some 300,000 people in the United States are diagnosed with Lyme disease, according to the Centers for Disease Control and Prevention, and that number is on the rise. Some people wait months or years to get a correct Lyme diagnosis. And their cases highlight a problem: Tests for Lyme in the first month of infection are frequently wrong. When diagnosed and treated early the infection is a simple one to get rid of, but left untreated it can cause a myriad of lingering symptoms, from severe arthritis to short-term memory problems.
Now, a number of research groups are working to improve Lyme tests to catch infections in the early stages. One avenue being studied by the CDC aims to create a Lyme signature of small molecules in the blood an approach that, in early testing, catches a dramatically higher share of early infections.
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Who Should Not Be Tested
The American College of Physicians recommends against testing in patients:
Presenting with nonspecific symptoms without objective signs of Lyme disease
With low pretest probability of infection based on epidemiologic exposures and clinical features
Living in Lyme-endemic areas with no history of tick exposure
Presenting less than 1 week after tick exposure
Seeking a test of cure for treated Lyme disease.
How It Is Done
The health professional taking a sample of your blood will:
- Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
- Clean the needle site with alcohol.
- Put the needle into the vein. More than one needle stick may be needed.
- Attach a tube to the needle to fill it with blood.
- Remove the band from your arm when enough blood is collected.
- Put a gauze pad or cotton ball over the needle site as the needle is removed.
- Put pressure on the site and then put on a bandage.
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Special Considerations For Vaccinated Horses
An approved Lyme vaccine for horses is currently not available. Horses are sometimes vaccinated with one of the three available Lyme vaccines for dogs for attempted protection of horses that are housed in Lyme endemic areas. Efficacy studies of canine vaccines in horses are not yet available, but experimental data suggested that anti-OspA antibodies are protective in horses.
All available vaccines contain OspA antigen as the sole or one of the vaccine components. Antibodies to OspA are identified by the Equine Lyme Multiplex Assay to determine the vaccination status in vaccinated horses. To provide our clients with the best interpretation for each animal, we need information on the vaccine used. This includes the name of the vaccine and the date when the horse was last vaccinated. Please include this information on the submission form when samples of vaccinated horses are submitted for testing.
Recent studies indicate that horses can respond to the canine vaccines, but the responses are typically short-lived17,18. It is therefore recommended to vaccinate horses in close proximity to tick season, approximately four weeks before ticks are typically abundant in the area. Additionally, confirmatory testing is recommended after vaccination of horses since low OspA antibody responses have been observed in individual horses.