What Is The Most Accurate Test For Lyme Disease
Lyme disease is more common than many people think. Figures from the Center for Disease Control suggest that roughly 300,000 Lyme disease cases occur every year in the US.
The numbers are alarming, but it gets worse as finding accurate diagnostic tests can be challenging. Although the disease is treatable, it is nearly impossible to tackle it effectively if it is not diagnosed accurately and early enough.
Late detection can lead to severe health problems such as arthritis, heart blockage, and inability to concentrate, among other problems.
Given the prevalence and seeming elusiveness of the disease, some of the logical questions concerned persons would ask are: what is the most accurate test for Lyme disease? And when should I get checked for Lyme disease? This article will proffer answers to these and many other related questions. But first, a little background would be in order.
How To Detect Treat And Prevent Lyme Disease
When 12-year-old Kaleigh Ahern was showering before school one morning, she discovered a tick on her shoulder. “She was screaming like Charles Manson was in the shower with her,” says Kaleigh’s mom, Holly Ahern, a professor of microbiology at the State University of New York’s Adirondack campus. “I came running into the bathroom and discovered the tick embedded in her skin, waving its arms and legs. I removed it and took both Kaleigh and the tick to the doctor.”
The doctor sent the tick to the health department, where it was identified as a black-legged tick, known to transmit Lyme. Ahern assumed the doctor would prescribe antibiotics, given the risk of Lyme disease. Instead, he said the recommended approach was to wait and watch for a bull’s-eye rash. He told her that if one appeared or if Kaleigh developed flulike symptoms, then bring her back.
Kaleigh seemed healthy and went off to college. During her freshman year, she became an NCAA All-American swimmer. But within a week of competing in the Nationals, she became seriously ill. She suffered from overwhelming fatigue and could barely get out of bed for months. She had searing headaches, muscle pain, and brain fog. “She had episodes where she would just lie on the floor writhing in pain, and there was nothing we could do to help her,” says Ahern.
Even when early symptoms are treated with antibiotics, it’s possible the bacteria remain dormant in the body with potential to do damage.
What Is Lyme Disease
This bacterial infection is spread through the bite of a young deer tick or black-legged tick. These eight-legged creatures, about the size of a poppy seed, can be found in wooded and grassy areas throughout the United States, especially in New England and the Rocky Mountains.
Because these ticks are so small, most people donât realize when theyâre bitten. But the longer a tick stays attached to you, the more likely it is to transmit Borrelia burgdorferi , if the tick is a carrier.
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Targeting Fats To Fight Lyme
We started this current work to learn how Borrelia burgdorferi acquires key nutrients, like fats, for growth, says Gwynne. The Lyme bacteria, despite being a very successful pathogen, is much more dependent than other bacteria on acquiring nutrients from its environment.
In the process of our research, we found that the organism takes fats called phospholipids directly from its surroundings in the host, and puts them on its surface, says Hu, the Vice Dean of Research at the school and Paul and Elaine Chervinsky Professor of Immunology. That finding led us to look to see if the direct use of a host fat by the bacteria might lead the immune system to recognize it as a foreign substance and create antibodies to it.
What the scientists discovered is that both animals and patients infected with the Lyme bacterium developed autoantibodies to multiple phospholipids. Because autoantibodies can be damaging to the host, these autoantibodies are tightly regulated and tend to disappear quickly once the stimulating factor is removed.
The antibodies also seem to develop much more quickly than traditional antibodies to the Lyme bacterialikely because your body has previously created these autoantibodies and downregulated them, says Hu.
How Do They Test For Lyme Disease
Lyme disease is best tested using two different blood testing methods. These are:
- The Enzyme-linked Immunosorbent Assay test: In a nutshell, this test will look for signs that your body is trying to fight off Lyme disease by producing antibodies. However, the ELISA test may come back negative even when a person is infected by the Borrelia burgdorferi bacteria. False-negatives can occur during the early stages of the disease, where the infected persons body has not produced enough antibodies to fight off the B. burgdorferi bacteria. For this reason, reliable diagnosis is not usually based only on the ELISA test results.
- Western Blot test: Heres a simple way to explain the western blot test without getting into all the nitty-gritty details of what it does and how it does it. Put simply, it separates the blood proteins and detects antibodies to the bacteria causing the Lyme disease. Usually, when an ELISA test comes back positive, a western blot test is performed to confirm the diagnosis.
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How Long Do Lyme Disease Flare Ups Last
These symptoms can include fatigue, joint or muscle aches, and cognitive dysfunction. They may last up to six months or longer. These symptoms can interfere with a persons normal activities and may cause emotional distress as a result. However, most peoples symptoms improve after six months to a year.
Can Infection Be Spread Directly From One Dog To Another Dog Or From My Dog To My Family
Direct spread of Lyme disease from one dog to another dog has not been reported, even when infected and uninfected dogs have lived together for long periods.
Spread of Lyme disease from dogs to people has not been reported either, but people are equally at risk for Lyme disease if they are bitten by an infected tick.
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Diagnosis Testing And Treatment
You may have heard that the blood test for Lyme disease is correctly positive only 65% of the time or less. This is misleading information. As with serologic tests for other infectious diseases, the accuracy of the test depends upon how long youve been infected. During the first few weeks of infection, such as when a patient has an erythema migrans rash, the test is expected to be negative.
Several weeks after infection, FDA cleared tests have very good sensitivity.
It is possible for someone who was infected with Lyme disease to test negative because:
If you are pregnant and suspect you have contracted Lyme disease, contact your physician immediately.
- Report being bitten by a tick, or
- Live in, or have recently visited, a tick-infested area.
What Is Lyme Disease How Does My Dog Get Infected
Lyme disease is an infectious disease caused by bacteria called Borrelia. The bacteria are most commonly carried by the deer tick . Infection occurs when a dog is bitten by an infected tick. It appears that the disease is not transmitted until the tick has fed for approximately 12 hours. The tick itself becomes infected by feeding on infected mice, birds, deer, and other animals.
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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.
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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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
Lyme Disease Is Remarkably Difficult To Diagnose
The problem with Lyme disease is that the bacteria can create a hard shell around themselves when inactive so that the blood tests are unable to detect them. This is especially true when the disease has reached the chronic stage. The timing of the symptoms is often used by a medical provider to establish a time line to a tick bite or exposure to a high-risk region where the disease is commonly transmitted.
Because the ticks that can spread Lyme disease are often the size of a pinhead, the ticks might not even be notice. A bulls-eye rash at the bite location is a trademark symptom of Lyme disease, but only about half of the people who are infected with the bacteria develop the rash. Once the disease reaches the chronic stage, chronic arthritis, joint pain, and neurological symptoms begin to appear, sometimes several months after the infection.
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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.
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.
What Do Testing Kits Typically Include
Depending on the method of collection, testing kits may include:
- a device to collect the blood, urine, or saliva sample
- a container to ship the sample back to the lab
- a shipping label
Some kits come with a bandage, wipes, and a biohazard bag. Kits may contain extras such as Styrofoam holders, labels, or tubes with varying solutions inside.
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What Do The Test Results Mean
Because there are three tests that are typically conducted for the Lyme disease blood test, then results can vary based on the combination of test results received. When all three tests are positive, then Lyme disease is likely. These other result combinations are usually interpreted in the following ways.
Positive IgM, Negative IgG, Negative Western Blot.This usually indicates that the Lyme disease infection is in its early stages or that the blood test has produced a false positive result.
Negative IgM, Positive IgG, Positive Western Blot.This is usually interpreted as having a late-stage Lyme disease infection. It may also be an indication that someone had a previous infection that has been removed from the body.
All results negative.This is usually interpreted as there not being any infection present and that the symptoms are being caused by another issue. In some specific instances, however, it can also be seen as the antibody levels being too low to detect.
Once Lyme disease is confirmed, there will almost always be detectable levels of the bacteria which causes the disease in the IgG antibodies in their blood. This will mean that their IgG blood test results will have a standard deviation in what is considered as normal because of the presence of the disease, even if it has been effectively cured.
Why Is It So Hard To Get A Lyme Disease Diagnosis
Lyme disease is a tick-borne illness that often has vague symptoms doctors brush off or misdiagnose. Here’s why.
Singer Avril Lavigne, for example, has been very vocal about her struggle with getting a Lyme disease diagnosis. She told Good Morning America in 2015 that she saw many doctors and underwent a battery of tests, but that it wasn’t until she found a Lyme disease specialist that she was given a correct diagnosis.
“I was in Los Angeles, literally, like the worst time in my life and I was seeing, like, every specialist and literally, the top doctors,” Lavigne explained. She said that some of these experts misdiagnosed her symptomsdebilitating pain and fatigueas chronic fatigue syndrome or depression, while others told her she was simply dehydrated or exhausted from touring.
“This is what they do to a lot of people who have Lyme disease,” she said. “They don’t have an answer for them so they tell them, like, ‘You’re crazy.'”
Lavigne started to suspect she had Lyme disease a few months after she began feeling exhausted and lightheaded. Her symptoms eventually got so bad, she felt like she couldn’t breathe, talk, or move. “I thought I was dying,” she told People.
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New Tests New Treatments
Recognizing that current treatments are leaving many people with Lyme suffering even decades later, doctors are trying new strategies. For instance, while antibiotics are still the frontline treatment for Lyme disease, researchers are learning they may work best in concert. Instead of giving a chronic Lyme patient a single antibiotic for 30, 60, or 90-plus days, doctors deploy antibiotics in pulses, to trick the persistent bacteria into reacting as if the chemical assault is over, and then hitting them again when they’re off-guard with additional doses or different drugs.
Much of this research is still in laboratory or animal trials, and without a reliable treatment available from conventional medicine, many patients are increasingly turning to integrative treatments and complementary remedies, even though there’s little research to indicate that these therapies may be successful.
Scientists recognize that since antibiotics are currently the only approved therapy for Lyme disease, and antibiotics are effective only during the early stages of the disease, successful treatment hinges on developing a replacement for the inaccurate diagnostic tests doctors currently rely on. Right now genetic sequencing is the most promising possibility. A Lyme activist named Tammy Crawford, who founded the patient advocacy organization Focus on Lyme after her daughter’s infection, was responsible for convincing researchers that the technology could be useful in diagnosing Lyme.