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.
Where Blacklegged Ticks Live
We continue to track where infected and uninfected blacklegged ticks are being found.
Public Health Ontarios Lyme disease page has a map that shows areas in Ontario where they estimate you are more likely to find blacklegged ticks.
Blacklegged ticks are spreading to new areas of the province because of climate change. They can also spread by traveling on birds and deer. While the probability is low, it is possible to find an infected tick almost anywhere in Ontario.
Ticks are most active in spring and summer, but can be found at any time of the year when the temperature is above freezing.
What Blacklegged Ticks Look Like
Blacklegged ticks are small and hard to see. They attach themselves to humans and animals and feed on their blood. They can range in size depending on how long they have been feeding.
You can find out if its a blacklegged tick by:
- calling your local public health unit or checking their website
- submitting a photo of the tick to etick.ca
Adult female blacklegged tick at various stages of feeding. Photo: Government of Canada
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How Is Lyme Disease Treated
Common antibiotics are effective at clearing the infection and early symptoms and in helping to prevent the development of complications. If untreated, the disease will progress to a longer-term form in about half of patients. Antibiotics are generally given for up to three weeks. If complications develop, intravenous antibiotics may need to be used to treat the infection. The bacteria can survive for long periods in the body even if no symptoms develop. If untreated, the bacteria can cause chronic irritation in in a number of the bodys organs. That is why early diagnosis and treatment with antibiotics is important.
Symptoms Of Lyme Disease
A circular or oval shape rash around a tick bite can be an early symptom of Lyme disease in some people.
The rash can appear up to 3 months after being bitten by an infected tick, but usually appears within 1 to 4 weeks. It can last for several weeks.
The rash can have a darker or lighter area in the centre and might gradually spread. It’s not usually hot or itchy.
The rash may be flat, or slightly raised, and look pink, red, or purple when it appears on white skin. It can be harder to see the rash on brown and black skin and it may look like a bruise.
Some people also get flu-like symptoms a few days or weeks after they were bitten by an infected tick, such as:
- a high temperature, or feeling hot and shivery
- tiredness and loss of energy
Some people with Lyme disease develop more severe symptoms months or years later.
This is more likely if treatment is delayed.
These more severe symptoms may include:
- pain and swelling in joints
- nerve problems such as pain or numbness
- heart problems
- trouble with memory or concentration
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Early Localized Lyme Disease
Early localized Lyme disease usually presents as an acute illness characterized by:
- the presence of a single, localized skin lesion known as erythema migrans
Not all patients will present with an EM. Therefore, diagnosis should not be based solely on the presence of EM.
Most patients will present with EMs within 7 days of the initial tick bite. However, the incubation period can vary between 3 and 30 days.
The skin lesion is characteristically an annular erythematous lesion greater than 5 cm in diameter that:
- slowly increases in size
- is usually painless and non-pruritic
The lesion sometimes develops central clearing, but it can be more homogenously erythematous. In dark-skinned patients, the rash may appear more as a bruise.
Variations of an EM are highly suggestive of Lyme disease and can take the following forms:
- blue-purple hues
- a bull’s-eye appearance
A skin lesion called erythema migrans can develop into a bull’s-eye at the site of a tick bite. It is shown here on a patient’s upper arm.Footnote 1
A typical sign of early non-disseminated Lyme disease is an expanding rash called erythema migrans. This can take on the appearance of a bull’s eye.Footnote 1
Some Lyme disease skin lesions are uniformly red and do not appear with the classic ring.Footnote 1
Some patients present with a central blistering lesion, commonly mistaken as a spider bite. This is likely due to an inflammatory reaction to the pathogen induced by the tick.Footnote 1
The Igenex Lyme Immunoblot Solves These Problems
IGeneX has developed a serological test that increases specificity without sacrificing sensitivity that has changed how to test for Lyme disease. It uses specifically created recombinant proteins from multiple species and strains of Lyme borreliae and reduces inconsistencies in reading and interpreting the test bands.
More species detected The Lyme ImmunoBlot tests for more species of Lyme borreliae than the traditional ELISA and Western blot tests, reducing the risks of false negatives due to the inability to detect antibodies to a certain strain or species of Lb. The test includes all Borrelia-specific antigens relevant in North America and Europe, not just B. burgdorferi B31 or 297.
The result is a single test that replaces at least 8 Western blots.
More accurate testing The ImmunoBlot uses specific recombinant proteins that are sprayed in precise amounts onto specific locations on the membrane strip, allowing for greater control of the quantity and location of the antigens. This makes reading the bands much more accurate and consistent.
Earlier detection The ImmunoBlot can detect infections at multiple stages of illness, letting you catch infections earlier.
The IgM and IgG ImmunoBlots superior specificity and sensitivity make them the best Lyme disease test available.
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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.
Lyme Disease Signs And Symptoms
Most symptoms of Lyme disease in humans usually appear between three and 30 days after a bite from an infected blacklegged tick.
You should contact your local public health unit or speak to a health care professional right away if you have been somewhere that ticks might live and experience any of the following symptoms:
- a bulls-eye rash (a red patch on the skin that is usually round or oval and more than 5 cm that spreads outwards and is getting bigger
- a bruise-like rash
- another type of unusual rash
- muscle aches and joint pains
- swollen lymph nodes
- spasms, numbness or tingling
- facial paralysis
If not treated, Lyme disease can make you feel tired and weak and, if it gets really bad, it can even harm your heart, nerves, liver and joints. Symptoms from untreated Lyme disease can last years and include recurring arthritis and neurological problems, numbness, paralysis and, in very rare cases, death.
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Lyme Disease Surveillance In Canada
Lyme disease became a national notifiable disease in December 2009.
Canada continues to monitor the evolving geographic distribution and prevalence of infected ticks and cases of Lyme disease. Therefore, you must report clinically diagnosed or laboratory-confirmed cases to your provincial or territorial public health authorities.
Health professionals in Canada play a critical role in identifying and reporting cases of Lyme disease. See the surveillance section for more information on surveillance in Canada.
Consult the national case definition for additional information.
Save That Tick It Can Be Tested For Lyme Disease
By Chris Williams on February 22, 2013.
Just because its almost winter, dont think that youre safe from deer ticks and the diseases that they transmit. In fall, the most common stage seen is the adult tick which remains active all winter, seeking blood from deer . Deer ticks dont hibernate they are not killed by frost or cold. Deer ticks remain active all winter unless they are covered by snow. This is not good news since the deer tick is the tick that transmits the three most common diseases in our Northeast region: Lyme disease, anaplasmosis, and babesiosis. The University of Massachusetts Extension Service may be able to offer some peace of mind if you, or a loved one, have been bitten by a tick. In cooperation with the University of Massachusetts Laboratory for Medical Zoology, the Extension Service operates a diagnostic lab that will identify a tick specimen and tell you whether or not that tick that you pulled off is a deer tick . The lab can also determine whether or not the tick carried Lyme disease, and can test for several other diseases as well. About 30% of the ticks tested at the lab carry the pathogen for Lyme disease. In addition, about 10% carry the bacterium that transmits anaplasmosis , and 5% carry the organism for babesiosis.
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How To Test For Lyme
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.
How To Confirm Lyme Disease
If you dont have the characteristic Lyme disease rash, your doctor might ask about your medical history, including whether youve been outdoors in the summer where Lyme disease is common, and do a physical exam. Lab tests to identify antibodies to the bacteria can help confirm or rule out the diagnosis.
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If I Am Worried About Lyme Disease Who Can I Talk To
Lyme disease is being increasingly recognised as causing illness and hardship, if the diagnosis is missed. Over the last number of years, there has been a marked increase in awareness of the condition among GPs and hospital doctors in Ireland. Each of the HSEs Hospital Groups have a number of Infectious Disease Consultants who are expert in the diagnosis and management of Lyme disease. If you have been bitten by a tick or have other reasons to strongly suspect you may have Lyme disease, you should visit your GP for advice.
Notes On Serological Tests
For patients with illness lasting over a month, only IgG testing should be performed . A positive IgM test alone is not sufficient to diagnose current disease in these patients.
Due to antibody persistence, a positive serological test cannot distinguish between active and past infection.
- should not be done as a test of cure
- cannot be used to measure treatment response
The EIA test:
- may yield false-positive results when used as a stand-alone test
- may cross-react with antibodies to commensal or pathogenic spirochetes
- there may be some viral infections for certain autoimmune diseases
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Where Lyme Disease Occurs
In the United States, Lyme disease typically occurs in the Northeast, Mid-Atlantic, and North Central states. It has also been reported to occur in Northern California. The most prevalent strain causing Lyme Disease in the United States is Borrelia burgdorferi.
If you live or have traveled to a state where Lyme disease is endemic, this increases your risk. Lyme disease is endemic in the following states: California, Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, Washington DC, West Virginia, and Wisconsin. For regulatory reasons, Everlywell is not able to offer testing in New Jersey, New York, or Rhode Island.
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.
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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Lyme Disease In Europe And Asia
Lyme disease can also occur in Europe and Asia, where Borrelia garinii and Borrelia afzelii are most commonly found.
Ticks infected with a Lyme disease bacterium can be found in woodlands across the European continent from northern Turkey to northern Sweden. However, Lyme disease is considered endemic in central Europe, where the following countries have the highest tick infection rates: Austria, Czech Republic, southern Germany,Switzerland, Slovakia, and Slovenia. In Europe, Lyme disease is primarily transmitted by the castor bean tick.
Lyme disease has been reported throughout Asia, as well, such as in Russia, Mongolia, northern China, Japan, and Koreaâ âthough infection from a Lyme disease bacterium appears to be relatively uncommon in these areas. In Asia, Lyme disease is transmitted by the taiga tick .
How Do Patients Test Negative For Lyme Disease In Ireland But Test Positive For Lyme Disease In Another Country
Laboratories in Ireland generally follow the laboratory testing recommendations of the US Centres for Disease Control and Prevention , the Infectious Disease Society of America , the European Federation of Neurological Societies and the British Infection Association .
The antibody tests used in Ireland are made by commercial companies and meet strict quality criteria. Irish laboratories have their own quality assurance methods to make sure the tests are working correctly as well as being accredited by the Irish National Accreditation Body to perform the test correctly.
Testing which is performed abroad may be performed in laboratories which have not met National or International Accreditation . In some cases they may use tests which are made in the laboratory rather than purchased from commercial companies. These tests may not have the same or consistent levels of quality as commercial tests which must meet specific European criteria called CE marking. These tests may be more likely to give a false positive result for those reasons.
Some laboratories abroad do not use antibody tests like the EIA and western blot and instead will use other types of tests. For example, testing for levels of a specific white blood cell or lymphocyte transformation tests . These types of tests are not currently recommended by international groups such as the CDC, IDSA or BIA for a number of reasons:
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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.
Does Every Tick Bite Lead To Lyme Disease
Most people who get tick bites do not get Lyme disease. Not all ticks are infected, and the risk for contracting the disease increases the longer the tick is attached to the body. Within one to four weeks of being bitten by an infected tick, most people will experience some symptoms of Lyme disease.
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The Role Of Lyme Disease Tests
The purpose of the most common type of Lyme disease testing is to determine whether you have developed antibodies as a result of past exposure to the Borrelia bacteria that cause Lyme disease. Antibodies are proteins created by the immune system that target specific threats like bacteria and viruses.
Blood testing alone cannot determine whether you have Lyme disease. Instead, testing can provide helpful information that your doctor can consider along with other factors, such as any symptoms youve had and whether youve been exposed to ticks that can carry Borrelia, to determine if a diagnosis of Lyme disease is appropriate.
Beyond blood testing, it is possible to analyze fluid from the central nervous system for signs of the Borrelia bacteria.
How Do You Test Tick For Lyme Disease
TickCheck can determine with 99.99% accuracy if the tick that bit you carries Lyme or 9 additional tick-borne diseases. Heres how it works: Order a tick test on TickCheck.com. Send your tick directly to our lab no waiting for a kit! Get your tick test results within 24-48 hours of lab receipt.
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