Figuring Out Your Exposure
Diagnosis Of Lyme Disease
Many cases of Lyme disease are initially misdiagnosed. Lyme disease can be difficult to diagnose because early symptoms of fever, severe fatigue, and achiness are also common in many other illnesses. In addition, diagnostic blood tests are not always dependable, particularly in early disease. However, the round expanding red lesion rash is a unique sign that is more specific for Lyme disease, and many times a diagnosis can be made based on the tell-tale erythema migrans rash itself. Yet, it is important to understand that the erythema migrans rash is not always present or recognizable, and symptoms can fluctuate.
Think the Lyme disease rash is always a bulls-eye? Think again.Think its a spider bite? Think again. Please refer to our poster of varied rash manifestations as a helpful Lyme disease rash identification tool.
Recognizing the Lyme disease erythema migrans rash can be crucial to early diagnosis and treatment.
Despite common belief, the stereotypical ring within a ring bullseye rash is only present in a minority of Lyme disease patients. Instead, the majority of Lyme disease rashes are uniformly red or blue-red and do not have a central clearing or bullseye. Sometimes the site of the tick bite is clearly visible in the center of this lesion. The erythema migrans rash is almost always round or oval and expands over days to a diameter greater than 2. The Lyme rash is often confused with a spider bite, despite spider bites not expanding in this way.
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.
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How To Check For Lyme Disease
Last reviewed: Medically reviewed
Canadian singer Justin Bieber recently revealed that he has Lyme disease – a tick-borne infection that can take months or years to resolve, even after treatment.
Bieber is the latest celebrity to raise awareness of the infection, which affects thousands of people in the US every year .
It’s not always easy to tell if you have Lyme disease because the symptoms resemble those of many other conditions. However, this article should help you better understand the condition and how to reduce your risk of developing it.
Is There A Blood Test For Lyme Disease
If your doctor suspects that you have Lyme disease, they may order two blood tests. These will look for signs that your body is trying to fight it off. The results are most precise a few weeks after youâve been infected.
These tests are:
ELISA test. This test canât check for the bacteria that causes Lyme disease. It can only look for your immune systemâs response to it.
Although itâs the most common way to check for Lyme disease, the ELISA test isnât perfect. It can sometimes give false âpositiveâ results. On the other hand, if you have it done too soon after youâve been infected, your body may not have developed enough antibodies for the test to detect them. This will give you a ânegativeâ result even though you do have Lyme disease.
Western blot test. Whether your ELISA test comes back positive or negative, your doctor will need to do this blood test, too.
A Western blot uses electricity to split certain proteins in your blood into patterns. This is then compared to the pattern of people known to have Lyme disease.
At least five band matches means that you have Lyme disease. Still, not all labs have the same standards. Thereâs a chance that you could get a âpositiveâ result from one and a ânegativeâ result from another.
- Alzheimerâs disease
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When Not To Take This Lyme Disease Test
Do not take this Lyme disease antibody test if:
- You are experiencing a round rash after a tick bite, such as the typical bullseye rash associated with early Lyme disease. Seek immediate medical attention instead of taking this test. A round rash could be a sign of Lyme disease, and it’s best to consult a medical professional and receive treatment as soon as possible to help prevent complications associated with the disease.
- You suspect you might have been infected with Lyme disease bacteria less than 6 weeks ago . The antibodies detected by this test take several weeks to build up in your bloodstream, taking the test before 6 weeks have passed may result in a false negative.
- You havenât lived in or traveled to an area where Lyme disease occurs. Consider discussing any symptoms with your healthcare providerâinstead of taking this testâto help determine if youâve been exposed to a Lyme disease bacterium.
- Youâve previously received a Lyme disease diagnosis, was treated for the disease, and are still symptomatic. Consider discussing any new or ongoing symptoms with your healthcare provider instead of taking this test.
- You are currently being treated for Lyme disease infection or taking antibiotic treatment for other infections. Consider discussing any symptoms with your healthcare provider instead of taking this test.
Because interpreting Lyme disease test results can be difficult, weâve designed your test results to be easy to read and understand.
Stage : Late Disseminated Lyme Disease
Late disseminated Lyme disease occurs when the infection hasnt been treated in stages 1 and 2. Stage 3 can occur months or years after the tick bite.
This stage is characterized by:
- arthritis of one or more large joints
- brain disorders, such as encephalopathy, which can cause short-term memory loss, difficulty concentrating, mental fogginess, problems with following conversations and sleep disturbance
- numbness in the arms, legs, hands, or feet
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Stage : Early Disseminated Lyme Disease
Early disseminated Lyme disease occurs several weeks to months after the tick bite.
Youll have a general feeling of being unwell, and a rash may appear in areas other than the tick bite.
This stage of the disease is primarily characterized by evidence of systemic infection, which means infection has spread throughout the body, including to other organs.
Symptoms can include:
- disturbances in heart rhythm, which can be caused by Lyme carditis
- neurologic conditions, such as numbness, tingling, facial and cranial nerve palsies, and meningitis
The symptoms of stages 1 and 2 can overlap.
What Is The Difference Between This Indirect Blood Diagnostic Test And A Direct Test
Direct diagnostic tests measure the presence of the bacteria directly and are much more reliable than tests looking for indirect measurement of antibodies that measure a persons immune response to an infection. Lyme disease diagnoses and disease management would benefit from validated diagnostic tests that directly measure the infection such as a culture, PCR test, or antigen detection tests. Direct tests are vital to the management of other infectious diseases such as HIV, hepatitis C, strep, and COVID-19, but have not yet become widely available for Lyme disease.
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Notice To Readersrecommendations For Test Performance And Interpretation From Thesecond National Conference On Serologic Diagnosis Of Lyme Disease
The Association of State and Territorial Public HealthLaboratory Directors, CDC, the Food and Drug Administration, theNational Institutes of Health, the Council of State and TerritorialEpidemiologists, and the National Committee for Clinical LaboratoryStandards cosponsored the Second National Conference on SerologicDiagnosis of Lyme Disease held October 27-29, 1994. Conferencerecommendations were grouped into four categories: 1) serologictest performance and interpretation, 2) quality-assurancepractices, 3) new test evaluation and clearance, and 4)communication of developments in Lyme disease testing. Thisreport presents recommendations for serologic test performance andinterpretation, which included substantial changes in therecommended tests and their interpretation for the serodiagnosis ofLD.
It was recommended that an IgM immunoblot be consideredpositive if two of the following three bands are present: 24 kDa * , 39 kDa , and 41 kDa . It was furtherrecommended that an that IgG immunoblot be considered positive iffive of the following 10 bands are present: 18 kDa, 21 kDa *,28 kDa, 30 kDa, 39 kDa , 41 kDa , 45 kDa, 58 kDa , 66 kDa, and 93 kDa .
The details of both plenary sessions and the work groupdeliberations are included in the publication of the proceedings,which is available from the Association of State and TerritorialPublic Health Laboratory Directors telephone 822-5227.
Negative C6 Elisa On Serum
Early clinical Lyme disease in the form of erythema migrans with associated history of a tick bite should be treated empirically. There is no need for testing unless there are further symptoms.
A negative ELISA result in the early stages of Lyme disease does not exclude infection. If acute Lyme disease is suspected but serology results are negative, we recommend that the test is repeated in 4-6 weeks with a fresh sample to look for seroconversion.
In patients with long term symptoms a negative ELISA test usually excludes Lyme disease as a cause of these symptoms. Information on differential diagnosis for patients with persistent symptoms and negative Lyme disease serology results is available.
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The Chance Of Getting Lyme Disease
Not all ticks in England carry the bacteria that causes Lyme disease.
But it’s still important to be aware of ticks and to safely remove them as soon as possible, just in case.
Ticks that may cause Lyme disease are found all over the UK, but high-risk places include grassy and wooded areas in southern and northern England and the Scottish Highlands.
Ticks are tiny spider-like creatures that live in woods, areas with long grass, and sometimes in urban parks and gardens. They’re found all over the UK.
Ticks do not jump or fly. They attach to the skin of animals or humans that brush past them.
Once a tick bites into the skin, it feeds on blood for a few days before dropping off.
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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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.
Key Points To Remember
- Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
- Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
- Antibodies normally persist in the blood for months or even years after the infection is gone therefore, the test cannot be used to determine cure.
- Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
- Some tests give results for two types of antibody, IgM and IgG. Positive IgM results should be disregarded if the patient has been ill for more than 30 days.
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How To Check For Lyme Disease After Tick Bite
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. How is Lyme Disease Treated?
How To Avoid Tick Bites
To reduce the chance of being bitten:
- cover your skin while walking outdoors and tuck your trousers into your socks
- use insect repellent on your clothes and skin products containing DEET are best
- stay on clear paths whenever possible
- wear light-coloured clothing so ticks are easier to see and brush off
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Lyme Disease Blood Test Results Fully Explained
The Lyme disease blood test is used to discover if someone who has the symptoms of a Borrelia burgdorferi infection actually has the bacteria in their bloodstream. Recent infections are much easier to detect and an IgM and IgG blood test will often be ordered as complimentary information gathering tools. This blood test does not always detect the presence of the disease, so patients that have persistent symptoms after having the test may be re-tested in a few weeks.
If any of these tests come back as positive, then other samples will be used to track the stage of the disease to determine if it has reached the chronic infection stage. At this point, a medical provider will order a Western blot test to confirm the presence of Lyme disease.
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
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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.
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.
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Who’s At Risk And Where Are Ticks Found
The risk of getting Lyme disease is higher:
- for people who spend time in woodland or moorland areas
- from March to October because more people take part in outdoor activities
Ticks are found throughout the UK and in other parts of Europe and North America. There are a high number of ticks in the Scottish Highlands.
It’s thought only a small proportion of ticks carry the bacteria that cause Lyme disease. Being bitten doesn’t mean you’ll definitely be infected. However, it’s important to be aware of the risk and speak to a GP if you start to feel unwell.