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.
Lyme Disease Test: How To Check For Lyme Disease
27 Sep 2022
- Dr. Andrea Pinto Lopezon September 28, 2022
Vector-borne diseases are infectious diseases which are spread through a type of insects called arthropods. These insects include ticks, mosquitoes, fleas, and triatomine bugs. If you live in certain areas of the United States, its very likely that youve heard about Lyme disease in the past. This disease is relatively common in some locations of the country. It can cause a wide range of symptoms that range in severity, but how do you check for Lyme disease?
Keep reading to find out the answers to all your questions about Lyme disease detection now.
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.
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Other Lyme Disease Tests
Three other tests that may be used to diagnose Lyme disease are polymerase chain reaction , antigen detection and culture testing. They are called direct tests because they detect the bacteria, not just your immune response to it.
PCR multiplies a key portion of DNA from the Lyme bacteria so that it can be detected. While PCR is highly accurate when the Lyme DNA is detected, it produces many false negatives. This is because the Lyme bacteria are sparse and may not be in the sample tested.
Antigen detection tests look for a unique Lyme protein in fluid . Sometimes people whose indirect tests are negative are positive on this test.
Culture is the gold standard test for identifying bacteria. The lab takes a sample of blood or other fluid from the patient and attempts to grow Lyme spirochetes in a special medium.
Although culture tests are generally accepted as proof of infection, the CDC has advised caution on the only commercially available culture test developed by Advanced Laboratory Services. LDo recognizes that the test is new and requires further validation in other studies. However, we believe that informed patients should be able to choose the test if they prefer. Choice is particularly important given the low quality of Lyme disease tests generally.
Treatment For Lyme Disease
Lyme disease is commonly treated with antibiotics, the most common being doxycycline. However, the specific antibiotic depends on many factors such as known allergies and interactions with other medications. All medications taken for any illness should be prescribed by a healthcare professional. While antibiotics like doxycycline may be easy to obtain online, exact dosages depend on the individual. Improper dosage of antibiotics can cause resistance, ineffectiveness, illness, or even death in some cases.
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.
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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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 doctor 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 Puja Uppal, DO, a board certified family medicine physician and the chief medical officer at Think Healthy.
A doctor 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.
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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British Columbia Specific Information
Ticks are tiny bugs which feed on blood. For information on ticks, removing ticks, and how to avoid being bitten, see HealthLinkBC File #01 Tick Bites and Disease. You may also be interested in the HealthLinkBC File #96 Insect Repellent and DEET.
While most tick bites do not result in diseases, some can. Some of the diseases passed on by ticks include relapsing fever, tularemia, Rocky Mountain Spotted Fever , Q Fever and anaplasmosis. The most well-known is Lyme disease. For more information on Lyme Disease, visit BC Centre for Disease Control – Lyme Disease .
How To Remove A Tick
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Lyme Disease Treatment Options
Early detection and treatment of Lyme are crucial. Most Lyme disease infections clear up with the help of a course of antibiotics you can take at home.
In some cases, however, people who are treated with antibiotics may continue to experience symptoms. When this happens, its called chronic Lyme disease or post-treatment Lyme disease syndrome. Doctors may treat chronic Lyme disease with a continued course of antibiotics, but the treatment often also involves managing symptoms like pain and inflammation.
If youre experiencing symptoms of Lyme disease and think you may have been bitten by a tick and were in an area where it is common, seek medical care as soon as possible. If certain symptoms and risk factors are present, doctors will typically treat for Lyme disease without waiting for a test result.
How To Test For Lyme Disease
This article was medically reviewed by Sarah Gehrke, RN, MS. Sarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013.There are 7 references cited in this article, which can be found at the bottom of the page. This article has been viewed 11,511 times.
Lyme disease, caused by spirochetal bacteria, is found in wild animals, particularly deer and rodents. Ticks carry the disease between these animals, as well as to humans. To test for this disease, use a two-step process that consists of the ELISA test and the Western blot test. Before these tests are performed, a doctor will use your likely exposure to the disease and your presentation of symptoms to determine if they should do these tests.
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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 UK Health Security Agency Porton where ISO15189 accredited confirmatory testing is also provided. RIPL also provides 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.
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When To Get A Tick Tested
You should strongly consider having your tick tested if:
- The tick was attached to your body, not simply crawling around
- You live in or have visited a place where there are infected ticks
Lyme disease has been reported in 49 US states and 65 countries around the world. Infected ticks have been found in 42 of 58 California counties. See here for a CDC map showing geographic reporting of Lyme disease.
In addition, tick testing may be especially important if there is skepticism about the presence of Lyme disease in your community.
If you are showing symptoms call your doctor immediately. Take the tick with you and ask your doctor about a tick test. Keep in mind that symptoms may take weeks or longer to appear. It may also take several weeks to get back the results of a tick test.
Note: tick testing is not a substitute for clinical diagnosis. Tick testing provides information about whether and/or what pathogens the tick may be carrying and about potential risk to the individual bitten by the tick, but it is not an assessment of human infection. You should consult your doctor for medical advice or treatment.
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When Should I Test For Lyme Disease
Lyme disease can sometimes show no obvious signs or symptoms for weeks, months, or even years . If symptoms do the show, they may include:
- Red target-like skin rash
- Muscle and joint aches
It can take 2-6 weeks after a tick bite for the Lyme Disease Test to identify antibodies in the blood. If you are concerned about Lyme disease you should consider testing 6 weeks after the tick bite. If you develop the erythema migrans rash, or if you experience any neurological symptoms, you should contact your doctor immediately.
The earlier the infection is identified, the easier it becomes to treat. This, along with the fact obvious signs dont always emerge, makes it so important to take a Lyme Disease Test if you believe youve been exposed to ticks during any outdoor adventures. The process is simple:
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.
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Serological Testing Of Serum For The Diagnosis Of Lyme Disease
The most commonly used tests look for antibodies to the Borrelia species that cause Lyme disease in the UK and Europe, but they also detect infections from strains of Borrelia from the US.
The antibody response takes several weeks to reach a detectable level, so antibody tests in the first few weeks of infection may be negative. If the first sample was taken within 4 weeks from the onset of symptoms and is negative and there is a clinical suspicion of Lyme disease, then retesting in 4 to 6 weeks may be useful.
It is very rare for patients to have negative antibody tests in longstanding infections. Borrelia antibodies persist indefinitely in some patients and this does not indicate continuing disease or a need for re-treatment.
Serological testing for Lyme disease in the UK and much of the world follows a two-step approach:
Signs And Symptoms Of Untreated Lyme Disease
Seek medical attention if you observe any of these symptoms and have had a tick bite, live in an area known for Lyme disease, or have recently traveled to an area where Lyme disease occurs.
Untreated Lyme disease can produce a wide range of symptoms, depending on the stage of infection. These include fever, rash, facial paralysis, and arthritis.
The appearance of the erythema migrans rash can vary widely.
- Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes may occur in the absence of rash
- Erythema migrans rash :
- Occurs in approximately 70 to 80 percent of infected persons
- Begins at the site of a tick bite after a delay of 3 to 30 days
- Expands gradually over several days reaching up to 12 inches or more across
- May feel warm to the touch but is rarely itchy or painful
- Sometimes clears as it enlarges, resulting in a target or bulls-eye appearance
- May appear on any area of the body
- Does not always appear as a classic erythema migrans rash
- Severe headaches and neck stiffness
- Additional EM rashes on other areas of the body
- Arthritis with severe joint pain and swelling, particularly the knees and other large joints.
- Intermittent pain in tendons, muscles, joints, and bones
- Heart palpitations or an irregular heart beat
- Episodes of dizziness or shortness of breath
- Inflammation of the brain and spinal cord
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