You Do Not Usually Need Tests To Show That You Have Lyme Disease
In most cases, theres a clear sign of Lyme diseasea painless, spreading rash that often grows to look like a bulls eye. If you have this rash, and you recently had a tick bite or were in an area known for Lyme disease, you dont need a test. Instead, your doctor can just start treating you with antibiotics, as appropriate.
How Are Humans Tested For Lyme Now And What Are The Shortcomings
They are serology antibody tests, tests that look for antibodies in a persons blood that might indicate infection with Lyme. They are the only ones approved by the U.S. Food and Drug Administration.
But these tests are indirect measuring only the bodys response to exposure to Borrelia burgdorferi, the microbe that causes the disease. So the antibody tests do not indicate active disease. They can only tell you, in the best circumstances, that youve been exposed to the microbe. It doesnt tell you when. Is it right now, or a year ago, or five years ago?
Another problem with the antibody tests is a high rate of false negatives if they are used too early in the first couple of weeks of the infection.
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.
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Sample Types For Lyme Disease Testing
For routine Lyme disease serological testing, you must send a serum sample .
For testing for neurological Lyme disease, you must send paired CSF and serum samples taken on the same day. If possible, please provide CSF cell count and total albumin, IgG and IgM values. If albumin, IgG and IgM measurements are not available, RIPL will make arrangements for these measurements at additional cost.
PCR testing is available. We recommend that specialists call RIPL to discuss appropriate sample types for PCR. These may include joint fluid, biopsy tissue, CSF and EDTA plasma. Please submit biopsies as fresh tissue in a sterile container, ideally with a drop of sterile saline to prevent the tissue drying out.
Can I Catch Lyme Disease From My Dog
Dogs are not a direct source of infection for people. Lyme disease cant be transmitted from one pet to another, nor from pets to humans, except through tick bites. However, a carrier tick could come into your house on your dogs fur and get on you.
If your dog is diagnosed with Lyme disease, you and any other pets have probably been in the same outdoor environment and may also be at risk, so it is a good idea to consult with your physician and veterinarian to see whether you should test other pets or family members.
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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 .
Figuring Out Your Exposure
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Completion Of Lyme Disease Test Request Form
Diagnostic samples must be submitted with a completed RIPLLyme disease test request form . Please use a single request form for each patient even when sending several samples.
Please provide details of the sample type, patients symptoms and onset date, tick bite or exposure history and, if relevant, travel and treatment history. Symptom onset date is particularly important for interpretation of laboratory results.
When sending CSF, please provide the cell count and total albumin, IgG and IgM levels for the CSF and serum pair, if available.
Ideally the clinician who sees the patient should print out and complete the appropriate request form . Send the request to the local laboratory with the clinical sample along with a local laboratory request form, whether this is paper or electronic.
The local laboratory should complete the senders information on the request form and then forward the completed form and sample to RIPL. Before sending samples, clinicians are advised to liaise with their local laboratory because local arrangements may vary.
If only immunoblot confirmation is required because the local laboratory has already obtained a positive Lyme screening test result on the serum sample being submitted, tick the Line blot confirmation only box and write the positive screening test result below.
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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Can You Use A Serology Test To Diagnose The First Stage Of Lyme Disease
Serology antibody tests are generally more helpful for second and third stages of Lyme disease than first stage Lyme disease. Antibodies take weeks to develop, and if the initial presentation of Lyme disease is in the early stage those antibody tests may be falsely negative because the immune system has not yet had enough time to produce antibodies. If a physician is suspicious of Lyme disease but cannot make a diagnosis by the rash, then the antibody test in that first stage should be repeated 3 to 4 weeks later since a Lyme disease diagnosis can be missed with a false negative test in the first few weeks.
The Centers for Disease Control and Prevention recommends using a two-step testing process. If an ELISA test is positive, it is then followed by a Western blot test. However, this antibody-based testing system can produce some false positive results and high numbers of false negative results, particularly in early infection.
In addition, the immune response to borrelia is heterogeneous, and not all cases are captured by current antibody-based diagnostics. Antibody testing can also be a problem in patients with early disease who are treated with antibiotics. In these cases, a follow up antibody test done after treatment may be negative and never turn positive.
A negative antibody test does not necessarily rule out Lyme disease and should always be considered in the context of a full health history and clinical assessment.
Bottom Line: Experts Say At
I would be a bit hesitant and a bit skeptical about using them, Dr. Dattwyler says. Home tests may not be covered by your insurance company if you have insurance, but it is typically an accepted health care expense if you have a flexible spending account or a health savings account . These tests can run anywhere between about $90 to $120, according to various at-home test company websites. So initially, this may cost less than getting tested through a medical provider if you dont have insurance or if your insurance doesnt cover Lyme disease testing.
But its not that simple. Again: Testing for Lyme disease is far from perfect even when its done in a qualified lab and analyzed by an expert. Add on the margin for user erroryoud need to collect a perfect blood sample during the ideal post-infection window and it would need to make it to its destination intactand youve got a recipe for misleading results.
Plus, even if you do test positive for Lyme disease using an at-home kit, you still need to see a doctor. Chances are, your physician wont accept an at-home test in place of a standard laboratory test, so they would likely recommend going through the official process anyway. They will also need to do a thorough assessment of your overall health because diagnosing Lyme relies on more information than a lab test alone, Dr. Dattwyler says.
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Where Are Ticks Found
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.
They can be found in any areas with deep or overgrown plants where they have access to animals to feed on.
They’re common in woodland and moorland areas, but can also be found in gardens or parks.
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.
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Can Lyme Disease Be Detected By A Blood Test
In a word: yes!
A blood test does not only detect Lyme disease it is the most accurate and preferred test for diagnosing the disease. If a patient with Lyme disease shows signs that the central nervous system has been affected by the disease, western blot testing on the cerebrospinal fluid can be performed. If ordering from Walk-In Lab, a doctors note is not needed. Just pick your Lyme disease test and place your order online.
Do I Need A Lyme Disease Test
Your doctor will consider whether your symptoms and risk factors suggest Lyme disease when deciding whether you need a Lyme test. Laboratory tests can support a clinical diagnosis, but should not be used on their own to confirm or rule out a current Lyme disease diagnosis.
Your doctor may also do tests to see if other conditions with similar or overlapping symptoms for example, thyroid disease, autoimmune disease, or other tick-borne diseases could be causing your symptoms. If you have been traveling, your doctor might test you for species of Borrelia that cause Lyme disease in other parts of the world.
If you think you may have Lyme disease, but your doctor hasnt considered it or has ruled it out before testing you for it, heres how you can start a conversation: Give your doctor a list of Lyme disease symptoms and risk factors , and ask them if, given your own symptoms and risk factors, Lyme disease could be a possible cause and whether you should be tested.
In some cases, a Lyme test may not be helpful. Using todays tests it is difficult to distinguish between current and previous infections, so if you were previously diagnosed with Lyme disease and may have been re-infected, your doctor should make the diagnosis based on your symptoms and risk factors.
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Additional Novel Diagnostic Approaches
Another approach to improve sensitivity for detection of early Lyme disease involves identifying diagnostic proteins and metabolites in serum of patients with Lyme disease. These methods, referred to as proteomics and metabolomics, respectively, are particularly appealing because they also have the potential to identify biomarkers indicative of cure . Researchers have also reported promising results using immuno-PCR, which combines the sensitivity of PCR with EIA-based antibody detection .
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 Do I Know If I Have Lyme Disease
In order to tell if you have Lyme disease, you may need to get a Lyme disease blood test. However, many cases are diagnosed through a combination of your personal history, exposure to tick bites, physical examination, and symptoms.
According to MedlinePlus, Lyme diagnostic tests identify the presence of antibodies that your body produces in response to the disease. However, it can take a few weeks for these antibodies to show up in your blood. If you get tested before this happens, a test for Lyme disease can come back negative even if you do have the condition.
However, testing can be very useful if the clinical diagnosis for your condition is unclear. According to the Mayo Clinic, there are different types of tests used to diagnose Lyme disease, including:
- Enzyme-linked immunosorbent assay test
- Western blot test
According to the CDC, its currently recommended to get both of these Borrelia burgdorferi tests done to confirm a Lyme diagnosis. The ELISA test should be done first if the result is positive, a Western blot test is done to confirm the diagnosis. If the ELISA result is negative, no further testing is needed.
Its also recommended that all children aged 3 months to 18 years are screened for Lyme disease if they live in or have traveled to an area with a high risk for Lyme disease transmission.
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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Does The Time Of Year Matter In The Diagnosis Of Lyme Disease
Since Lyme disease is a tick-borne infection, the seasonality of the disease is linked tightly to the life cycle and behavior of ticks. May, June, July, and early August are the biggest risk months for acquiring first stage Lyme disease in the US. This is the feeding time for nymph and adolescent ticks which are difficult to see. A viral-like illness in those early summer months might be Lyme disease. There is also some transmission of Lyme disease via adult ticks in the fall and winter and throughout the year anytime the temperature is above 40 degrees, but to a lesser degree.
The risk of acute Lyme disease is more of a year-round risk in more temperate regions such as northern California and the pacific northwest. Later stage Lyme disease, however, can manifest at any time.