Submission And Collection Notes
If European Lyme disease testing is required: enter ‘European Lyme disease’ under Test Description of the and provide travel history including location of travel and dates.
European Lyme is referred to the National Microbiology Laboratory in Winnipeg.
Indicate the following on the :
- date of onset
- exposure
How Is It Diagnosed
If youâve been outside in an area where ticks are known to live, you should tell your doctor. Theyâll also want to know about the symptoms youâre having. These details are crucial to making a diagnosis of Lyme disease.
Early symptoms that usually occur within the first month after a tick bite can include:
- Rash at the site of the tick bite that may look like a âbullâs-eyeâ
- Racing heart
- Problems with your short-term memory
Symptoms that come and go are common with Lyme disease. They will also depend on the stage of the disease.
Why It Is Done
A Lyme disease test is done to diagnose Lyme disease in people who have symptoms of Lyme disease. Symptoms may include:
- An expanding red rash with a pale centre. This is sometimes called a “bull’s eye” rash.
- Extreme tiredness.
- Headache and stiff neck.
- Muscle and joint pain.
Symptoms of chronic Lyme disease infection include joint pain, stiffness, and problems with the heart, brain, or nerves.
Testing is most accurate when you have risk factors for Lyme disease or symptoms of the disease.
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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.
Letsgetchecked Lyme Infection Test
LetsGetCheckeds kit tests for Borellia IgG and IgM antibodies through a fingerprick collection. The website states people should receive the test 57 days after ordering.
The company requires individuals to activate the kit, so they can collect the sample and send it back using the prepaid shipping label. They can then access their results on their online account within 25 days.
In addition, LetsGetCheckeds laboratories have a certification, meaning they are compliant with federal certifications.
This Lyme disease test costs $119 and comes with free shipping.
Pros and cons
The LetsGetChecked Lyme Infection Test features the following advantages:
- There is a nursing team available to discuss results.
- The company offers free shipping.
- People can pay through a health savings account or a flexible spending account .
However, the company also has some disadvantages. Firstly, its single-test kits can be expensive. Additionally, shipping is not available to all countries.
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High Endemicity Screening Of A Child
A healthy child from an area of high endemicity receives an annual physical. The mother notes that the child enjoys playing in the backyard, which is adjacent to a heavily wooded area.
Serologic testing should not be ordered because the child is asymptomatic. A false-positive test result would expose the child unnecessarily to the risks of treatment. In this scenario, the probability that a positive test represents true infection is less than 25 percent.
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.
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Learn More About Lyme Disease Diagnosis Testing
Tests can not only help to diagnose a disease, but also to manage an illness. A good test can help a doctor assess the severity of disease, estimate the patients prognosis, monitor the course of disease progression, stability or resolution, detect relapse, and select drugs or adjust therapy. Unfortunately, a test with this capability does not exist for Lyme disease. To learn more about specific tests, visit: Lyme Disease Tests.
LymeDisease.org has developed a Lyme disease symptom checklist to help you document your exposure to Lyme disease and common symptoms for your healthcare provider. You will receive a report that you can print out and take with you to your next doctors appointment that may be helpful in your Lyme disease diagnosis.
References Choosing A Test
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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.
What Is An At
An at-home Lyme disease test will typically be a blood finger prick test.
If you have been exposed to the bacteria Borrelia that leads to the infection of Lyme disease, your body will have created two antibodies to fight it off. The test will look for the presence of both types of antibodies, known as immunoglobulin M and immunoglobulin G .
You will receive your test kit along with account information so that you can get your test results as soon as they are ready. Follow the manufacturers instructions exactly as they are described.
Each test has different instructions, so its very important that you read the kits detailed information before getting started.
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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.
Investigation Of Suspected Lyme Disease
Erythema migrans is a clinical diagnosis and does not require confirmation by laboratory testing. Lyme disease is not a notifiable disease so there is no statutory requirement to notify clinically suspected cases to the local Health Protection Team.
The 2018 NICE Lyme disease guideline provides detailed advice about when a diagnosis of Lyme disease should be suspected and about which tests to use and when.
The NICE Lyme disease guideline also contains a useful summary diagram of the routine serological testing recommendations for Lyme disease.
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Borrelia Species Pcr Results
Borrelia species DNA may occasionally be detected in the blood by PCR, but a negative PCR test is of no value in excluding localised Lyme disease.
The overall sensitivity of PCR on a skin biopsy of an EM or ACA rash is around 50% and is limited by the chance of a single biopsy hitting a site with a significant number of organisms.
In neurological Lyme disease involving the CNS, up to 10% of cases may be PCR positive on a CSF sample a negative PCR result does not exclude the diagnosis.
Synovial fluid may be positive by PCR in up to 50% of cases. A negative result does not exclude the diagnosis.
Figuring Out Your Exposure
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How Will Pregnancy Affect Treatment For Lyme Disease
Early treatment of Lyme disease during pregnancy is important. Thats because if Lyme disease is left untreated, it can affect the placenta. According to the CDC , transmission of Lyme disease from mother to fetus is possible, though rare.
For pregnant people, treatment includes a round of antibiotics. Certain treatments for Lyme disease may not be used, as they can affect the fetus. If you suspect that you have Lyme disease, talk with a healthcare professional immediately.
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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Serological Testing Of Csf For The Diagnosis Of Neurological Lyme Disease
Serological testing for neurological Lyme disease is based on demonstrating intrathecal synthesis of Borrelia-specific antibodies in CSF. For laboratory testing for neurological Lyme disease, separate IgG and IgM ViraChip® serology assays are performed on CSF and paired serum and the results compared.
CSF samples must be tested in parallel with a contemporaneous serum sample and protein and immunoglobulin levels compared between the two sample types to produce a meaningful result.
For necessary sample types and volumes see Sample types for Lyme disease testing
Why Lyme Is Tough To Diagnose
- Lyme symptoms are similar to other illnesses, so misdiagnosis is common.
- Many Canadian doctors are unfamiliar with Lyme, so they dont test for it or administer the wrong tests.
- Only a handful of blood tests effectively detect Lyme bacteria, so the infection is often missed.
Dont get discouraged if you get a negative diagnosis. Seek out second, and even third, opinions if you must!
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What Happens If You Go Untreated For Lyme Disease
If you happen to test positive for Lyme disease but go untreated, then your symptoms may increase significantly. You may develop early-onset arthritis, facial palsy, and inflammation of the brain stem and spine. Those symptoms can affect how your brain works and your ability to function cognitively.
Everlywell Lyme Disease Test
Everlywells Lyme Disease Test checks for a persons exposure to any of the three strains of Borrelia bacteria. The test is suitable for those experiencing fatigue, headaches, or joint pain. The test offers a fingerprick sample collection.
Once people receive their kits, they can register them online, collect their sample, and return it to the labs using the prepaid shipping labels. They can access their results through their online dashboards.
The kit costs $109.
There are some advantages that Everlywell services offer:
- It works with CLIA-certified labs.
- Independent board-certified physicians review and approve peoples tests.
- It offers free shipping.
QuestDirects Lyme Disease Test is available in person. People purchase their test and book an appointment with a nearby Quest Patient Service Center, where a medical professional collects the sample.
They then receive their results through their MyQuest accounts.
The cost for the test is $89, with an additional $6 fee that covers the physicians visit.
Pros and cons
QuestDirect has some advantages. Firstly, the MyQuest portal allows individuals to view their results online. Additionally, the companys health team can contact the customer if their results require prompt attention.
However, disadvantages include the fact that there is an additional physician fee. The service is also unable to provide a receipt for health plan reimbursement.
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Current Problems With Lyme Disease Diagnosis & Patient Care
- Diagnostic tests cannot yet accurately identify the earliest stage of Lyme disease when making the diagnosis is crucial.
- The rash is not always present or easily recognized
- Misdiagnosis and delayed diagnosis can make Lyme disease more difficult to treat and lead to prolonged and debilitating illness
- Early symptoms can be mistaken for a summer flu
- Lyme disease can involve several parts of the body, including joints, connective tissue, heart, brain, and nerves, and produce different symptoms at different times.
- Antibody testing done after early treatment may be negative and never turn positive for some cases
- Borrelia burgdorferi can evade our protective immune system and trigger immune system dysfunction.
- No reliable blood test is presently available to measure treatment success, necessitating close clinical follow up and improved physician education.
- Presently there is no vaccine to prevent Lyme disease available to humans.
Laboratory Tests That Are Not Recommended
Some laboratories offer Lyme disease testing using assays whose accuracy and clinical usefulness have not been adequately established. Examples of unvalidated tests include:
- Capture assays for antigens in urine
- Culture, immunofluorescence staining, or cell sorting of cell wall-deficient or cystic forms of B. burgdorferi
- Lymphocyte transformation tests
- In-house criteria for interpretation of immunoblots
- Measurements of antibodies in joint fluid
- IgM or IgG tests without a previous ELISA/EIA/IFA
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Persistent Symptoms Following Treatment
In most cases, timely treatment according to the appropriate regimen described in the chart above is effective. However, some Lyme disease patients have persistent symptoms following treatment. Research continues into the causes and methods of treatment.
There is no definitive evidence that persistent symptoms represent ongoing infection. Post-infectious inflammation due to damage from the infectious process may respond to anti-inflammatory drugs.
Lyme Disease Diagnosis And Testing Highlights
- LLMDS consider the specificity of the particular bands that test positive for a patient.
- Although the CDC requires 5 of 10 bands for IgG surveillance purposes, 2 of 5 bands have specificity of 93-96% and a sensitivity of 100%. .
- 56% of patients with Lyme disease test negative using the two-tiered testing system recommended by the CDC.
- The CDC case surveillance definition allows single-tier IgG immunoblot seropositivity using established criteria.
- The CDC states: This surveillance case definition was developed for national reporting of Lyme disease it is not intended to be used in clinical diagnosis.
- The College of American Pathologists found that ELISA tests do not have adequate sensitivity to be used for screening purposes.
- 52% of patients with chronic disease are negative by ELISA but positive by Western blot.
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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.