Thursday, May 19, 2022

Testing For Lyme Disease In Humans

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Bartonella Suppresses The Immune System

Testing for Lyme DiseaseWhat You Need to Know

Another mechanism Bartonella uses to ensure its survival in humans is by suppressing the immune system response. A class of chemical compounds secreted by the immune system called cytokines influence the immune response. Bartonella stimulates the cytokine interleukin-10 , which is an essential regulator of the immune system response.

When IL-10 is present, the function of immune cells is suppressed interfering with innate and adaptive immunity. The result is a lower level of inflammation that minimizes tissue damage and, therefore, symptoms. However, immune suppression by IL-10 allows the Bartonella to persist in the infected person.

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.

These symptoms are often compared to fibromyalgia and chronic fatigue syndrome.

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

References Choosing A Test

  • Wormser GP, Liveris D, Hanincova K et al. Effect of Borrelia burgdorferi genotype on the sensitivity of C6 and 2-tier testing in North American patients with culture-confirmed Lyme disease. Clin Infect Dis, 47, 910-914 .
  • Wormser GP, Schriefer M, Aguero-Rosenfeld ME et al. Single-tier testing with the C6 peptide ELISA kit compared with two-tier testing for Lyme disease. Diagn Microbiol Infect Dis, .
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    How Do You Test For Lyme Disease With An At

    Hereâs how to check for Lyme disease with the Everlywell test.

    To take our at-home Lyme Disease Test, collect a small sample of blood with a simple finger prick. Youâll then send the sample to a lab for analysis , and youâll be able to view your results on our secure, online platform.

    Consider taking this Lyme test if:

    • You have traveled to areas infested with ticks that can transmit Lyme bacteria , found ticks on your body, and are now experiencing symptoms of Lyme disease.
    • If you believe you have been exposed to a tick and are experiencing symptoms , taking this antibody test can help assess for Lyme disease. If you have been tested previously, but are now having new symptoms, this Lyme disease test kit can also help.

    Early Localized Lyme Disease

    Lyme Disease ELISA Test Archives

    Early localized Lyme disease usually presents as an acute illness characterized by:

    • fever
    • headache
    • 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:

    • blistering
    • 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

    • fatigue

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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.

    Which Is The Best At

    All four Lyme disease tests on this list are great choices, but my top recommendation is LetsGetChecked, thanks to fast results, reliability, competitive pricing, and global shipping of tests.

    Everlywellprovides the best value-for-money, testing for three strains of Borrelia bacteria with one kit, ideal if youre unsure which type of tick has bitten you, or you just want to cover all your bases.

    The cheapest test is from Personalabs, as there are no shipping or kit costs involved when you go directly to the lab to provide your sample.

    If you live in an area where ticks are common, knowing your potential risk of developing Chronic Lyme disease could prove useful. With information from SelfDecode, you will know the importance of getting treatment early if you have a suspected tick bite.

    At-home testing doesnt end with Lyme disease. Why not find out what information is hidden within your genes with the best at-home cheap DNA tests.

    Recommended Reading: Early Symptoms Of Lyme Disease

    Lyme Disease Diagnosis And Laboratory Testing

    Lyme disease is diagnosed based on the presence of symptoms, a physical exam, the possibility of exposure to infected ticks and, if necessary, laboratory testing. If your health care provider suspects Lyme disease, you may be asked to provide a blood sample for testing.

    Public health and laboratory experts in Canada, the United States and worldwide support the 2-step testing used in Alberta as the best laboratory method for supporting the diagnosis of Lyme disease. These high standards help protect individuals from misleading false-positive results and unnecessary treatments.

    In Alberta, laboratory testing for the first step is done by the Provincial Laboratory for Public Health. The second verification step is done by the National Microbiology Laboratory in Winnipeg to reduce the chances of false-positive results.

    The Alberta government advises against the use of laboratory testing offered by some private laboratories outside of Canada. Some of these laboratories use non-standardized testing methods. These methods may report a higher number of false-positive results.

    False positives can result in misdiagnosis that can lead to a delay in finding the actual cause of an individuals illness, as well as unnecessary, expensive and sometimes harmful treatments.

    A 2014 study found that one alternate United States laboratory had incorrectly diagnosed Lyme disease in up to 57% of healthy people who did not have Lyme disease.

    Can Infection Be Spread Directly From One Dog To Another Dog Or From My Dog To My Family

    Officials harvest ticks, test for Lyme disease in Sacramento area

    Direct spread of Lyme disease from one dog to another dog has not been reported, even when infected and uninfected dogs have lived together for long periods.

    Spread of Lyme disease from dogs to people has not been reported either, but people are equally at risk for Lyme disease if they are bitten by an infected tick.

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    Choosing A Lyme Disease Test

    Often the diagnosis of Lyme disease depends upon the physicians readiness to listen and ask questions and on the mutual exchange of information, beginning with the initial doctor-patient interview.

    Often the diagnosis of Lyme disease depends upon the physicians readiness to listen.

    Lyme disease should be diagnosed clinically, without reliance on testing. However, all too often, physicians will ignore clinical presentations if laboratory tests are negative. Yet there are numerous scientific articles documenting false negatives and low sensitivity of such tests.

    There can be several reasons for the inaccurate results. The sensitivity of the tests varies greatly depending upon how long an individual has been infected and on the type of clinical manifestations. If a patient has received antibiotics in the early stage of the disease, antibody levels may be too low to be detected or nonexistent. Antibodies to Borrelia burgdorferi do not appear in the blood until several weeks after the tick bite. The Lyme bacteria are not always present in the blood. The person could have been infected with a strain of Bb that is not covered in testing.

    That said, laboratory tests can be used to support the diagnosis. Because of the varied presentations and necessity of relying on a patients symptoms, several tests may be helpful.

    The ELISA and Western blot are the most common tests used to diagnose Lyme disease. Both tests measure antibodies to Bb, the bacterium that causes Lyme disease.

    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
    • headache
    • 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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    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.

    If The C6 Test Is Positive What Is The Next Step

    Natural Strategies to Overcome Lyme Disease

    A positive C6 test means antibodies to C6 were found. The next step is to do a QC6 test, which determines if the levels of antibody are high enough to justify treatment. If the value of the QC6 is higher than 30 IU/mL and signs of illness are present, then antibiotic treatment should be considered. If the QC6 is less than 30 IU/mL and there are no signs of illness, then treatment may not be necessary.

    In addition to doing the QC6 test, your veterinarian may want to take samples of blood and urine to assess kidney function and to look for protein in the urine. A positive test for protein in the urine could signal serious underlying kidney disease.

    Read Also: How Do You Contract Lyme Disease

    Bartonella: More Problematic Than Lyme Disease

    Bartonellosis, the infection caused by the bacteria Bartonella, is possibly a more problematic human infection than Lyme disease. Like Lyme disease, Bartonella can be transmitted to humans through a tick bite. However, Bartonella can also be transmitted to humans by various other vectors. Historically, testing for Bartonellosis has been insensitive. Bartonella causes similar symptoms as Lyme disease but requires different treatment so is important to identify. However, the biggest concern Bartonella poses over Lyme disease is most physicians are entirely unaware of this prevalent bacteria.

    Laboratory Testing Of Ticks For Surveillance

    Only ticks that have been requested to be submitted to the lab following photo identification through eTick will be accepted for testing at the lab. This ensures the best use of laboratory services. Most ticks found in Alberta are not the type that can transmit Lyme disease.

    Note that Alberta Health Services Environmental Public Health and Indigenous Services Canada First Nations and Inuit Health Branch offices are not accepting tick submissions.

    If you are asked to submit your tick to the Alberta Public Health Laboratory through eTick, complete and print the Tick Testing Request form that must accompany your tick to the lab . Submitting a tick to the lab when requested is optional. By submitting the tick when requested, you are helping Alberta Health to monitor for ticks of public health concern in Alberta.

    Members of the public can drop off their completed Tick Testing Request form and tick specimen at a local lab location, or send it by mail.

    Collection, shipping instructions, drop off locations and mailing address are provided on the Tick Testing Request form as well as below:

  • Place the tick in a small hard plastic container with a tight fitting lid such as clean empty pill bottle. DO NOT USE GLASS CONTAINERS OR STRAWS.
  • Label the container with the e-Tick identification number provided to you in your e-Tick notification.
  • Place the container in a clean plastic bag and close securely .
  • Complete the Tick Testing Request form for downloadable document)
  • Mail to:
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    The Blood Tests Can Have False Positives

    The blood tests can trigger false positives, suggesting that you have the disease when you really dont. This can happen in up to one out of four tests.

    This can lead to unnecessary treatment with antibiotics. These drugs are usually safe, but they sometimes cause side effects, such as nausea, vomiting, diarrhea, and increased sensitivity of the skin to sunlight. In rare cases, they can even cause dangerous allergic reactions.

    Using too many antibiotics can also lead to the growth of drug-resistant bacteria. This means that bacteria in your body may get stronger and more difficult to treat with antibiotics in the future.

    A false positive can also lead to more unneeded blood tests, urine tests, X-rays, and doctor visits.

    If you have a false positive, you may not get treated for the real cause of your pain. For example, rheumatoid arthritis is a disease that causes joint pain. It can lead to permanent and severe joint damage if you do not start taking the right medicines as early as possible.

    Lyme Disease Test Western Blot

    What’s the Best Test for Lyme Disease?

    Labs performing a Western blot use electricity to separate proteins called antigens into bands. The read-out from the Western blot looks like a bar code. The lab compares the pattern produced by running the test with your blood to a template pattern representing known cases of Lyme disease. If your blot has bands in the right places, and the right number of bands, it is positive.

    The CDC requires 5 out of 10 bands for a positive test result. However, because some bands on the Western blot are more significant than others your doctor may decide you have Lyme disease even if your Western blot does not have the number of bands or specific bands recommended by the CDC. Different laboratories use different methods and criteria for interpreting the test, so you can have a positive test result from one lab and a negative test result from another.

    For a comprehensive explanation of the western blot test, download Understanding Western Blot Lyme disease test.

    The chart below will help you understand how to interpret the western blot test.

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    Alternative Diagnostic Tests Not Available At Ripl

    Tests used in the NHS and PHE to identify Lyme disease are well characterised, standardised, and are highly reproducible between laboratories. They are the methods of choice recommended in the 2018 NICE Lyme disease guideline, following an extensive review of the evidence and literature. International external quality assurance schemes are in place to ensure consistency between different centres offering these tests.

    Several private laboratories in Europe and the USA offer an alternative type of test called an ELISpot to diagnose Lyme disease. This looks for different markers in blood samples compared to conventional validated Lyme disease serology tests. The laboratories using these tests in the diagnosis of Lyme disease do not publish their methods, and have not produced any peer reviewed publications on their clinical value.

    This makes it very difficult to verify their results, especially as there are no national or international EQA schemes for Lyme disease ELISpot tests and therefore no independent verification of performance between laboratories. Without independent evidence it is impossible to determine the validity of results produced using these alternative tests.

    RIPL cannot interpret the results of alternative diagnostic tests.

    Bartonella Contributes To Small Vessel Disease

    Bartonella has a preference for the cells that line blood vessels called endothelial cells. Bacteria inside of the vessel wall create inflammation and fibrin deposition, causing narrowing of the vessel where blood flows. Blood vessel constriction reduces blood flow and oxygen delivery to organs and tissues. Decreased oxygen causes damage to tissue and leads to loss of function to cells contributing to symptoms. Tissue that receives blood from small vessels like capillaries is most at risk.

    The central nervous system especially the brain is susceptible to decreased oxygen delivery. The white matter of the brain does not have collateral circulation, so neurological symptoms manifest early in an infection with Bartonella. Symptoms such as cognitive impairment, disconnection syndrome, poor executive function , decreased working memory, delayed processing speed, and mood swings are associated with small vessel disease caused by Bartonella.

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