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.
Symptoms Diagnosis And Treatment
Symptoms of Lyme disease vary and may develop days or weeks after a person is infected from a tick bite. Early symptoms may include:
- Fever, chills, headache, muscle and joint pain, fatigue or swollen lymph nodes.
- A rash at the site of the tick bite develops in 70 to 80 per cent of people infected.
- A distinctive expanding, red ‘bulls-eye’ rash may develop at the site of the bite in some people.
- Later symptoms may include dizziness, abnormal heartbeat, mental confusion or inability to think clearly , nervous system disorders .
Getting a diagnosis of Lyme disease can be difficult as your symptoms may be similar to other illnesses. Inform your health care provider of any travel outside of the province and whether you have developed a rash around a recent tick bite.
Prevention and early diagnosis of Lyme disease are important. Consult a health care provider as soon as possible if you think you may have Lyme disease. The earlier you receive a diagnosis and treatment, the better your chances to make a full recovery.
Your health care provider should:
- review your symptoms
- find out if you were in an area at risk of having Lyme-infected blacklegged ticks
- do a physical examination and
- order laboratory blood tests to see if you have certain antibodies that could indicate you have the disease.
- sleep disturbance
- muscle and joint pain or
- mental confusion or inability to think clearly.
Living With Lyme Disease
Most people treated in the early stages of Lyme disease make a quick and complete recovery. Some may experience symptoms for a few weeks after treatment. If you were treated for Lyme disease but you still dont feel well, call your family doctor. He or she can make sure there isnt something else wrong. They can help you find ways to ease your symptoms. Some patients have found relief with treatments typically used for chronic fatigue syndrome or fibromyalgia.
Other things you can do to help manage Lyme disease include:
- Educate yourself.There is a lot of inaccurate information to be sorted through, especially on the internet. Ask your doctor if you have questions.
- Track your symptoms.Keep a diary of your sleep patterns, eating habits, exercise routines, and how youre feeling. You or your doctor may be able to make connections between them.
- Take care of yourself.Eat a healthy diet. Exercise as regularly as you can. Get plenty of rest.
Find support. It can be hard to not feel well and not know why. Some people may think your symptoms arent real. Talk to friends and family. If they cant offer support, talk with a counselor who can help you.
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Inspection And Tick Removal
Because recommendations for avoidance are not always practical, particularly for children and during the summer, daily close inspection for ticks should be performed each time one has been outdoors. Parents of children in endemic areas must be vigilant to check for ticksespecially the nymphs, because of their smaller size from the spring to the fall. Checking inside skin folds, behind ears, the umbilicus, groin, axilla, hairline, and scalp must be routine. If one tick is found, search thoroughly for others.
See the image below for a tick removal diagram and instructions.
While these instructions may represent the optimal method for removing the tick, it is more important to remove it promptly than to delay removing it while obtaining forceps or gloves.
A common misperception is that pressing a hot match to the tick or trying to smother it with petroleum jelly, gasoline, nail polish, or other noxious substances is beneficial. This only prolongs exposure time and may cause the tick to eject infectious organisms into the body. Finally, do not squeeze, crush, or puncture the body of the tick because its fluids may contain infectious organisms.
Once the tick is removed, wash the bite area with soap and water or with an antiseptic to destroy any contaminating microorganisms. Additionally, the person who removed the tick should wash his or her hands. The removed tick should be submitted for species identification.
How Soon After A Tick Bite Can You Get An Antibody Test
Several weeks after infection, FDA cleared tests have very good sensitivity. Some people who receive antibiotics early in disease may not have a fully developed antibody response or may only develop an antibody response at levels too low to be detected by the test.
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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.
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.
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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.
Can You Test For Lyme Disease After A Tick Bite
Diagnostic testing is not recommended for individuals who do not develop any symptoms suggestive of Lyme disease after a tick bite. Some commercial companies offer services to test removed ticks for the presence of the bacteria that cause Lyme disease. PHE does not provide such tick-testing services.
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Protect Yourself From Ticks
While most ticks do not cause serious health problems, it is important to protect yourself, your family and even your pets from tick bites. It is also important to remove attached ticks immediately in order to avoid potential infection or diseases that can be transmitted from the bite. Some tips to prevent tick bites include:
- Walk on cleared trails whenever possible and avoid walking in tall grassy or wooded areas.
- Wear light-coloured clothing and cover up as much skin as possible. For example, a hat, long-sleeved shirt and long pants with the legs tucked into socks or boots.
- Use a bug spray that contains the chemical DEET or Icaridin to repel ticks and reapply as frequently as directed.
- Check yourself for ticks after leaving a grassy or wooded area where ticks may live.
- Check your pets for ticks after they have been outside. You cannot get Lyme disease from your pet, but your pet can bring infected ticks inside. These ticks can fall off your pet and attach themselves to you.
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.
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What Does An At
Once ordered, an at-home Lyme disease test kit is delivered to your home, where you can collect the sample privately and comfortably. The kit will include the instructions, the sample collector, and the box to return the sample.
Once the results are ready, you will receive them in your email or through the company’s online portal, or they will be sent to your doctors office.
What Happens During Lyme Disease Testing
Lyme disease testing is usually done with your blood or cerebrospinal fluid.
For a Lyme disease blood test:
- A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
If you have symptoms of Lyme disease affecting your nervous system, such as neck stiffness and numbness in hands or feet, you may need a test of cerebrospinal fluid . CSF is a clear liquid found in your brain and spinal cord. During this test, your CSF will be collected through a procedure called a lumbar puncture, also known as a spinal tap. During the procedure:
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Is Lyme Disease Curable
While there is no vaccine to prevent us from getting Lyme disease, it can be treated with antibiotics, and most people recover within a few weeks. However, some people can get what is known as Post-Treatment Lyme Disease Syndrome, in which symptoms such as pain, fatigue, or difficulty thinking can last for months.
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.
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The Following Are The Most Common Misunderstood Facts About Tick Bites:
How To Remove A Tick Safely
Although the risk of Lyme disease is very low in Alberta, there are other tick-borne diseases that can be transmitted by ticks.
It is important to properly remove a tick as soon as possible. Removing a tick 24 to 36 hours after a tick bite usually prevents Lyme disease from developing.
If a tick is attached to your skin, you can safely remove it.
- Using tweezers, gently grasp its head and mouth parts as close to your skin as possible to avoid leaving mouthparts in the skin or crushing the tick.
- Without squeezing the tick, slowly pull the tick straight up off the skin do not jerk or twist it.
- Do not apply matches, cigarettes, dish soap, petroleum jelly or any other substance to the tick. This will not encourage the tick to detach and may cause it to release infectious blood back into the wound.
- Once the tick has been removed, clean the bite area with soap and water and disinfect the area with an antiseptic. Wash hands with soap and water.
- Consider submitting a photograph of the tick to the Submit-a-Tick program.
- If you do not plan to submit a photograph of the tick to the Submit-a-Tick program, you can kill the tick by placing it in a freezer for 24 hours, or putting it in rubbing alcohol. Once killed, dispose of it by flushing it down the toilet, or placing it in the garbage. Avoid crushing a tick with your fingers as they may be filled with blood and other infectious material.
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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.
So When Do You Need Blood Tests For Lyme Disease
In some cases, you can have Lyme disease without the rash. Or you may not see the rash before it goes away on its own.
In these cases, your doctor should ask you about your medical history and do a thorough physical exam. Your doctor should look for these signs that you might have Lyme disease:
- You were in an area with ticks and Lyme disease.
- You also have fever or redness, warmth, and swelling in one or a few joints at a time usually the knees, shoulders, or wrists.
Other symptoms can occur later on. Talk to your doctor about testing and treatment choices.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
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The Best Test For Lyme Disease
Lyme disease is a tick-borne illness spread by Lyme borreliaebacteria which includes, but is not limited to, Borrelia burgdorferi sensu stricto. The Centers for Disease Control and Prevention estimate that there are 400,000 cases of Lyme disease annually, making Lyme a serious public health concern that only stands to grow as the spread of ticks affects disease endemicity and seasonality.
One of the biggest challenges of fighting Lyme disease is providing patients with accurate diagnostic tests. Without access to the best tests for Lyme disease, its impossible to diagnose this treatable disease in a timely manner. When the disease isnt caught in time, it can spread throughout the body and cause chronic health problems that could otherwise be avoided with earlier detection and treatment.