Does My Healthcare Provider Include A Blood Test For Genital Herpes When They Test Me For Everything
Herpes blood tests may or may not be part of the tests your healthcare provider gives you. They may choose tests based on several factors .
They will also evaluate you for signs or symptoms of herpes to choose which tests to use. This is why its important to talk openly and honestly with your provider during your visit. Ask them which infections they are and are not testing you for and why.
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Igenex Lyme Disease Test
People who wish to buy a test kit from IGeneX have to pay a $20 deposit fee. They need to complete the paperwork with their doctor to determine which tests they should use.
Afterward, an individual can collect their sample at home and mail it to IGeneX. The company then sends the results to the doctor.
The tests cost $295546.
People who use IGeneX may benefit from some of its advantages:
- The testing centers are CLIA-certified.
- Doctors help the clients choose a test kit.
- There are several collection methods available.
However, there are some disadvantages to this service. Firstly, it is not a true home test, as people have to work with a doctor to complete the paperwork and receive their results. Additionally, the paperwork and billing system can be complex.
CDC , people should perform two tests for Lyme disease, and they can use the same blood sample.
If they receive a negative result, they do not need to perform another test. However, if their first test is positive or indeterminate, it is best to test again.
The CDC states the overall result is only positive for Lyme disease when the first and second tests produce a positive result.
Tests detect IgM and IgG antibodies that the body produces in response to an infection. The IgM antibodies appear early in response to the exposure, while the IgG antibodies appear 46 weeks after the infection and can persist for years.
False positives can occur if a person has other conditions, including
What Health Professionals Need To Know About Lyme Disease
Lyme disease is a serious illness caused by the bacterium Borrelia burgdorferi. The bacterium is a spirochete transmitted by certain species of Ixodes ticks. It is spread through the bite of infected blacklegged ticks and western blacklegged ticks.
Health professionals are encouraged to further their knowledge of Lyme disease in Canada. This includes the ability to:
- understand and identify the signs and symptoms
- prescribe appropriate treatment for patients diagnosed with the disease
- report human cases through appropriate channels
Symptoms sometimes appear in overlapping stages, as:
- early localized Lyme disease
- early disseminated Lyme disease
- late disseminated Lyme disease
It is important to note that some people with Lyme disease may have no or minimal symptoms. Others may suffer more severe symptoms.
Some people may not develop symptoms until weeks after the initial bite, as described in the early localized disease stage below. In this case, they may not remember the tick bite or associate the illness with the bite. Because the blacklegged tick is so small and usually painless, some people may not even know they were bitten by a tick.
Health professionals should be knowledgeable about the clinical manifestations and epidemiological risk factors of Lyme disease. Consider Lyme disease as part of your differential diagnosis in a patient who presents with compatible symptoms and signs.
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Can Infection Be Spread Directly From One Dog To Another Dog Or From My Dog To My Family
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.
What Are The Extra Costs
The doctors visit to discuss the possibility of having the disease could cost $150 to $250 without any health insurance.
A polymerase chain reaction test can detect the genetic material of the Lyme disease bacteria, and in some cases, it may be used to identify a current infection if a doctor suspects you have the symptoms of Lyme disease and/or you didnt get better with a round of antibiotics.
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Lyme Disease Testing: How It Works
Two common lab tests for Lyme disease are the enzyme immunoassay test and the Western blot test. These tests measure the antibodies that form when someone is infected with Borrelia burgdorferi .
Enzyme immunoassay test
The EIA test is whatâs typically used to screen for Lyme disease by detecting antibodies for B. burgdorferi.
According to the Centers for Disease Control and Prevention, if the EIA test shows negative for the antibodies, no further testing is needed. However, if this screening test comes back with results that are positive or unclear, a second round of testingâusing the Western blot methodâis recommended. This second test is referred to as a confirmatory test.
Western blot test
When the EIA test is positive, the Western blot test is usually done next. This two-step approach to Lyme disease testing helps reduce the number of false positives. The Western blot test detects antibodies for several proteins belonging to Lyme bacteria.
Type Specific Igm Tests
Very few testing formats have been adapted to detect type specific IgM to gG-2. As described elsewhere, Gull Laboratories developed prototype gG based IgM that could detect seroconversion much faster than could the Gull type specific IgG tests. However, the IgM ELISA was not useful for discriminating primary episodes from recurrent episodes since 35% of recurrent HSV-2 episodes elicited IgM to HSV-2.
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There Are Many Types Of Lyme Tests
There are a variety of tests that can help diagnose Lyme disease by finding evidence of Lyme infection. These include ELISA, IFA, PCR, immunoblot done as a western blot, the new immunoblot with synthetic proteins, Elispot, and blood culture. Although these tests are helpful aids they are far from perfect. In this article I review each of these tests and give them a grade. With these grades in mind, I describe the way I use these tests to help decide if someone has Lyme disease.
At the end of the article I tell you what I think the best Lyme test is and why.
As you read about the tests, note that a test does not diagnose a disease. In my Seattle practice I, I did not treat a test I treated a person. Tests can be wrong. To make a diagnosis consider
- the risks of getting the infection like having a known tick bite, or a history of hiking where there are a lot of ticks that carry Lyme like in Minnesota, or a number of other risk factors,
- the symptoms,
- physical exam findings, and
- whether there is supportive testing.
Note that I said supportive testing. So the result of testing is only one part to consider in making a diagnosis. See How to Diagnose Chronic Lyme Disease. More Than A Test. for more information about this complex issue.
Newer Immunoblot Using Synthetic Proteins From Igenex: Grade A
In an immunoblot using synthetic proteins grown in bacteria through recombinant dna, only the protein regions specific for Lyme on protein 31, 41, and 93 are grown. This decreases the chances of a false positive testing which I outlined above in the western blot section. In this method, like the western blot above, attention is still paid to certain Lyme specific proteins.
IGenex goes one step further in its new Lyme Immunoblot test and uses 8 different strains of Lyme proteins. These include: B. burgdorferi B31, B. burgdorferi 297, B. californiensis, B. mayonii, B. spielmanii, B. afzelii, B. garinii and B. valaisiana.
Using internal validation standards, an IGM Immunoblot is positive if there are antibodies attached to 2 of the following four proteins: 23, 31, 39, and 41. The IGG Immunoblot is positive if there are antibodies attached to 2 of the following 6 proteins: 23, 31, 34, 39, and 41.
Based on internal validation studies, IGenex reports the tests has a sensitivity of 90.9% and a specificity of 98%. This means this is by far the best test at finding Lyme with a very limited chance of false positives.
Grade: A-. The only reason I do not give this test an A grade is that it still misses 9% of Lyme. This can occur for a variety of reasons including immune suppression making it difficult to make antibodies or due to Lyme hiding where the immune system cannot see the germ.
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How Do Patients Test Negative For Lyme Disease In Ireland But Test Positive For Lyme Disease In Another Country
Laboratories in Ireland generally follow the laboratory testing recommendations of the US Centres for Disease Control and Prevention , the Infectious Disease Society of America , the European Federation of Neurological Societies and the British Infection Association .
The antibody tests used in Ireland are made by commercial companies and meet strict quality criteria. Irish laboratories have their own quality assurance methods to make sure the tests are working correctly as well as being accredited by the Irish National Accreditation Body to perform the test correctly.
Testing which is performed abroad may be performed in laboratories which have not met National or International Accreditation . In some cases they may use tests which are made in the laboratory rather than purchased from commercial companies. These tests may not have the same or consistent levels of quality as commercial tests which must meet specific European criteria called CE marking. These tests may be more likely to give a false positive result for those reasons.
Some laboratories abroad do not use antibody tests like the EIA and western blot and instead will use other types of tests. For example, testing for levels of a specific white blood cell or lymphocyte transformation tests . These types of tests are not currently recommended by international groups such as the CDC, IDSA or BIA for a number of reasons:
Why Is It Called Western Blot
W. Burnette definitely gave the technique the name Western blotting as a nod to Southern blotting and because their lab was on the west coast. He developed his technique independently, including the electrophoretic transfer step, but became aware of Starks and Towbins publications before he submitted his in 1979.
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What If Lyme Disease Goes Untreated
If Lyme disease goes untreated, it can affect other systems in the body. According to the , common symptoms of later stage Lyme disease include:
- severe headaches and neck stiffness
- additional erythema migrans rashes on other areas of the body
- facial palsy, which is a loss of muscle tone or droop on one or both sides of the face
- arthritis with severe joint pain and swelling, particularly in the knees and other large joints
- intermittent pain in tendons, muscles, joints, and bones
- heart palpitations or an irregular heartbeat
- episodes of dizziness or shortness of breath
- inflammation of the brain and spinal cord
- nerve pain
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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.
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Testing And Diagnosing Coinfections And Related Microbes
There are quite a few microbes spread by blood-sucking insects that have stealth characteristics similar to those of Borrelia burgdorferi some we know about, and others still waiting to be discovered.
They all have stealth characteristics and the ability to infect and thrive inside cells. They are masters of evading the immune system, and can be even harder to diagnose than borrelia. Symptoms profiles are similar to borrelia and related mostly to stimulation of cytokine cascades, not concentrations of microbes. Though they each have slightly different strategies, their motive is the same: complete a lifecycle stage within the host and move on.
The primary known players in chronic Lyme include mycoplasma, bartonella, and chlamydia species. The most well-known species of babesia, anaplasma, ehrlichia, and rickettsia are more apt to cause acute illness and less apt to be associated with chronic illness, but research is discovering lesser known and lesser virulent species of these microbes that are associated with chronic Lyme. Reactivation of herpes-type viruses is common in chronic Lyme.
Though testing is possible for some species of these microbes, when a natural route of recovery is chosen, extensive testing is not necessary and can actually be very misleading.
Elisa And Ifa: Grade F
These are screening tests to see if a person has antibodies that attach to the covering of Lyme germs. Unfortunately not only do Lyme antibodies attach but other types of antibodies made against viral infections or other germs can also attach. Because of this these are “could” tests. When these tests are positive they indicate that a person could have antibodies against a Lyme germ.
As a screening test for Lyme the ELISA and IFA are very poor. In fact numerous studies indicate an ELISA test only has a sensitivity of 50%.
Believe it or not, even with such poor reliability, the CDC and the Infectious Disease Society of America recommend this as the first test to perform on a person suspected of having Lyme disease. They recommend a two step method that includes an ELISA or IFA as step one. If one of these are positive then the second step is to perform a western blot which I describe below.
Grade: F. These tests have such a low sensitivity that they should not be used. They are an absolute waste of money even when performed by a high quality Lyme testing lab such as IGenex.
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Catch It Early And Treat It
While its tempting to wait for symptoms, studies show the longer you wait, the harder itll be to get rid of the bug. Think of the Borrelia burdorferi as a burrowing little critter who likes to hide. The more time you give it, the longer itll take to hunt it down.
As months go by, the cork-screw shape bacteria will worm its way from bloodstream to joints and bones and even nerves.
Most horses that are infected, dont show it, said Dr. Sandra Bushmich, CVMDL director, who noted that Western Blot detects antibodies about a month after the suspected infection If you treat it right then, you have a pretty good chance of getting rid of the infection.
When youre finished with treatment, you still may not be out of the woods. Some vets recommended retesting. Bushmichs lab stores
Consider using Ranger Ready, which contains picaridin and can be used on horses AND humans
results so clients can monitor recovery, response to treatment, and potential reinfection.
Flaherty, of Maine Equine Associates, doesnt retest.
Even though you wont see improvement with antibody levels, the horse will be better after treatment, said Flaherty. Owners get confused by the lack of correlation between numbers and symptoms.
Reilly just does another in-stall SNAP test to check horses response to treatment.
Is There Anything Else I Should Know
Herpes can make people more susceptible to HIV infection. The skin lesions give other sexually transmitted diseases , including HIV, openings for entering the body. Likewise, it can make HIV-infected individuals more infectious. Infection with HSV can also increase HIV viral load. HSV-2 infection is a significant opportunistic infection in HIV-infected individuals due to immune system deficiencies up to 90% of HIV-infected individuals are co-infected with HSV-2.
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Avoid Unnecessary And Unscientific Testing
As part of the admirable Choosing Wisely campaign to reduce unnecessary tests and treatments, the American College of Rheumatology warns:
Dont test for Lyme disease as a cause of musculoskeletal symptoms without an exposure history and appropriate exam findings.
The CDC , French Society of Internal Medicine, and other experts around the world have expressed similar sentiments to the ACR.
Experts also warn against unvalidated testing . Quackwatch and Science-Based Medicine both provide accessible explanations about the differences between validated and unvalidated tests.
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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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