What Do Testing Kits Typically Include
Depending on the method of collection, testing kits may include:
- a device to collect the blood, urine, or saliva sample
- a container to ship the sample back to the lab
- a shipping label
Some kits come with a bandage, wipes, and a biohazard bag. Kits may contain extras such as Styrofoam holders, labels, or tubes with varying solutions inside.
Question 8 Is There A Test To Prove Cure For Lyme Disease
There is no test to prove cure for Lyme disease. Antibodies frequently persist in the blood for months or even years after the infection is resolved, despite absence of detectable/viable B burgdorferi.7 Therefore, antibody tests cannot be used to determine a cure. There is no evidence that antibiotics cause Lyme serology blood tests to become negative following treatment.3,5,6
Some Frequently Asked Questions
If I got a negative Lyme test LESS than 6 weeks after a tick bite, might I really have Lyme disease?
Antibodies to Borrelia burgdorferi can take 6 weeks to develop and sometimes even longer. During the first six weeks after developing symptoms, a Lyme disease test could therefore be negative.
If the first ELISA test was negative within this time frame but a person still has Lyme symptoms, the test should be repeated, as set out in the flow chart above.
If I got a negative test MORE than 6 weeks after being infected, might I really have Lyme disease?
It is possible, although less likely than in the scenario described above.
There are different possible explanations why some symptomatic patients may test negative for Lyme disease using two-tier blood testing.
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Is there a more reliable test that I could have done privately?
No, there is no type of test for Lyme disease currently proven to be more accurate than the tests used by the NHS. Some private laboratories do offer other types of tests which they claim are more reliable than the NHS tests, including modified western blot tests, ELISPOT, MELISA, and CPR tests that seek to detect the bacterial DNA.
See the question below, Why wont my NHS doctor prescribe me treatment based on my positive private Lyme disease test? for more information on this.
What is the Lyme disease ELISA test?
What is the Lyme disease western blot test?
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How Much Does A Lyme Disease Test Cost
The cost of a Lyme disease test depends on what type of test is performed an ELISA test or a combination of ELISA and western blot tests.
Averagely, the cost for an ELISA test for Lyme disease is in the vicinity of $120 or more. If you include a confirmation western blot test, it can attract an additional $130 or more. More details on pricing can be referenced on our website.
Although an ELISA test might come back negative, it is best to combine it with a western blot test because not everyone shows the rash or bulls eye symptoms of Lyme disease.
After a successful diagnosis and treatment, it is equally important to do a follow-up test for Lyme disease years later to be sure that any similar flu-like symptoms are something else and not the same disease reoccurring.
Testing Guidelines And Interpretation For This Patient
Erythema migrans , the characteristic skin lesion of early Lyme disease, is an expanding circular patch that usually reaches at least 5 cm in diameter . Classically EM has a target-like appearance, but it can be confluent. This patients rash was not consistent with EM since it was present for more than 6 weeks and never exceeded 5 cm. Moreover, EM initially appears at the tick bite site. It is unlikely a parent or child would have missed an engorged tick on the anterior neck for more than 1 day. Residence in a low-incidence state with a rash inconsistent with EM suggests low pretest probability.5 Testing in this setting is not useful and risks a false-positive result.6
Individually positive bands in the immunoblot are not clinically significant .7 Misinterpretation can cause diagnostic errors and unnecessary antibiotic exposure.8
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Lyme Disease Treatment Options
Early detection and treatment of Lyme are crucial. Most Lyme disease infections clear up with the help of a course of antibiotics you can take at home.
In some cases, however, people who are treated with antibiotics may continue to experience symptoms. When this happens, its called chronic Lyme disease or post-treatment Lyme disease syndrome. Doctors may treat chronic Lyme disease with a continued course of antibiotics, but the treatment often also involves managing symptoms like pain and inflammation.
If youre experiencing symptoms of Lyme disease and think you may have been bitten by a tick and were in an area where it is common, seek medical care as soon as possible. If certain symptoms and risk factors are present, doctors will typically treat for Lyme disease without waiting for a test result.
Lyme Igg/igm Antibody Serology
The IgG/IgM Antibody Serology test is an ELISA , which indicates the presence of both IgG and IgM antibodies to B. burgdorferi. IgM antibodies are present shortly after infection takes place. IgG antibodies often persist long after symptoms have disappeared. The presence of either IgG/IgM antibodies indicates exposure to Lyme-causing Borrelia, not the active disease. A positive or equivocal test must be confirmed by both IgG and IgM ImmunoBlots Blots.
Reference Range
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The Clinical Diagnosis Of Lyme Disease
Misconception: Lyme disease is a clinical diagnosis that should be made based on a list of symptoms.
Science: No clinical features, except erythema migrans or possibly bilateral facial nerve palsyin the appropriate contextprovide sufficient specificity or positive predictive value. Laboratory confirmation is essential except with erythema migrans.
Question 2 How Is The Diagnosis Of Lyme Disease Made
Diagnosis of Lyme disease is made through clinical assessment or clinical assessment supported by laboratory testing. The presence of an erythema migrans rash is diagnostic of Lyme disease without laboratory investigation.1,2
Patients who do not develop a rash but have symptoms suggesting Lyme disease, and have been to areas with a high risk of tick exposure, may undergo laboratory testing to help identify the cause of symptoms.1,2 For more information, see the Quest Diagnostics Clinical Focus Tick-borne Diseases: Laboratory Support of Diagnosis and Management available here.
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Lyme Disease Testing: Useful When Performed Appropriately
One known problem is that we can produce antibodies for years or decades after a Lyme infection has been eradicated. Therefore, a seropositive test on its own is not necessarily indicative of active infection.
In addition, it can take a few weeks for detectable antibodies to build up in the body. Pseudoscience advocates frequently mislead about Lyme antibody testing by failing to differentiate testing performance in early infection from testing performance in late infection.
Below is a CDC-produced illustrative example of antibody production in Lyme disease, which triggers a positive test once a detection threshold is reached.
Two types of antibodies are shown: IgG and IgM. Typically, a detectable IgM antibody response is produced first, followed by a detectable IgG response.
Important: Dont Misinterpret A Negative Test As Positive
Many people without Lyme disease will test positive for some bands. Therefore, CDC cautions:
It is not correct to interpret a test result that has only some bands that are positive as being mildly or somewhat positive for Lyme disease.
For example, in one study, 43% of healthy people and 75% of syphilis patients tested positive for IgG band 41. In a study of US veterans in New York, 76% of those without Lyme disease tested positive for IgG band 41. In a 1996 study, in healthy people, 55% and 21% tested positive for IgG band 41 and IgM band 41, respectively.
Even without a Borrelia burgdorferi infection, many of us produce antibodies that will react on a Lyme test. Notably, harmless bacteria found naturally in our mouths can cause us to test positive for band 41.
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What Do My Test Results Mean
If both tests come back positive, that means you have had Lyme disease at some point in time.
If either or both of your tests come back negative, your doctor may still diagnose Lyme disease, particularly if you recently developed Lyme-like symptoms, regardless of your test results. But, if your doctor does not diagnose you with Lyme disease, you can ask to be re-tested in a few weeks. If you do have Lyme disease, your body may build up sufficient antibodies by that point to be detected by a blood test.
Two-step blood testing for later stages of Lyme disease is more accurate than for early infection because your body should have had sufficient time to produce the antibodies detected by diagnostic tests.
Interpreting the Western blot test
The Western blot test looks at whether you have an immune response the production of IgM or IgG antibodies to specific proteins on the Lyme disease bacteria. IgM antibodies are usually made by your body when the infection is new and recent, while IgG antibodies are usually made some weeks later. When the IgM or IgG antibodies combine with specific proteins from the Lyme disease bacteria, this produces dark spots, or bands on the Western blot test strip.
The CDC considers a Western blot test to be positive for Lyme disease if at least two of three IgM bands are positive within 30 days of symptom onset, or five of 10 IgG bands are positive at any time.
If your Western blot test comes back negative, ask your doctor:
The Igenex Lyme Immunoblot Solves These Problems
IGeneX has developed a serological test that increases specificity without sacrificing sensitivity that has changed how to test for Lyme disease. It uses specifically created recombinant proteins from multiple species and strains of Lyme borreliae and reduces inconsistencies in reading and interpreting the test bands.
More species detected The Lyme ImmunoBlot tests for more species of Lyme borreliae than the traditional ELISA and Western blot tests, reducing the risks of false negatives due to the inability to detect antibodies to a certain strain or species of Lb. The test includes all Borrelia-specific antigens relevant in North America and Europe, not just B. burgdorferi B31 or 297.
The result is a single test that replaces at least 8 Western blots.
More accurate testing The ImmunoBlot uses specific recombinant proteins that are sprayed in precise amounts onto specific locations on the membrane strip, allowing for greater control of the quantity and location of the antigens. This makes reading the bands much more accurate and consistent.
Earlier detection The ImmunoBlot can detect infections at multiple stages of illness, letting you catch infections earlier.
The IgM and IgG ImmunoBlots superior specificity and sensitivity make them the best Lyme disease test available.
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Submission And Collection Notes
If European Lyme disease testing is required: enter ‘European Lyme disease’ under Test Description of the General Test Requisition Form 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 General Test Requisition Form:
References Choosing A Test
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What Do The Results Mean
Lyme disease is difficult to diagnose. The symptoms are common to many conditions, and test results alone can’t diagnose the disease. To make a diagnosis, your provider will consider your test results along with your medical history, exposure, and symptoms. You may also need other tests.
A negative blood test result means that antibodies to fight the Lyme disease bacteria were not found in your blood. If you had symptoms for longer than 30 days before your test, you probably don’t have Lyme disease.
But if you had symptoms for less than 30 days before you gave your blood sample, you may need to have another Lyme disease test. That’s because it may take a few weeks for your body to make enough antibodies to show up on a test. If your test was done too soon, you could be infected even though your test was negative. This is called a “false negative.”
A positive blood test result means that antibodies to fight the Lyme disease bacteria were found in your blood. In this case, the Centers for Disease Control and Prevention recommends a second blood test on the same blood sample. If the second test is positive and you have symptoms of infection, you probably have Lyme disease.
But positive test results don’t always mean that Lyme disease is causing your symptoms. You could have antibodies from a past case of Lyme disease that your body successfully fought off months or even years ago.
Learn more about laboratory tests, reference ranges, and understanding results.
Why Is It Important
Most cases of Lyme disease respond well to antibiotic treatment when diagnosed early. Late diagnosis may be more difficult to treat, but detection can inform treatment. When left untreated, Lyme disease can result in the spread of the infection leading to joint disorders including arthritis, cognitive impairments, and health problems with your heart and nervous system.
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Management Of Lyme Disease
Patients with Lyme disease are treated with antibiotics.2 The choice of antibiotic and the duration of treatment depend on the stage of Lyme disease, associated complications, and the response to treatment.2,11-13 Prophylaxis or serologic testing after a tick bite is usually not indicated in areas where less than 20% of ticks are infected however, the CDC recommends laboratory testing, including tick identification, in areas where infected ticks are endemic.2,16
How Lyme Antibody Testing Works
Antibody testing for Lyme disease requires two different tests to establish a positive result. If either the first tier test or the second tier test is negative, the test result is negative overall.
But in the event of a negative result, Dr. Adriana Marques of the NIH states:
For patients with signs or symptoms consistent with Lyme disease for less than or equal to 30 days, the provider may treat the patient and follow up with testing of convalescent-phase serum.
The first tier of the two-tiered testing system is an Enzyme Immunoassay .
The second tier of the well-established Standard Two-Tiered Testing involves IgM and IgG Western Blot tests, which can be complicated to understand. The Western Blot is also called an immunoblot or a line blot.
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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.
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.
04/2013
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If I Am Worried About Lyme Disease Who Can I Talk To
Lyme disease is being increasingly recognised as causing illness and hardship, if the diagnosis is missed. Over the last number of years, there has been a marked increase in awareness of the condition among GPs and hospital doctors in Ireland. Each of the HSEs Hospital Groups have a number of Infectious Disease Consultants who are expert in the diagnosis and management of Lyme disease. If you have been bitten by a tick or have other reasons to strongly suspect you may have Lyme disease, you should visit your GP for advice.
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Lyme Disease Blood Test Western Blot
The Lyme disease blood test, western blot is used to detect antibodies specific for B burgdorferi.
Also Known As: Borrelia burgdorferi Antibodies Lyme Disease Antibodies , Immunoblot
Methodology: Western blot
Preparation: No special preparation required.
Test Results: 7-10 days. May take longer based on weather, holiday or lab delays.
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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.