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.
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.
Other Diagnostic Tests For Lyme Disease
Some laboratories offer Lyme disease testing using urine or other body fluids. These tests are not approved by FDA because they have not been proven to be accurate. For example, one study of urine-based polymerase chain reaction assays for Lyme disease diagnosis showed that with currently available tools, urine cannot be used to accurately diagnose Lyme disease. Another study by NIAID-supported scientists showed that the Lyme Urinary Antigen Test was unreliable and resulted in excessive numbers of false positives. In the same study, researchers confirmed that an ELISA followed by a Western blot test was nearly 100 percent reliable in diagnosing Lyme disease. With the availability of so many Lyme disease tests, including non-commercial tests developed by individual facilities, it is impossible to address the accuracy of each one. The development of new, rapid, clearly validated diagnostic tests continues to be a need.
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Is There A Blood Test For Lyme Disease
If your doctor suspects that you have Lyme disease, they may order two blood tests. These will look for signs that your body is trying to fight it off. The results are most precise a few weeks after youâve been infected.
These tests are:
ELISA test. This test canât check for the bacteria that causes Lyme disease. It can only look for your immune systemâs response to it.
Once Borrelia burgdorferi gets into your blood, your body begins to make special proteins called antibodies to fight it off. The ELISA test checks for those antibodies.
Although itâs the most common way to check for Lyme disease, the ELISA test isnât perfect. It can sometimes give false âpositiveâ results. On the other hand, if you have it done too soon after youâve been infected, your body may not have developed enough antibodies for the test to detect them. This will give you a ânegativeâ result even though you do have Lyme disease.
Western blot test. Whether your ELISA test comes back positive or negative, your doctor will need to do this blood test, too.
A Western blot uses electricity to split certain proteins in your blood into patterns. This is then compared to the pattern of people known to have Lyme disease.
At least five band matches means that you have Lyme disease. Still, not all labs have the same standards. Thereâs a chance that you could get a âpositiveâ result from one and a ânegativeâ result from another.
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What Is The Most Accurate Test For Lyme Disease
Lyme disease is more common than many people think. Figures from the Center for Disease Control suggest that roughly 300,000 Lyme disease cases occur every year in the US.
The numbers are alarming, but it gets worse as finding accurate diagnostic tests can be challenging. Although the disease is treatable, it is nearly impossible to tackle it effectively if it is not diagnosed accurately and early enough.
Late detection can lead to severe health problems such as arthritis, heart blockage, and inability to concentrate, among other problems.
Given the prevalence and seeming elusiveness of the disease, some of the logical questions concerned persons would ask are: what is the most accurate test for Lyme disease? And when should I get checked for Lyme disease? This article will proffer answers to these and many other related questions. But first, a little background would be in order.
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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 untreated, it can affect the placenta. According to the CDC , the 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.
Where Is Lyme Disease Found
In the United States, Lyme disease has been reported in every state, but over 95% of cases are from the Northeastern, Mid-Atlantic, and upper Midwestern states, with a small number of cases reported along the West Coast, especially Northern California. In Canada, Lyme-positive dogs are found mostly in southern Ontario and southern Manitoba, with a small number of cases in southern Quebec and the Maritime provinces.
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Should You Get Tested For Lyme Disease
The current laboratory diagnostic tests for Lyme disease are blood tests to detect the antibodies created by your body to fight and kill the bacteria that causes Lyme. This bacteria is called Borrelia burgdorferi, or Bb.
However, with early-stage Lyme your antibodies may not have had time to develop in your body. Therefore a blood test at this time will often appear negative. It can take your body up to two months to develop enough antibodies to be detected by these tests. In other words you could have Lyme but the test results will still come up negative.
What does this mean for you? By all means, if your doctor recommends a test, get the test. But dont rely on it completely. Trust your body and trust your homework. Monitor your symptoms. Ask questions.
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Early Stages Of Lyme Disease
If presenting with classic features in an endemic area, is diagnosed straightforwardly. Diagnosis is more challenging however if symptoms are not typical, and laboratory testing is indicated. Most patients symptomatic with B. burgdorferi infection are sero-positive , demonstrating an initial IgM response best shown by antibody capture EIA. If a patient is suspected of having early Lyme disease is initially sero-negative, repeat follow-up testing is very useful. The evolution of the host immune response to B. burgdorferi infection is typically very quick. In as short a time as a week or two, an initially seronegative patient can develop robust seropositivity. The IgA response on antibody capture EIA is noted in early infection as well. Unlike the IgM and IgG response , IgA levels usually fall rapidly with effective treatment and infection resolution, often becoming undetectable within the first few months. In that early window of an infection, when a patient is sometimes acutely symptomatic but prior to developing a detectable serologic response, it is possible with PCR technology to detect the DNA of B. burgdorferi in a whole blood specimen. It has been our observation that this window of B. burgdorferi bacteremia is brief, and by the time the patient has developed the characteristic serologic response, whole blood PCR testing for Lyme will have become negative.
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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.
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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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Persistent Lyme Disease Symptoms Arent Helped By Long
Microbiologist Elli Theel, who directs the Infectious Diseases Serology Laboratory at Mayo Clinic, calls the 2015 study incredibly promising. The sensitivity they showed just in early Lyme disease patients was very high, the highest Ive actually seen, she said.
In an upcoming publication, the researchers also showed that metabolomics can differentiate Lyme from a similar tick-borne disease called southern tick-associated rash illness . The disease causes similar symptoms as Lyme, including a bullseye rash, and occurs in overlapping geographic regions. Currently there is no laboratory test to diagnose STARI, and little is known about how the disease progresses and how to treat it, something Molins hopes will change with better testing.
When A Lyme Diagnosis Is Simple
A person who notices a tick bite and gets a bullseye rash will typically get a Lyme disease diagnosis. Treatment can start right away without any testing.
Another straightforward example would be a person who has spent time outdoors in an area where Lyme disease is common. Lets say that person doesnt have a bullseye rash but has other possible symptoms of Lyme disease. Their doctor does a standard two-step blood test, and both are positive. In this case the person gets a Lyme disease diagnosis and starts treatment.
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Available Culture Test Panels
Doctors and patients can choose between three test panels for culturing.
Borreliosis cePCR Test PanelIncludes two-week culture, plus real-time PCR for Lyme and TBRF.
Co-infection cePCR Test PanelIncludes two-week culture, plus real-time PCR for Babesia, Bartonella, HME, HGA, and Rickettsia.
Tick-Borne Disease cePCR Test PanelIncludes two-week culture, plus real-time PCR for Lyme, TBRF, Babesia, Bartonella, HME,HGA, and Rickettsia.
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.
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Lyme Disease Blood Test Results Fully Explained
The Lyme disease blood test is used to discover if someone who has the symptoms of a Borrelia burgdorferi infection actually has the bacteria in their bloodstream. Recent infections are much easier to detect and an IgM and IgG blood test will often be ordered as complimentary information gathering tools. This blood test does not always detect the presence of the disease, so patients that have persistent symptoms after having the test may be re-tested in a few weeks.
If any of these tests come back as positive, then other samples will be used to track the stage of the disease to determine if it has reached the chronic infection stage. At this point, a medical provider will order a Western blot test to confirm the presence of Lyme disease.
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.
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Future Possibilities For Diagnostic Tools
NIAID-supported scientists have identified genome sequences for multiple strains of B. burgdorferi. Greater advances in diagnostics are anticipated as genetic information is combined with advances in microarray technology, imaging, and proteomics. These growing fields of science are expected to lead to improved diagnostic tools as well as provide new insights on the pathogenesis of Lyme disease. Examples of tools being developed with NIAID support include use of metabolomics to characterize new biomarkers of infection, next generation T-cell based measurements, and novel antigens for improved measurement of effective treatment.
Interpret Laboratory Results Based On Pretest Probability
The usefulness of a laboratory test depends on the individual patients pretest probability of infection, which in turn depends on the patients epidemiologic risk of exposure and clinical features of Lyme disease. Patients with a high pretest probabilityeg, a history of a tick bite followed by the classic erythema migrans rashdo not need testing and can start antimicrobial therapy right away.
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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:
Enzyme Immune Assay Testing:
This test detects antibodies to the different kinds of bacteria that are known to cause symptoms of Lyme disease. Different strains of Borrelia are found in the USA and Europe but the tests are designed to detect all of the Borrelia that cause symptoms.
The EIA is the first test performed as it is designed to be very sensitive . If the EIA test is negative for Lyme disease, this can be relied upon to exclude Lyme disease in the patient, especially if the sample is taken when symptoms have been present for several weeks.
The disadvantage of the EIA is because it is very sensitive it can give false positive results. This means that the EIA test is reacting with something else present in the blood sample which is not related to Lyme disease. False positive EIA results can happen when there are infections with other bacteria or viruses, or in certain inflammatory /automimmune conditions. This is why a positive EIA test should be confirmed by a second test the Western Blot.
In Ireland, 2.5% of over 4,800 people who were tested by the National Virus Reference Laboratory in a single year had a positive Lyme test result. In Europe, between 3- 5% of the general population show evidence of infection with Borrelia bacteria at some point in their lifetime while a study in Ireland previously found that the background rate of infection in the Irish population was 3.4%.
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First Comes Igm Then Igg
The pathogenesis and the different stages of infection should inform laboratory testing in Lyme disease.
It is estimated that only 5% of infected ticks that bite people actually transmit their spirochetes to the human host. However, once infected, the patients innate immune system mounts a response that results in the classic erythema migrans rash at the bite site. A rash develops in only about 85% of patients who are infected and can appear at any time between 3 and 30 days, but most commonly after 7 days. Hence, a rash occurring within the first few hours of tick contact is not erythema migrans and does not indicate infection, but rather an early reaction to tick salivary antigens.
Antibody levels remain below the detection limits of currently available serologic tests in the first 7 days after exposure. Immunoglobulin M antibody titers peak between 8 and 14 days after tick contact, but IgM antibodies may never develop if the patient is started on early appropriate antimicrobial therapy.
If the infection is not treated, the spirochete may disseminate through the blood from the bite site to different tissues. Both cell-mediated and antibody-mediated immunity swing into action to kill the spirochetes at this stage. The IgM antibody response occurs in 1 to 2 weeks, followed by a robust IgG response in 2 to 4 weeks.
Because IgM can also cross-react with antigens other than those associated with B burgdorferi, the IgM test is less specific than the IgG test for Lyme disease.