Wednesday, September 21, 2022

When To Be Tested For Lyme Disease

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What Happens At Your Appointment

Testing for Lyme DiseaseWhat You Need to Know

The GP will ask about your symptoms and consider any rash or recent tick bites you know about.

Lyme disease can be difficult to diagnose. It has similar symptoms to other conditions and there’s not always an obvious rash.

2 types of blood test are available to help confirm or rule out Lyme disease. But these tests are not always accurate in the early stages of the disease.

You may need to be retested if you still have Lyme disease symptoms after a negative result.

Hhs Federal Research Updates On Lyme Disease Diagnostics

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Diagnosis Testing And Treatment

You may have heard that the blood test for Lyme disease is correctly positive only 65% of the time or less. This is misleading information. As with serologic tests for other infectious diseases, the accuracy of the test depends upon how long youve been infected. During the first few weeks of infection, such as when a patient has an erythema migrans rash, the test is expected to be negative.

Several weeks after infection, FDA cleared tests have very good sensitivity.

It is possible for someone who was infected with Lyme disease to test negative because:

  • 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.
  • Antibodies against Lyme disease bacteria usually take a few weeks to develop, so tests performed before this time may be negative even if the person is infected. In this case, if the person is retested a few weeks later, they should have a positive test if they have Lyme disease. It is not until 4 to 6 weeks have passed that the test is likely to be positive. This does not mean that the test is bad, only that it needs to be used correctly.
  • If you are pregnant and suspect you have contracted Lyme disease, contact your physician immediately.

    * Silver HM. Lyme disease during pregnancy. Infect Dis Clin North Am. 1997 Mar 11:93-7.

    The most common co-infections that occur with Lyme disease are anaplasmosis and babesiosis. In general:

    References:

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    The Most Common Lyme Disease Blood Tests

    The two most common diagnostic tests for Lyme disease are the enzyme-linked immunosorbent assay and the Western blot. These Lyme disease tests allow physicians to visualize the reaction between antibodies in an infected persons blood to specific antigens or parts of the bacteria that cause Lyme disease.

    In the case of the Western blot, for example, antigens are separated by size and then transferred onto a membrane strip. When an antibody reacts with an antigen on the strip, that band will turn dark purple. For test results to be positive, a specific combination of bands on the membrane strip must be present.

    Current Problems With Lyme Disease Diagnosis & Patient Care

    Natural Strategies to Overcome Lyme Disease
    • Diagnostic tests cannot yet accurately identify the earliest stage of Lyme disease when making the diagnosis is crucial.
    • The rash is not always present or easily recognized
    • Misdiagnosis and delayed diagnosis can make Lyme disease more difficult to treat and lead to prolonged and debilitating illness
    • Early symptoms can be mistaken for a summer flu
    • Lyme disease can involve several parts of the body, including joints, connective tissue, heart, brain, and nerves, and produce different symptoms at different times.
    • Antibody testing done after early treatment may be negative and never turn positive for some cases
    • Borrelia burgdorferi can evade our protective immune system and trigger immune system dysfunction.
    • No reliable blood test is presently available to measure treatment success, necessitating close clinical follow up and improved physician education.
    • Presently there is no vaccine to prevent Lyme disease available to humans.

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    Is Lyme Disease Common

    Lyme disease is fairly common in the United States with more than 300,000 people diagnosed with Lyme disease each year.

    Lyme disease can be difficult to diagnose, and it is often misdiagnosed as other illnesses. Lack of testing for Lyme disease can lead to the development of chronic Lyme disease, which often cannot be cured, only treated.

    If you suspect you could have Lyme disease, come into Fast Track Urgent Care today for a fast, affordable Lyme test. Early detection could mean the difference between a cure and a lifetime of health ailments.

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    Can Lyme Disease Be Prevented

    Most people with Lyme disease become infected during the late spring, summer, and early fall when immature ticks are out feeding. Except in warm climates, few tick bites take place during winter months.

    Deer ticks are most often found in wooded areas and nearby grasslands. They are especially common where the two areas merge, including neighborhood yards where deer occasionally roam. Ticks do not survive long on sunny lawns they dry out quickly and die. Although only about 1% of all deer ticks are infected, there are areas in which over 50% of the ticks carry the bacterium. The diseased ticks are often found in the U.S. Northeast and upper Midwest areas.

    The following tips can help you avoid tick bites:

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    When Should I Get Checked For Lyme Disease

    Generally, it is best to get tested for Lyme disease if you live where ticks are common or have recently visited such areas. Most certainly, you should get tested if you suspect that a tick has bitten you. It is important to talk to your doctor if you think you have any of the following early Lyme disease symptoms:

    • A rash resembling a bulls eye on the spot where youve been bitten

    Other symptoms dont show up immediately. Sometimes, it takes up to a few weeks or months after the tick bite to notice the following:

    • Swelling on the joints or severe joint pain
    • Tingling in the feet and hands
    • Shortness of breath

    While it is okay get checked early, Lyme disease test results numbers are more authentic a few weeks after youve been bitten by a carrier-tick. Your body would have developed antibodies within that period, and that can make it easier to detect the disease.

    Tick Testing Organizationswhere To Get The Tick Tested

    Long-awaited Lyme vaccine test begins

    There are many places to get a tick tested. You may go through your health provider or you may choose an independent laboratory. In addition, many state and local health departments offer tick testing. Depending on where testing is done, these tick tests may check for other tick-borne diseases besides Lyme.

    The following is a partial list of independent laboratories that do tick testing. Most offer mail-based service if you are not local. Please contact the Labs directly for more information.

    TickReport

    If you have developed symptoms after being bitten by a tick or spending time outdoors, immediately contact your GP or call NHS 111, mentioning where you have been and if you remember being bitten.

    A very small number of people treated for early Lyme disease can develop more severe symptoms months or years later, however, this is usually if the treatment they receive is delayed or not completed

    If you are exposed to Lyme disease, itâs recommended that you speak to your doctor if symptoms return or donât improve.

    If you have developed symptoms after being bitten by a tick or spending time outdoors, immediately contact your GP or call NHS 111, mentioning where you have been and if you remember being bitten.

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    Does The Time Of Year Matter In The Diagnosis Of Lyme Disease

    Since Lyme disease is a tick-borne infection, the seasonality of the disease is linked tightly to the life cycle and behavior of ticks. May, June, July, and early August are the biggest risk months for acquiring first stage Lyme disease in the US. This is the feeding time for nymph and adolescent ticks which are difficult to see. A viral-like illness in those early summer months might be Lyme disease. There is also some transmission of Lyme disease via adult ticks in the fall and winter and throughout the year anytime the temperature is above 40 degrees, but to a lesser degree.

    The risk of acute Lyme disease is more of a year-round risk in more temperate regions such as northern California and the pacific northwest. Later stage Lyme disease, however, can manifest at any time.

    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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    What To Do If Tick Tests Positive For Lyme

    If your tick submission comes back positive, there are steps that you can take to ensure the health of yourself or your loved one. Contact your health care provider immediately. Provide them with a copy of your TickCheck tick test report, and tell them when and where you were exposed to the infected tick.

    What Do Testing Kits Typically Include

    Lyme Disease

    Depending on the method of collection, testing kits may include:

    • a device to collect the blood, urine, or saliva sample
    • instructions
    • 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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    Feel Bad It Could Be Lyme Unless Proven Otherwise

    Do you have symptoms that come and go? Are you on a medication merry go round? Have you been to 10 or 20 doctors without relief? Maybe youve been misdiagnosed.

    Lyme disease, caused by Borrelia burgdorferi, is the No. 1 vector borne spreading epidemic worldwide. People often attribute uncomfortable symptoms to aging, stress, or the aches and pains of daily living, especially if blood tests and body scans are normal. What if you have Lyme and dont know it?

    Its not uncommon to get Lyme. If youve ever been for a walk in the woods, laid in the grass, live in or visited a Lyme-endemic area, or have a pet cat or dog, you may have exposed yourself to Lyme disease and associated co-infections. There is even the possibility of contracting Lyme if you were born to a mother who has been exposed. Tick born infections can also be transmitted from blood transfusions. This is scary, as Lyme has been found to persist in stored blood, and Ehrlichia and Babesia have been reported in patients receiving blood transfusions.

    Lyme Looks Like Other Diseases

    I interviewed Dr. Richard Horowitz, a board-certified internist in Hyde Park, N.Y., who has treated more than 12,000 chronically-ill patients with Lyme disease. This expert physician has noticed the trend of varying symptoms. Hes dubbed it Lyme-MSIDS, short for Multiple Systemic Infectious Disease Syndrome.

    Dr. Horowitz explained:

    Your Symptoms Are Real Even If Your Doctor Cant See Them

    To Me, Its Lyme Until Proven Otherwise

    Notice To Readersrecommendations For Test Performance And Interpretation From Thesecond National Conference On Serologic Diagnosis Of Lyme Disease

    The Association of State and Territorial Public HealthLaboratory Directors, CDC, the Food and Drug Administration, theNational Institutes of Health, the Council of State and TerritorialEpidemiologists, and the National Committee for Clinical LaboratoryStandards cosponsored the Second National Conference on SerologicDiagnosis of Lyme Disease held October 27-29, 1994. Conferencerecommendations were grouped into four categories: 1) serologictest performance and interpretation, 2) quality-assurancepractices, 3) new test evaluation and clearance, and 4)communication of developments in Lyme disease testing. Thisreport presents recommendations for serologic test performance andinterpretation, which included substantial changes in therecommended tests and their interpretation for the serodiagnosis ofLD.

    It was recommended that an IgM immunoblot be consideredpositive if two of the following three bands are present: 24 kDa * , 39 kDa , and 41 kDa . It was furtherrecommended that an that IgG immunoblot be considered positive iffive of the following 10 bands are present: 18 kDa, 21 kDa *,28 kDa, 30 kDa, 39 kDa , 41 kDa , 45 kDa, 58 kDa , 66 kDa, and 93 kDa .

    The details of both plenary sessions and the work groupdeliberations are included in the publication of the proceedings,which is available from the Association of State and TerritorialPublic Health Laboratory Directors telephone 822-5227.

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    Key Points To Remember

    • Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
    • Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
    • Antibodies normally persist in the blood for months or even years after the infection is gone therefore, the test cannot be used to determine cure.
    • Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
    • Some tests give results for two types of antibody, IgM and IgG. Positive IgM results should be disregarded if the patient has been ill for more than 30 days.

    Other Lyme Disease Tests

    Do you know the signs of Lyme disease?

    Three other tests that may be used to diagnose Lyme disease are polymerase chain reaction , antigen detection and culture testing. They are called direct tests because they detect the bacteria, not just your immune response to it.

    PCR multiplies a key portion of DNA from the Lyme bacteria so that it can be detected. While PCR is highly accurate when the Lyme DNA is detected, it produces many false negatives. This is because the Lyme bacteria are sparse and may not be in the sample tested.

    Antigen detection tests look for a unique Lyme protein in fluid . Sometimes people whose indirect tests are negative are positive on this test.

    Culture is the gold standard test for identifying bacteria. The lab takes a sample of blood or other fluid from the patient and attempts to grow Lyme spirochetes in a special medium.

    Although culture tests are generally accepted as proof of infection, the CDC has advised caution on the only commercially available culture test developed by Advanced Laboratory Services. LDo recognizes that the test is new and requires further validation in other studies. However, we believe that informed patients should be able to choose the test if they prefer. Choice is particularly important given the low quality of Lyme disease tests generally.

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    Prognosis And Chronic Lyme Disease

    The long-term prognosis for individuals who are treated appropriately with antimicrobials for Lyme disease, regardless of the stage of the illness, is excellent. The most common reason for a lack of response to appropriate antimicrobial therapy is misdiagnosis . Nonspecific symptoms, such as fatigue, arthralgia, or myalgia, may persist for several weeks even in patients with early Lyme disease who are treated successfully. Their presence should not be regarded as an indication for additional treatment with antimicrobials. These nonspecific symptoms will usually resolve without additional antimicrobial therapy.

    Positive C6 Elisa On Serum

    RIPL will automatically proceed to do IgM and IgG immunoblot tests after a positive or indeterminate ELISA test and will provide an overall interpretation of the ELISA and immunoblot in the light of the clinical details provided on the request form.

    Please provide clinical details to allow the interpretation of serological results. These are needed for interpretation because antibody levels from a protective humoral immune response to Borrelia species may persist indefinitely in patients who have had Lyme disease in the past. After successful treatment of Lyme disease antibody concentrations may slowly fall over time.

    Borrelia species are notifiable organisms. The numbers of positive results from laboratory confirmed cases in RIPL are reported to PHE and analysed for inclusion in PHE Health Protection Reports as part of Lyme disease epidemiology and surveillance.

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    The Chance Of Getting Lyme Disease

    Not all ticks in England carry the bacteria that causes Lyme disease.

    But itâs 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. Theyâre 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.

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