In late-stage Lyme disease, the Lyme spirochete has burrowed into tissues like muscles, joints, and organs. If antibiotics are taken early in an infection, the medication can prevent antibody formation resulting in future negative tests. In addition, if a test is performed too soon after a tick bite, antibodies may have not yet formed. In some circumstances, the level of antibodies may be low due to immune suppression which compromises the accuracy of the test. Additional Challenges with Lyme Disease TestingĪnother obstacle with many Lyme disease tests is that they rely on detecting antibodies produced by the immune system against the bacteria that causes Lyme disease. Specialized laboratory testing is more sensitive than general reference laboratory testing (LabCorp, Quest, etc.) and should be used to confirm the diagnosis. In many scenarios, other possible diagnoses have been ruled out, there has been a possible exposure to ticks (including the distant past with chronic Lyme disease), and the pattern of symptoms is consistent with Lyme disease. However, in recent years specialized laboratory testing has advanced and should be used to confirm a suspected diagnosis. A clinical diagnosis is made if the patient has signs and symptoms consistent with a tick-borne infection and other diagnoses that could explain the signs and symptoms have been excluded. Physicians that specialize in treating tick-borne infections have historically considered the diagnosis of late-stage Lyme disease a clinical diagnosis. This means the more sensitive western blot never gets tested. The sensitivity of the ELISA test is so poor that it reports a false negative about half of the time. If the ELISA test is negative, the western blot is not performed. This means an ELISA test is run first, and if it is positive, a second test called a western blot is performed to confirm the accuracy.
The traditional laboratory test used to diagnose Lyme disease is a “two-tiered” test. If a physician is familiar with the many presentations of Lyme disease and considers Lyme disease as a possible diagnosis, standard laboratory testing has poor sensitivity so many cases are missed.
Poor Sensitivity of Traditional Lyme Disease Testing Throw in the misconception that people can only contract Lyme disease in the northeastern U.S., and Lyme disease is not typically considered as a possible cause of symptoms in the rest of the country. ”Īnother limitation of the Lyme disease surveillance criteria is it only includes symptoms often seen in acute cases of Lyme disease and excludes many symptoms consistent with late-stage Lyme disease. “If a physician is familiar with the many presentations of Lyme disease and considers Lyme disease as a possible diagnosis, standard laboratory testing has poor sensitivity so many cases are missed. If someone had symptoms following a tick bite – or even years after a tick bite – but did not have a large bull’s-eye rash, meningitis, facial paralysis, or encephalomyelitis, they were told they did not have Lyme disease.
Unfortunately, the surveillance criterion made its way into doctor’s offices, and physicians began using the narrow criteria as diagnostic parameters for Lyme disease. The criteria needed to be narrow to increase the sensitivity of cases reported. When Lyme disease was first discovered in the 1970s, the Center for Disease Control (CDC) wanted to track the number of cases in the US, so they developed diagnostic criteria for surveillance reporting to local public health departments. There may not be a more complex infection to diagnose than chronic Lyme disease. How was Lyme Disease Testing Criteria Developed? Read below to learn about accurate testing for chronic or late-stage Lyme disease. There are many nuances associated with Lyme disease testing. However, when someone is sick with multiple symptoms for an extended period of time, it can take years to get a correct diagnosis. If someone develops flu-like symptoms following a tick bite or spending time in nature, the diagnosis of Lyme disease is often considered. D iagnosing acute Lyme disease is often straightforward.
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