What's New In Lyme Disease Testing?


Summer is here and it's time to savor those long, warm days by spending time outdoors. It's also the time of year when you're at greatest risk of being bitten by a tick that carries Lyme Disease or one of the other tick-borne infections. Over 96% of Lyme Disease cases occur in just 14 states, mainly concentrated in the Northeast and the Upper Midwest. One of those states is Massachusetts.

Taking proper precautions before venturing outdoors is essential. It's also important to know what to do if you find a tick on you or if you notice a rash or experience flu-like symptoms after spending time outdoors. Lyme Disease has been called the Great Imitator due to the myriad of symptoms accompanying it which can mimic many other illnesses. Joint pain, chronic fatigue, sleep disorders, headaches, cognitive dysfunction, depression and cardiac rhythm disturbances are just a few of the symptoms reported by patients suffering from Lyme Disease. Global Lyme Diagnostics has created a pinwheel which gives you an thorough overview of the symptoms caused by Lyme Disease.

Generally, it takes about 36-48 hours for a tick to transmit the bacteria, Borrelia Burgdorferi, that causes Lyme Disease to an individual. Early symptoms may include any of the following:

  • Flu-like symptoms, including fever, sore throat, headache, muscle aches, joint pain and neck stiffness.

  • Skin rash that may resemble a bull's eye, although not everyone with Lyme Disease develops a rash or even detects a rash. In fact, almost half of the patients who have Lyme Disease never recall having had a rash or being bitten by a tick.

Until recently, the earliest point in time that a lab test was able to detect Lyme Disease in an infected individual was 3-6 weeks after infection. Now, Global Lyme Diagnostics has developed a test that can detect Lyme Disease as early as 2 weeks after infection. What makes this test different from the other Lyme Disease diagnostic tests available is that it tests for antibodies that are created early on in a person infected with the bacteria that causes Lyme Disease. In addition, the Global Lyme Diagnostics test looks for antibodies to multiple strains of the Lyme Disease causing bacteria. This type of testing helps reduce the possibility of a false negative result.

The International Lyme Disease and Associated Disease Society, ILADS, cautions that testing for Lyme Disease using the ELISA test misses 35% of true cases of Lyme Disease. That means that you may actually have Lyme Disease, but the ELISA test may not detect it, leading to what is called a false negative result. The Western Blot test is used to confirm the diagnosis of Lyme Disease in patients who have tested positive or equivocal/indeterminate by the ELISA test and have symptoms. This second-tier of testing is meant to reduce the incidence of false positives (you test positive for Lyme Disease when, in fact, you do not actually have it) which may result if you have a certain co-infection - another illness carried by ticks - or if you have another medical condition. However, this test can also give a false negative result in 20-30% of patients.

Another diagnostic test available for Lyme Disease is the PCR test which looks for a portion of the DNA of the Lyme bacteria. This test, too, can produce a false negative if the blood or body fluid sample tested does not contain any Lyme bacteria even though that individual is infected with the Lyme bacteria elsewhere in his or her body. Other diagnostic tests are also available, but a test with perfect sensitivity (detects everyone who has been infected with the bacteria that causes Lyme Disease) and perfect specificity (detects only those individuals who truly have Lyme Disease) has yet to be developed.

Currently, the diagnosis of Lyme Disease remains a clinical diagnosis based on the presence of signs and symptoms of Lyme Disease and a history of exposure to the black-legged ticks that transmit Lyme Disease. According to the CDC, Lyme Disease accounts for 80% of all tick-borne infections and approximately 30,000 new cases of Lyme Disease are reported to the CDC each year, but CDC studies on the prevalence of Lyme Disease in the U.S. suggest that the number of people diagnosed with Lyme Disease annually is actually about 300,000.

If you find a tick on yourself:

  • Properly removing a tick can help prevent transmission of the disease, so check out a tick removal video such as the one from the International Lyme And Associated Diseases Society (ILADS).

  • Be sure to remove it correctly by grabbing the head of the tick with tweezers and steadily pull upward.

  • Do not touch the tick with your fingers, but place the tick directly in a plastic bag and then freeze it for later testing.

  • Be sure to clean the affected area with rubbing alcohol or soap and water, wash your hands thoroughly, and contact your health care practitioner.

If you have been bitten by a tick or if you have symptoms suggestive of Lyme Disease, or experience flu-like symptoms in the spring-summer-early fall months, it's important to see your healthcare practitioner. Better yet, don't let Lyme Disease catch you or a family member by surprise. Be prepared by:

  • Protecting yourself and your family when you are outdoors

  • Checking yourself and family members thoroughly for ticks after spending outdoors

  • Educating yourself about the symptoms of Lyme Disease

When it comes to Lyme Disease and the co-infections that are transmitted by ticks, the best defense is a good offense.

References

www.npr.org. Lyme Disease is on the rise again. Here's how to prevent it.www.npr.org/sections/health-shots/2018/05/07/607782359/lyme-disease-is-on-the-rise-again-heres-how-to-prevent-it.

www.cdc.gov/lyme/stats/humancases. September 30.2015.

www.ilads.org/lyme/lyme-quickfacts.php

www.lymedisease.org/lyme-basics/lyme-disease/diagnosis/

The contents of this blog are intended for educational purposes only. The information presented here is not a substitute for proper medical attention, diagnosis, or treatment by a qualified healthcare professional. Always seek the advice of your healthcare provider before starting or making any changes to an existing treatment plan, exercise program or dietary regimen and before using nutritional supplements.

~ Dr.Sarah Williams ~ Concord & Nantucket,Massachusetts ~

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