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
- 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.
Types Of Lyme Disease Tests
Antibody titer tests for Lyme disease measure antibodies that are specific to the bacteria that can trigger the condition. Antibodies are part of the bodys immune response. Tests look for two types of antibodies, known as immunoglobulin M and immunoglobulin G .
IgM antibodies usually peak within a few weeks after an infection with Borrelia bacteria and start to collapse 4-6 months after infection. IgG antibodies are slower to develop, beginning to show 4-6 weeks after exposure and may peak 4-6 months after exposure. While IgM tends to be associated with an active infection, both IgM and IgG can persist in the blood for many years.
The Centers for Disease Control and Prevention recommends a two-stage or two-tiered test for these antibodies. If the initial blood test is positive for IgM or IgG antibodies associated with the Borrelia bacteria, a second test is done, often using different laboratory methods.
Testing for IgM and IgG can support the finding that you have been exposed to Borrelia, but this on its own does not prove whether or not you have Lyme disease.
Follow-up testing may be necessary if testing is inconclusive. This could involve repeat blood tests or the use of different types of medical tests to rule out other health conditions. In people suspected of bacterial reinfection, imaging tests may be used to detect joint inflammation.
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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Biorepositories And Research Cohorts
Well-characterized samples are an essential tool to help researchers develop and validate new diagnostic tests and to better understand the complexities of LD. Well-characterized sample sets can benefit medical providers, test developers, and the public at risk for LD . It is critical that sample users understand the criteria used to enroll participants, how samples were collected and stored, and what additional clinical and testing data may be available. Additional benefits can be realized when multiple sample users are using the same well-characterized sample sets. Current sample sets available for researchers include the CDC Lyme Serum Repository , the Lyme Disease Biobank , and samples from the Studies of Lyme Immunology and Clinical Events at Johns Hopkins University School of Medicine. Additionally, some investigators also have their own sample collections with, in some cases, blood samples, skin biopsy specimens and synovial fluid which form the basis for collaborative studies .
Lyme Disease Biobank
Lyme Disease Research Center
Long Island Outdoor Worker Cohort
Is There A Cure For Late Stage Lyme Disease
Late stage Lyme disease is the third and final stage of a Lyme infection. It is referred to as stage 3 Lyme disease or rather late disseminated Lyme disease. This stage of the infection should not be taken lightly as it can be disabling and even life-threatening. Nonetheless, death from Lyme disease is a rare occurrence. The seriousness of Lyme disease lies on the severity of the symptoms one is experiencing and for how long one has been infected. If it is not treated promptly and appropriately, then Lyme disease can become chronic, which then makes it harder to treat. Since there is no definitive way to prove that one is Lyme free after antibiotic treatment, the course of treatment may be prolonged. This can be done until one no longer exhibits any symptoms of a Lyme infection.
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Laboratory Diagnosis Of Lyme Disease Infection
Lyme disease is the most common tick-borne illness in the United States. It is a complex multi-system disease caused by infection of Borrelia burgdorferi bacteria and transmitted by the bite of the deer tick. This infection elicits a series of predictable host immune responses which provide the basis for current blood tests, the principle laboratory method for documenting Lyme infection.
The most commonly used tests are relatively insensitive in the very early stages of infection. The traditional western blot test improves the specificity of the diagnosis during later stages of infection, but it too may lack both sensitivity and specificity in early infection.
Clinicians are frequently confronted with patients presenting with unexplained illnesses, fevers, rashes, swollen joints, or neurologic symptoms . There are also challenging patients with persistent nonspecific symptoms after being treated for well-documented Lyme disease, and patients who develop new symptoms raising the suspicion for re-infection. The combination of antibody capture EIA and immunoblotting in most cases can assist the clinician in assessing these situations and lead to the correct diagnosis.
Early Lyme disease
Late Lyme disease
No evidence of Lyme disease
IMUGEN
Offers a comprehensive Lyme Antibody Analysis which includes IgM, IgG, and IgA antibody capture EIA, IgG immunoblotting on 2 strains of B. burgdorferi, and PCR testing on SF, CSF, and whole blood.
The clinical validity
What Abnormal Results Mean
A positive ELISA result is abnormal. This means antibodies were seen in your blood sample. But, this does not confirm a diagnosis of Lyme disease. A positive ELISA result must be followed up with a Western blot test. Only a positive Western blot test can confirm the diagnosis of Lyme disease.
For many people, the ELISA test remains positive, even after they have been treated for Lyme disease and no longer have symptoms.
A positive ELISA test may also occur with certain diseases not related to Lyme disease, such as rheumatoid arthritis.
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Early Localized Lyme Disease
During this stage, the infection has not yet spread to other parts of the body. Diagnosing Lyme disease during stage 1 gives you the best chances of a quicker recovery.
Early localized Lyme disease commonly begins with a rash called erythema migrans. This rash, which occurs in 70% to 80% of infected people, typically develops seven days after a bite but can occur within three to 30 days.
The rash grows slowly over several days and can be more than 12 inches in diameter. The rash may be warm to the touch but is not usually painful or itchy. Some people may develop the classic bulls eye rash, but the rash’s appearance can vary greatly.
The following symptoms may also be present with or without a rash:
- Chills
- Joint or muscle pain
- Swollen lymph nodes
People treated during this stage often recover quickly and completely. Treatment involves 10 to 14 days of oral antibiotics.
Unfortunately, 10% to 25% of cases may go unnoticed and progress to later stages of the disease.
Cdc Supports The Development Of New Tests
New tests may be developed as alternatives to one or both steps of the two-step process. Before CDC will recommend new tests, they must be cleared by the Food and Drug Administration . For more details, see: Recommendations for Test Performance and Interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease.
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Risk Factors For Post
Youre at a greater risk for post-treatment Lyme disease syndrome if youre infected by the bite of a diseased tick. If the infection progresses to the chronic stage, your symptoms might continue for weeks, months, or even years after the initial tick bite.
You may also be at a higher risk for these long-term symptoms if youre not treated with the recommended antibiotics. However, even people who receive antibiotic therapy are at risk. Because the cause of post-treatment Lyme disease syndrome is unknown, theres no way to determine whether it will progress to the chronic stage.
Typically, the symptoms of post-treatment Lyme disease syndrome resemble those that occur in earlier stages. People with persistent symptoms often experience lingering episodes of:
- fatigue
Should You Get A Test For Lyme Disease
If Lyme disease is treated soon after a tick bite, the outlook is great. Most cases of Lyme disease respond to a 2- to 4-week round of antibiotics.
If Lyme disease goes untreated, it can be more difficult to eliminate. For some, it can lead to inflammation of the joints, heart, and nervous system. Progression of the disease, and its severity, can vary from person to person.
Lyme disease is staged in categories: acute, early disseminated, and late disseminated. Later stages of Lyme disease may involve multiple systems in the body.
The most common sign of Lyme disease is an erythema migrans, or bulls-eye rash. The rash often appears after a delay of 3 to 30 days after the tick bite, according to the
Research from 2014 suggests that the bulls-eye rash may last for 3 to 4 weeks. About 80 percent of people with Lyme disease have a single erythema migrans rash. But the bacteria can spread and lead to multiple rashes, indicating disseminated Lyme disease.
While a rash is the most common symptom of Lyme disease, it isnt the only one.
With disseminated Lyme disease, symptoms can also include neurologic conditions, such as cranial nerve palsy and meningitis that mimics aseptic meningitis. Heart inflammation can also be a sign of Lyme disease.
If youre experiencing any of these signs or symptoms, an at-home test may help you identify Lyme disease. With the click of a button, a test can be shipped to your front door.
To select the best tests, we look at studies and user reviews.
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Late Lyme Disease Treatment
Lyme arthritis Lyme arthritis can usually be treated successfully with antimicrobial agents administered orally. Doxycycline , amoxicillin , or cefuroxime axetil for 28 days is recommended for adult patients without clinical evidence of neurologic disease.
For children, amoxicillin , cefuroxime axetil , or, if the patient is 8 years of age, doxycycline is recommended. Oral antibiotics are easier to administer than intravenous antibiotics, are associated with fewer serious complications, and are considerably less expensive.
Neurologic evaluation, that may include lumbar puncture, should be performed for patients in whom there is a clinical suspicion of neurologic involvement. Adult patients with arthritis and objective evidence of neurologic disease should receive parenteral therapy with ceftriaxone for 24 weeks. Cefotaxime or penicillin G administered parenterally is an acceptable alternative. For children, intravenous ceftriaxone or intravenous cefotaxime is recommended penicillin G administered intravenously is an alternative.
Adult patients with late neurologic disease affecting the central or peripheral nervous system should be treated with intravenous ceftriaxone for 2 to 4 weeks . Cefotaxime or penicillin G administered intravenously is an alternative. Response to treatment is usually slow and may be incomplete. Re-treatment is not recommended unless relapse is shown by reliable objective measures.
Heart Failure
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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Symptoms Of Late Stage Lyme Disease
Your suffering has moved from an occasional inflammation flare-up to chronic pain in your muscles, tendons, and joints. You may have been diagnosed with some form of arthritis. Your headaches have become severe. You may even experience dizziness or vertigo.
Additional symptoms include a stiff neck, sleep disorders like insomnia, and numbness in your outer extremities. You may also lack the ability to focus, and paying attention when having conversations has become difficult. Your fatigue is so bad you sometimes do not want to attempt getting out of bed.
The worse symptom may be that you have tried to get the right help, but doctors have failed to give you an accurate diagnosis. Because of this, you may feel like you are crazy, or your friends and family may not believe you are in pain.
You may be wondering how you were able to reach late stage Lyme disease without proper treatment.
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 a Western Blot test, which can be complicated to understand. The Western Blot is also called an immunoblot or a line blot.
The Western Blot test typically reports two types of antibodies that may be indicative of a Lyme infection: IgM and IgG.
According to the CDC, Positive IgM results should be disregarded if the patient has been ill for more than 30 days.
According to a consensus of experts, including representatives of the American Academy of Pediatrics, American Academy of Neurology, American College of Rheumatology, and Infectious Diseases Society of America:
Immunoglobulin G seronegativity in an untreated patient with months to years of symptoms essentially rules out the diagnosis of Lyme disease, barring laboratory error or a rare humoral immunodeficiency state.
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Lyme Disease Frequently Asked Questions
If you have not done so already, remove the tick with fine-tipped tweezers.
The chances that you might get Lyme disease from a single tick bite depend on the type of tick, where you acquired it, and how long it was attached to you. Many types of ticks bite people in the U.S., but only blacklegged ticks transmit the bacteria that cause Lyme disease. Furthermore, only blacklegged ticks in the highly endemic areas of the northeastern and north central U.S. are commonly infected. Finally, blacklegged ticks need to be attached for at least 24 hours before they can transmit Lyme disease. This is why its so important to remove them promptly and to check your body daily for ticks if you live in an endemic area.
If you develop illness within a few weeks of a tick bite, see your health care provider right away. Common symptoms of Lyme disease include a rash, fever, body aches, facial paralysis, and arthritis. Ticks can also transmit other diseases, so its important to be alert for any illness that follows a tick bite.
References:
Moody KD, Barthold SW, 1991. Relative infectivity of Borrelia burgdorferi in Lewis rats by various routes of inoculation.external iconAm J Trop Med Hyg 44: 135-9.
There are no reports of Lyme disease being spread to infants through breast milk. If you are diagnosed with Lyme disease and are also breastfeeding, make sure that your doctor knows this so that he or she can prescribe an antibiotic thats safe for use when breastfeeding.
What I Want You To Know About Living With Late Stage Lyme Disease
Most of us have heard of Lyme Disease, but arent aware that living with Late Stage Lyme Disease can go far beyond treatment of a bulls-eye rash.
*Please be aware that the following post is provided for general informational and educational purposes only and it is not intended as, and shall not be understood or construed as, professional medical advice, diagnosis, or treatment, or substitute for professional medical advice, diagnosis, or treatment. Before taking any actions based upon such information, I expressly recommend that you seek advice from a medical professional.*
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Chronic Lyme: What Happens When Lyme Goes Untreated
The Lyme community typically uses the term chronic Lyme disease to describe a range of physical, cognitive, and emotional symptoms that crop up after getting Lyme disease and persist for months to years after infection.
The risk of chronic Lyme increases the longer a Lyme infection goes untreated or undertreated. In other words, patients are more likely to recover fully if their Lyme infection is detected and treated as early as possible after the discovery of a tick bite. This stage is usually marked by symptoms such as fevers, chills, muscle aches, and sometimes rashes.
When left untreated or undertreated, however, Lyme disease can spread throughout the body and affect:
- The central nervous system
- Muscles and joints
As Lymedisease.org points out, these symptoms can evolve, disappear, and reappear at different times.