DIAGNOSIS & TESTING
Diagnosis
Doctors typically base their diagnosis of Tick-Borne disease on a patient's clinical history, symptoms and the presence of the classic “bullseye” rash (which only appears 50% of the time). They will confirm their diagnosis using several different types of laboratory tests (blood culture tests, antibody tests) before they begin their treatment plan.
Most doctors follow the CDC and/or IDSA guidelines for Tick-Borne disease testing which involves 2 tests (ELISA and WESTERN BLOT) done together at the same time. Some doctors do not follow the guidelines and perform only one of the tests recommended by the CDC which increases the frequency of false negative results which may lead to misdiagnosis and improper treatment. Unfortunately, the ELISA and WESTERN BLOT tests used to detect Lyme disease and co-infections are not 100% accurate so co-infections often go undiagnosed. Doctors normally test for Lyme and not co-infections so be your own advocate and tell the doctor you want testing done for co-infections in addition to the Lyme tests.
These two tests based on the presence of antibodies. The ELISA test is used as a screening test to detect anyone who might have the disease. This test is highly insensitive and fails to identify Lyme Disease 52% of the time. Patients who have tested negative on ELISA have tested positive on the WESTERN BLOT test.
The WESTERN BLOT test is a highly specific test intended to make sure only people with the disease are diagnosed. Occasionally the WESTERN BLOT test shows false positive results. The two-tiered test system misses roughly 54% of patients with Lyme disease. Follow this link to the CDC>> article to view additional information regarding the two-step lab testing process.
In addition to the antibody tests, three other tests are available that can be used to diagnose Lyme disease. They are the polymerase chain reaction (PCR), antigen detection and culture testing. They are called “direct” tests because they detect the bacteria, not just your immune response (antibodies) to it. The "gold" standard among these tests is the "culture" test. Follow the link to the LYME DISEASE ORG ARTICLE>> article regarding diagnosis and testing.
Testing For Pathogens
The following labs test blood for Tick Borne Diseases <click on links>:
Stony Brook University Laboratory
Testing Ticks(No Processing Fee)
There are several labs that test ticks for pathogens. One lab, the Bay Area Lyme Foundation, will test ticks for 6 pathogens at no charge. Ticks must be sent within 72 hours after removal to the lab located at Northern Arizona University. Use the Bay Area Lab>> link for more information and mailing instructions.
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Ticks (dead or alive) are tested by the Bay Area Lyme Foundation for:
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Borrelia burgdorferi - causes Lyme disease
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Borrelia miyamotoi - causes tick-borne relapsing fever
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Anaplasma phagocytophilum - causes human granulocytic anaplasmosis
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Ehrlichia chafeensis - causes human monocytic erhlichiosis
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Rickettsia rickettsii - causes Rocky-mountain spotted fever
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Babesia microti - protozoan pathogen
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Testing Ticks(Processing Fee)
The following labs charge a processing fee to test ticks for pathogens. <click on links> for more information.
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Northeast Wildlife DNA Laboratory East Stroudsburg University
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