You got bitten by a deer tick--now what? A Lyme disease blood test is used to look for evidence of infection with bacteria that cause the disease, according to laboratories that offer the test. Physicians say the test has poor accuracy until at least three weeks after the bite, but can be used if a patient has late-stage symptoms.
According to the Centers for Disease Control and Prevention, 27,444 cases of Lyme disease were reported in 2007. The disease is caused by the Borrelia burgdorferi bacterium and is often treated with antibiotics. It is spread by black-legged ticks, also known as deer ticks, and is most common in Connecticut, Massachusetts, Maryland, Minnesota, New Hampshire, New Jersey, Delaware, Pennsylvania, New York and Wisconsin, according to the CDC.
Tim Foley The most common test involves two tests from the same sample. It typically costs about $25 to $70 and is often covered by insurance. Based on CDC guidelines, the blood is usually analyzed first with an antibody test called ELISA. If it is positive or unclear, then a confirmatory test called the Western blot is done.
Allen C. Steere, a Harvard University scientist who led the team that discovered Lyme disease in 1975, says the two-tier test is "quite accurate" as long as you use it properly--which means for the most part, not too soon after the suspected infection. In a study published last year, Dr. Steere and his colleagues found that of 76 patients exhibiting a bulls-eye-shaped rash characteristic of early Lyme disease, only a third tested positive for the disease. The bulls-eye rash typically appears within a week or two of infection, according to the CDC. But three to four weeks later, two-thirds of the group tested positive.
Given the tests' low sensitivity in the early stages of Lyme disease, physicians recommend treating with antibiotics when the patient develops the rash or other clear symptoms.
Still, individuals bitten by a tick in an area where Lyme disease is prevalent often think they should be tested immediately. Many people go to their doctors and say "I got bit by a tick. Test me!" says Wisconsin researcher Edward A. Belongia, director of the Epidemiology Research Center at the Marshfield Clinic Research Foundation. Dr. Belongia is author of a 2004 study that found only 20% of 356 Lyme tests the scientists reviewed were clearly appropriate, based on the patients' symptoms. Doctors say it is also wrong to get a test after being treated for the disease, since the antibodies can linger for years in your blood.
Critics of the test, such as Raphael B. Stricker, a past president of International Lyme and Associated Diseases Society, a Bethesda, Md., group of doctors specializing in treating chronic Lyme disease, say the tests miss many patients with late-stage Lyme disease. These patients can often test negative, Dr. Stricker says.
Dr. Steere says that in his experience, the test is very effective in patients with late-stage manifestations of the disease, such as arthritis or nerve damage. He does his testing in a research lab at Massachusetts General Hospital. Accuracy may vary from laboratory to laboratory, Dr. Steere adds.
Some labs specializing in Lyme disease test for additional proteins they say are a sign of infection, and as a result some doctors believe they are more accurate. But Dr. Steere says the tests haven't been proven scientifically. The CDC Web site warns consumers to beware of labs offering nonstandard Lyme disease tests. The CDC encourages patients to "ask their physicians whether their testing was performed using validated methods."
You can get the tick tested, but doctors say that generally isn't necessary. Even if the tick has Lyme bacteria, the disease won't be transmitted to you unless the tick fed on you for 24 to 72 hours.
seekhelp
Frequent Contributor (5K+ posts)
Member # 15067
posted
So these extra bands Igenex tests for don't cause disease such as 83-93, 18, 31, 34 etc. on a IgM portion of the WB?
IDSA really hates Igenex, huh?
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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canbravelyme
Frequent Contributor (1K+ posts)
Member # 9785
posted
Is Steere one of the ones who owns shares in the test kit?
-------------------- For medical advice related to Lyme disease, please see an ILADS physician. Posts: 1494 | From Getting there... | Registered: Aug 2006
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northstar
Frequent Contributor (1K+ posts)
Member # 7911
posted
mmmm.Wall Street Journal writing on medical topics?
Their financial IQ also is in question: they were raving about financial stability/good buy, for AIG stock, after 9/11......
and we all know what AIG is today.
Northstar
Posts: 1331 | From hither and yonder | Registered: Sep 2005
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posted
Lots of problems with this article...here are some of them:
- EM rashes not always presented or found - no mention of the many types of co-infections and their geographic spread - no mention of the large # of Bb strains, and why that often eludes Western Blot and ELISA tests - no mention of Lyme being a clinical disgnosis - no mention that the CLIA certification is what matters for testing labs - no mention that some (smart, proactive)labs optimize their testing assays for diagnosing regional strains of Bb - no mention that the first few weeks is critical; this is when Bb and coinfections will disseminate into the body into all kinds of systems (blood, CNS, organs, joints, etc.) - no mention that Bb assumes three different forms and creates biofilm to protect itself from the immune system and (some) antiobiotics - no mention that Bb tunnel into blood cells, even white blood cells, to hide or reproduce - no mention that many other ixodes (not just deer ticks) carry Bb and other nasty pathogens
Geez, should I keep going? There are more inaccurate statements, but I don't want to take steal any one else's thunder.
One other really, really disgusting note: the writer taking Steere's bait to delay seeing a Lyme-literate doctor. As I said, the first few weeks is the BEST time to diagnose and treat. If you miss this window of urgent opportunity, you may be SCREWED the rest of your life. Why would an "expert" encourage patients not be more cautious? This is beyond irrational.
Shame on the reporter -- and especially the alleged Lyme "expert" for conveying this misinformation. Why does this keep happening?!
-------------------- My biofilm film: www.whyamistillsick.com 2004 Mycoplasma Pneumonia 2006 Positive after 2 years of hell 2006-08 Marshall Protocol. Killed many bug species 2009 - Beating candida, doing better Lahey Clinic in Mass: what a racquet! Posts: 830 | From Mass. | Registered: Aug 2006
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tick battler
Frequent Contributor (1K+ posts)
Member # 21113
posted
I think we should all write to Laura with our stories. Maybe we will get through to her.
Cold feet - why don't you send her that list you made? It might get her thinking. I would also add the important fact that lyme can be transmitted immediately...that 12 to 48 hour rule is a bunch of baloney. I was told that and was very diligent about removing ticks before 24 hours and my entire family of 5 is sick with lyme.
tickbattler
Posts: 1763 | From Malvern, PA | Registered: Jul 2009
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canbravelyme
Frequent Contributor (1K+ posts)
Member # 9785
posted
So is it Steere who has a stake in the test kits? If not, which ones?
Best wishes,
-------------------- For medical advice related to Lyme disease, please see an ILADS physician. Posts: 1494 | From Getting there... | Registered: Aug 2006
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bettyg
Unregistered
posted
up to read tomorrow; signing off ... dead tired!
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canbravelyme
Frequent Contributor (1K+ posts)
Member # 9785
posted
Can someone explain to me why anyone is interviewing Wormser or Steere re: Lyme disease after the conflicts of interest finding?
Shall we bring up this subject with the WSJ journalist?
-------------------- For medical advice related to Lyme disease, please see an ILADS physician. Posts: 1494 | From Getting there... | Registered: Aug 2006
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