![]() ![]() Western blot tests are also available for Borrelia strains that are found in Europe, but not in B.C. If that test is positive, it is then followed by the Western Blot test, which further confirms diagnosis. The two tiered model involves a preliminary ELISA test, which, after antibodies have developed, is sensitive enough to pick up all varieties of Lyme infection. We use a two-tiered method, which is standard across North America and based on the best available scientific evidence. complies with international best practices for Lyme disease testing. When objective and nonspecific systemic symptoms of Lyme disease are absent, or when systemic symptoms have not persisted for a sustained period, serologic testing is not recommended.Please visit, the BC Centre for Disease Control for a comprehensive overview of Lyme disease: Lyme Disease Testing in B.C.ī.C. When objective signs of Lyme disease are absent, but unexplained nonspecific systemic symptoms have persisted for a long time (i.e., several weeks) in an individual from a highly or moderately endemic area for Lyme disease, two-step testing should be considered. Samples drawn within four weeks of disease onset should be tested for immunoglobulin M and immunoglobulin G, and samples drawn four weeks or more after disease onset should be tested for immunoglobulin G only. When pretest probability is moderate (e.g., a patient from a moderately endemic area with objective clinical findings), laboratory testing should be performed by means of the two- step approach. Lyme disease may be diagnosed without serologic testing in a patient from a highly endemic area with objective clinical findings. Physicians should assess the pretest probability of a patient with suspected Lyme disease on the basis of clinical signs and symptoms and the likelihood of exposure. When unexplained non-specific systemic symptoms such as myalgia, fatigue, and paresthesias have persisted for a long time in a person from an endemic area, serologic testing should be performed with the complete two-step approach described above. Patients who show no objective signs of Lyme disease have a low probability of the disease, and serologic testing in this group should be kept to a minimum because of the high risk of false-positive results. Samples drawn from patients within four weeks of disease onset are tested by Western blot technique for both immunoglobulin M and immunoglobulin G antibodies samples drawn more than four weeks after disease onset are tested for immunoglobulin G only. When the pretest probability is moderate (e.g., in a patient from a highly or moderately endemic area who has advanced manifestations of Lyme disease), serologic testing should be performed with the complete two-step approach in which a positive or equivocal serology is followed by a more specific Western blot test. ![]() ![]() These patients do not require serologic testing, although it may be considered according to patient preference. In patients from endemic areas, Lyme disease may be diagnosed on clinical grounds alone in the presence of erythema migrans. The approach to diagnosing Lyme disease varies depending on the probability of disease (based on endemicity and clinical findings) and the stage at which the disease may be. The use of serologic testing and its value in the diagnosis of Lyme disease remain confusing and controversial for physicians, especially concerning persons who are at low risk for the disease. ![]()
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