![]() ![]() For example, there are different tests to identify Lyme disease acquired in Europe/Asia versus North America Footnote 12, and different tests are used for early infections versus infections that may have been present for some time Footnote 13. Detailed travel history and date of onset of symptoms - This information should be included on the laboratory requisition, as it helps the diagnostic laboratory apply the most appropriate test platform.The following information is required prior to testing: Testing, however, should be limited to those with objective signs of infection Footnote 10 Footnote 11. Typically, diagnostic testing is appropriate for people with a history of tick exposure and symptoms of disseminated Lyme disease infection, since test sensitivity improves as the bacteria affect tissue systems other than the skin Footnote 8 Footnote 9. A presumptive diagnosis can be made on the basis of the clinical presentation and a credible history of exposure to infected blacklegged ticks Footnote 8. Results Considerations prior to testingĮarly localized Lyme disease does not require diagnostic testing before antibiotic therapy is started. We also outlined future research plans to be undertaken by the Agency's National Microbiology Laboratory. We then summarized the key parameters to consider before Lyme disease testing is conducted, described the current best practice of a two-tiered serological algorithm for the laboratory confirmation of disseminated Lyme disease and explored the advantages and disadvantages of the supplemental tests. MethodsĪn extensive review of peer-reviewed literature was carried out. The objective of this article is to describe the current diagnostic tests for Lyme disease, including a review of the recommended approaches to laboratory testing, and identify future research priorities for Lyme disease diagnostics in Canada. Lyme disease has been a nationally notifiable disease since 2009 Footnote 7. There has been a steady increase in the incidence of Lyme disease in parts of central and eastern Canada Footnote 3 Footnote 4 Footnote 5 due to the recent range expansion of the primary tick vector, Ixodes scapularis Footnote 6. The symptoms of Lyme disease occur in stages and involve a variety of tissues and organs, including the skin, joints, heart and nervous system Footnote 2. garinii (primarily in Europe, Russia and northern Asia) Footnote 1. afzelii (in Western Europe, central Europe and Russia) and B. burgdorferi sensu stricto (in North America and Western Europe), B. ![]() Lyme disease (LD) is a tick-borne infection caused primarily by three species of spirochetes in the Borrelia burgdorferi sensu lato genogroup: B. The Public Health Agency of Canada (the Agency) will seek to improve on this approach through standardization of the Lyme disease diagnostics used across laboratories in Canada, evaluation of test performance characteristics of current and new diagnostic platforms and development of a process to secure robust serum panels to assist in the development and evaluation of new diagnostic tests for Lyme disease. A number of other diagnostic tests are available however, these are largely for research purposes.Ĭonclusion: Two-tiered serology is currently the best approach available to assist doctors when they are making a diagnosis of disseminated Lyme disease. To maximize sensitivity and specificity, a two-tiered serological approach is recommended, consisting of an enzyme immunoassay (EIA) screening test followed by confirmation with Western blot (WB) testing. Results: Diagnostic testing is indicated in people who have symptoms of disseminated disease and a history of exposure to vector ticks. We then summarized parameters to consider before Lyme disease testing is conducted, described the current best practice to use a two-tiered diagnostic algorithm for the laboratory confirmation of disseminated Lyme disease, and analyzed the advantages and disadvantages of the supplemental tests for Lyme disease. Methods: A review of the literature was carried out. Objective: To describe the current diagnostic tests for Lyme disease, review the recommended approach to laboratory testing for Lyme disease and identify future research priorities for Lyme disease laboratory diagnostics in Canada. It is a notifiable disease, and when infection is disseminated, serological testing provides supplemental evidence to confirm a case. Lindsay LR 1*, Bernat K 1 and Dibernardo A 1 Affiliationġ National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba DOIīackground: Lyme disease is on the rise in Canada. Volume 40-11, May 29, 2014: Clinical aspects of Lyme disease Review article Laboratory diagnostics for Lyme disease ![]()
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