Testing

The CDC does not recommend testing blood by Western blot without first testing it by ELISA or IFA. Doing so increases the potential for false positive results. Such results may lead to patients being treated for Lyme disease when they don't have it and not getting appropriate treatment for the true cause of their illness. For detailed recommendations for test performance and interpretation of serologic tests for Lyme disease, see the CDC Recommendations.

Presently, physicians perform laboratory testing such as the ELISA and Western Blot for testing Lyme disease. Over the last 10 years, the ELISA has been shown to be an unreliable test in many patients with Lyme disease, both in early infection and later disease.  This is mostly due to the lack of sensitivity of this test.

Because Western blots separate the proteins of the Borrelia, specific reactions can be visualized and more accurate interpretations of the results made. Over 75% of patients with chronic Lyme disease are negative by ELISA, while positive by Western blot.

If a person suspects Lyme infection, s/he should seek medical attention immediately.   Despite the CDC recommended protocol, the Western blot is the most sensitive test and is the best indicator of disease. Therefore, if ELISA testing is negative, patients should request the Western blot test from their physician.

Infectious Disease physicians are the most knowledgeable in treating Lyme disease and should be consulted concerning appropriate blood tests and diagnostic testing results.

One authority writes: “…doctors (infectious disease, internists, family practice, etc.) most often use the Centers for Disease Control (CDC) criteria to define a positive test…To adequately detect and treat chronic Lyme disease, physicians must understand that standard tests will miss the majority of these cases. One must undergo more specialized testing and a multi-system integrative treatment approach to achieve success in the majority of patients. If one uses an expanded Western blot with revised CDC requirement criteria for diagnosis, studies have demonstrated an improved sensitivity of detection of over 90%, while having a low false positive rate of less than 3%.”

There is a great deal of controversy today concerning the diagnosis of Lyme disease.  This controversy surrounds the accuracy of diagnostic tests, interpretation of testing results and treatment plans.  Consult your physician, and if necessary an Infectious Disease specialist in Lyme disease.

Reference

Weintraub P. Cure Unknown: Inside the Lyme Disease Epidemic. St. Martin’s Press, 2008. ISBN: 978-0-312-37812-7