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Lyme Disease Tests

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Also known as: Lyme Antibodies Detection; Lyme Antibodies IgM/IgG by Western Blot; Lyme Disease by PCR
Formal name: Borrelia burgdorferi Antibodies, IgM/IgG; Borrelia burgdorferi DNA Detection by PCR

At a Glance

Why Get Tested?

To determine if you have been exposed to the bacterium that causes Lyme disease

When to Get Tested?

When you show symptoms of Lyme disease, especially when you live in or have recently visited an area where black legged ticks are endemic and suspect that you have been bitten by a tick

Sample Required?

A blood sample drawn from a vein in the arm; sometimes a cerebrospinal fluid (CSF) sample or sample of joint fluid (synovial fluid)

Test Preparation Needed?

None

The Test Sample

What is being tested?

Lyme disease tests measure Borrelia burgdorferi antibodies in the blood or in the cerebrospinal fluid (CSF) if there are signs and symptoms of central nervous system disease. These antibodies are produced by the body's immune system in response to exposure to Borrelia burgdorferi (B. burgdorferi), the bacterium that causes Lyme disease. Infected deer ticks or western black legged ticks transmit this bacterium to a person through a bite. The disease is most common in the spring and summer in the regions where these ticks live, such as the northeastern, mid-Atlantic, north-central, and western United States.

Lyme disease infection causes symptoms that may include a characteristic erythema migrans (EM) or "bulls-eye" rash that spreads from the site of the bite, fever, chills, headache, and fatigue. If left untreated, Lyme disease may progress to cause intermittent joint pain, meningitis, facial paralysis (Bell's palsy), weakness and numbness in the arms and legs, memory problems, and may rarely affect the heart or eyes.Characteristic rash of Lyme disease

It takes the body some time to begin producing B. burgdorferi antibodies. B. burgdorferi IgM (immunoglobulin M) antibodies are usually detectable in the blood about two to three weeks after exposure. IgM levels increase to maximum concentrations at about six weeks and then begin to decline. IgG (immunoglobulin G) antibodies are detectable several weeks after exposure, increase to maximum levels at about four to six months, and may remain at high levels for several years.

Two tests are typically used to detect and confirm Lyme disease. The Centers for Disease Control and Prevention (CDC) recommend that an ELISA or IFA test method be used first to measure B. burgdorferi IgM and/or IgG antibodies. Since these tests may be positive with infections caused by other bacteria similar to B. burgdorferi, such as the bacterium that causes syphilis, the CDC recommends that any positive or indeterminate test results then be followed by a second test, called a Western blot, in order to confirm the findings.

How is the sample collected for testing?

A blood sample is taken by needle from a vein in the arm. If there are symptoms of meningitis, a sample of cerebrospinal fluid (CSF) is collected by a doctor from the lower back using a procedure called a lumbar puncture or spinal tap. Sometimes a sample of joint fluid (synovial fluid) from an infected joint will be drawn.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.

The Test

Common Questions

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Article Sources

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used in Current Review

Levin, M. (Updated 2012 March 15). Lyme disease antibody. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003554.htm. Accessed June 2012.

(Updated 2011 November 15). Lyme Disease, Laboratory Testing. CDC [On-line information]. Available online at http://www.cdc.gov/lyme/diagnosistreatment/LabTest/ through http://www.cdc.gov. Accessed June 2012.

Cook, J. et. al. (Updated 2011 June). Borrelia burgdorferi - Lyme Disease ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/LymeDisease.html?client_ID=LTD through http://www.arupconsult.com. Accessed June 2012.

(Updated 2012 March 7). Lyme Disease Frequently Asked Questions (FAQ). CDC [On-line information]. Available online at http://www.cdc.gov/lyme/faq/index.html through http://www.cdc.gov. Accessed June 2012.

(Updated 2011 March 29). Lyme Disease. National Institute of Allergy and Infectious Diseases [On-line information]. Available online at http://www.niaid.nih.gov/topics/lymedisease/understanding/pages/intro.aspx through http://www.niaid.nih.gov. Accessed June 2012.

(© 2012). Lyme Disease: A Patient's Guide, Diagnosis. American College of Physicians [On-line information]. Available online at http://www.acponline.org/clinical_information/resources/lyme_disease/patient/diagnosis.htm through http://www.acponline.org. Accessed June 2012.

Meyerhoff, J. (Updated 2011 September 27). Lyme Disease. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/330178-overview through http://emedicine.medscape.com. Accessed June 2012.

Pagana, K. D. & Pagana, T. J. (© 2011). Mosby's Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 652-653.

Centers for Disease Control and Prevention. Frequently Asked Questions – Lyme Disease. Available online at http://www.cdc.gov/lyme/faq/index.html#accurate through http://www.cdc.gov. Accessed July 2012. 

Centers for Disease Control and Prevention. Transmission – Lyme Disease. Available online at http://www.cdc.gov/Lyme/transmission/index.html through http://www.cdc.gov. Accessed July 2012.

Centers for Disease Control and Prevention. Post-Treatment Lyme Disease Syndrome. Available online at  http://www.cdc.gov/lyme/postLDS/index.html through http://www.cdc.gov. Accessed July 2012.

Sources Used in Previous Reviews

Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

Wormser GP, et al. The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America, Clinical Infectious Diseases 2006;43:1089–1134. Available online at http://www.journals.uchicago.edu/doi/full/10.1086/508667?cookieSet=1 through http://www.journals.uchicago.edu. Accessed June 2009.

(May 1, 2008) Press Release: Agreement Ends Lyme Disease Investigation by Connecticut Attorney General. Available online at http://www.idsociety.org/Content.aspx?id=11182 through http://www.idsociety.org. Accessed June 2009.

Pagana, K. D. & Pagana, T. J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 632-633.

Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 1538.

Forbes, B. et. al. (© 2007). Bailey & Scott's Diagnostic Microbiology, 12th Edition: Mosby Elsevier Press, St. Louis, MO. Pp 537-539.

(Modified 2009 January 27). Learn About Lyme Disease. Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov/ncidod/dvbid/lyme/ through http://www.cdc.gov. Accessed March 2009.

(Reviewed 2008 October 7). Lyme Disease Diagnosis. Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov/ncidod/dvbid/lyme/ld_humandisease_diagnosis.htm through http://www.cdc.gov. Accessed March 2009.

Editorial staff (Updated 2008 May). Lyme Disease. Familydoctor.org [On-line information]. Available online at http://familydoctor.org/online/famdocen/home/common/infections/common/bacterial/257.printerview.html through http://familydoctor.org. Accessed March 2009.

(2007 June 27). Beware of Ticks … & Lyme Disease. U.S. Food and Drug Administration [On-line information]. Available online at http://www.fda.gov/consumer/updates/lymedisease062707.html through http://www.fda.gov. Accessed March 2009.

(Reviewed 2008 October 8). Lyme Disease Treatment and Prognosis Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov/ncidod/dvbid/lyme/ld_humandisease_treatment.htm through http://www.cdc.gov. Accessed March 2009.

Mayo Clinic Staff (2008 May 2). Lyme disease. MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/print/lyme-disease/DS00116/METHOD=print&DSECTION=all through http://www.mayoclinic.com. Accessed March 2009.

(2008 July). Lyme Disease - The Facts The Challenge. National Institute of Allergy and Infectious Diseases, National Institute of Arthritis and Musculoskeletal and Skin Diseases [On-line information]. PDF available for download at http://www3.niaid.nih.gov/topics/lymeDisease/PDF/LymeDisease.pdf through http://www3.niaid.nih.gov. Accessed March 2009.

(© 2009). Lyme Disease: A Patient's Guide. American College of Physicians [On-line information]. Available online at http://www.acponline.org/clinical_information/resources/lyme_disease/patient/ through http://www.acponline.org. Accessed March 2009.

Edlow, J. (Updated 2008 December 12). Tick-Borne Diseases, Lyme. Emedicine [On-line information]. Available online at http://emedicine.medscape.com/article/786767-overview through http://emedicine.medscape.com. Accessed March 2009.

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