Putting tests to the test

The Western immunoblot test is the most widely used test for diagnosing Lyme disease. Recently, the US Centers for Disease Control (CDC) revised their criteria for the test. These new criteria fail to include the most significant antigens and so may fail to make the diagnosis even when disease is present.

In addition, other factors can interfere with the diagnosis when testing blood, including:

Recent infection before an immune response

The causal spirochaete bacteria may be encapsulated by host tissue

There may be no spirochaetes in the body fluid on the day of the test

The test only looks for one strain of B. burg dorferi, yet there are over 300 strains

Recent antibiotic or anti inflammatory treatment

Babesiosis co-infection (another tick borne disease) may cause immunosuppression

There may be other causes of immunosup pression (e.g. immunosuppressive drugs)

The lab test is not standardised to detect late stage disease

The lab may have a poor technical capability for detecting Lyme disease.