At the end of May, I went on a vacation with my husband and Shiba Inu, Wolfgang, to visit my parents and my husband’s mother in New England. My parents live in Connecticut (where I grew up) and my husband’s mother lives in Vermont. Before I left, I read an update from the CDC on the increasing amount of Lyme and other tickborne diseases. I’m sure all of MLO’s readers from the Northeast can attest to what a hotspot the region is for ticks.
The CDC stated, “Over the past two decades, seven new tickborne germs that can cause illness have been identified in the United States: Borrelia mayonii, Borrelia miyamotoi, Ehrlichia ewingii, Ehrlichia muris eauclairensis, Heartland virus, Rickettsia parkeri, and Rickettsia species 364D. New laboratory tests that look for DNA are finding new germs in ticks and people. CDC’s Advanced Molecular Detection (AMD) program has supported research to more broadly detect bacteria that may be causing illness in patients with suspected tickborne disease.”1
I remember ticks becoming a big deal in Connecticut when I was a kid roughly two decades ago—my mom and dad were always reminding me to check myself after coming inside from playing in our two acres of woods. It was standard protocol. Unfortunately, I know a number of people who have contracted Lyme disease.
My 2019 trip was no different—after being outdoors I found ticks not only on myself, but my husband, and my poor dog (who is on preventive medication, thankfully)!
All of these ticks got me thinking about laboratory testing for tickborne illnesses. I’m familiar, as I’m sure all of you fine laboratorians are too, with the ELISA and Western blot tests. These tests don’t detect the actual Lyme disease bacterium, just the reactions in the individual’s body to the presence of the pathogen. In addition, recent studies reveal that many of the test kits are only designed to identify a few species of B. burgdorferi, which means infections caused by more recently discovered Borrelia species such as B. mayonii, could be missed. According to a report published in January 2017, the overall sensitivity of the FDA-approved two-tier test for B. burgdorferi was only 53.7 percent.2
According to Tick Talk, newer, more precise and advanced tests are available through some laboratories certified by Clinical Laboratory Improvement Amendments (CLIA). These tests don’t require FDA clearance and include newly developed Lyme immunoblots that detect all the common species of B. burgdorferi sensu lato (including B. mayonii) in the U.S. and Europe. These tests include Polymerase Chain Reaction (PCR) assays, Immunoblot assays, T-Cell test, and Culture test.2
I wonder if these new tests will become more commonplace due to the increase in tickborne illnesses … I sure hope so. Are any of your labs running these tests?
REFERENCES
1. Centers for Disease Control and Prevention. (2019). Prevention is key in fight against Lyme and other tickborne diseases. [online] Available at: https://www.cdc.gov/media/dpk/diseases-and-conditions/lyme-disease/index.html [Accessed 3 Jun. 2019].
2. IGeneX Tick Talk. (2019). Tick-Borne Disease Testing for Lyme & More | IGeneX Tick Talk. [online] Available at: https://igenex.com/ticktalk/2018/01/12/tick-borne-disease-lab-tests/ [Accessed 3 Jun. 2019].
