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2014 ; 40
(11
): 209-217
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Laboratory diagnostics for Lyme disease
#MMPMID29769843
Lindsay LR
; Bernat K
; Dibernardo A
Can Commun Dis Rep
2014[May]; 40
(11
): 209-217
PMID29769843
show ga
BACKGROUND: Lyme disease is on the rise in Canada. It is a notifiable disease,
and when infection is disseminated, serological testing provides supplemental
evidence to confirm a case. 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. METHODS: A review of the literature was carried out. 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. RESULTS:
Diagnostic testing is indicated in people who have symptoms of disseminated
disease and a history of exposure to vector ticks. 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. A number of other diagnostic tests are available; however,
these are largely for research purposes. CONCLUSION: Two-tiered serology is
currently the best approach available to assist doctors when they are making a
diagnosis of disseminated Lyme disease. 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.
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