''There are cases of Lyme disease where people contracted it years before coming down with the disease.
In animals, you have chronic disease with spirochete in the brain tissue that is viable months later...
I am convinced the same thing is true with humans"
---Dr. Willy Burgdorfer, Discoverer of the Lyme bacteria
Sensitivity of the CDC Two-Tier Testing for Lyme disease 1993-2003
|Schmitz et al. 1993||66%|
|Engstrom et al. 1995||55%|
|Ledue et al. 1996||50%|
|Trevejo et al. 1999||29%|
|Nowakowski et al. 2001||66%|
|Bacon et al. 2003||68%|
The ELISA test is the most commonly used screening test for Lyme disease.
The ELISA (and Western blot) are both "indirect" or antibody tests, which means that they test for the antibodies that fight against the Lyme spirochete, not the actual bacteria itself.
Results that are falsely negative may be due to lack of antibody response from to a weakened immune system, testing too early ( It takes four weeks from the day of the tick bite to test positive), or being on antibiotics. Treatment should not be delayed pending a positive test result if the suspicion of Lyme disease is high (exposure, tick bite, possible rash).
The College of American Pathologists found that the ELISA tests do not have adequate sensitivity to be used as a screening test for Lyme disease. In two blinded studies that tested laboratories accuracy, the ELISA failed miserably. In the latest study by the College of American Pathologists, 516 labs were tested. The overall result: 55% inaccurate! (Bakken 1997).
Lyme disease researcher and physician, Dr. Sam Donta of Boston University Medical Center reported that 52% of patients are negative by the ELISA, but positive through the Western Blot. (Donta, 2002).
Because of this, the best antibody test to use for diagnosis is the Western Blot.
The Western Blot makes a map of the different antibodies the immune system produces to the bacteria. The antibodies are made to fight against different parts of the Lyme bacteria,
It is like the old story of different blind people touching an elephant. Based on the part of the elephant each one touched, each person had their own perception. Likewise, the antibodies attach to different and specific parts of Borrelia burgdorferi.
The laboratory performs two types of Western blots, the IgG and IgM
According to the CDC's diagnostic criteria
Because Lyme disease is a chronic persistent infection more IgM bands are positive in chronic Lyme than IgG. Every time Borrelia burgdorferi reproduces itself, it may stimulate the immune system to form new IgM antibodies.
Some of the bands are more significant for Lyme than others, it is important to keep in mind that the result may read "negative", some doctors feel the presence of one or two specific bands, may be suspicious for Lyme disease, even if your western blot does not have enough bands or the right bands to be reported to the Centers for Disease Control and Prevention (CDC) for surveillance purposes.
"Significant" bands on the Western Blot are said to be: 18, 22, 23-25, 28, 30, 31, 34, 37, 39, 41, 83, and 93.
Lyme disease is known to inhibit the immune system and 20-30% of patients have falsely negative antibody tests.
Test results seem counter-intuitive since the sickest patients (or those who have been sick the longest) tend to have fewer positive tests than those who have mild disease. A very positive test, in which a large number of antibodies are present demonstrates a healthy immune system that is reacting appropriately to the infection. The sicker patients have fewer antibodies and are barely positive (if at all).
*To read more about interpretation of the Western Blot click here
Polymerase chain reaction (PCR) test. Polymerase chain reaction (PCR) testing detects the genetic material (DNA) of the Lyme disease bacteria. PCR testing may be used to identify a current (active) infection if you have symptoms of Lyme disease that have not gotten better with antibiotic treatment. PCR testing is not done as often as antibody testing because it requires technical skill and expensive equipment. Also, standards have not yet been developed for PCR testing and there is a risk of false-negative test results.
Skin Culture. A skin culture checks a tissue sample for the bacteria that causes Lyme disease. It may take several weeks for test results to come back. For this reason, antibody testing is done more often than a tissue culture, it is also very rare to find the pathogen in the skin biopsy.
Spinal Tap, Through a spinal tap, doctors may be able to detect brain and spinal cord inflammation, and can look for antibodies in the spinal fluid. Normal results, however, DOES NOT rule out neuroborreliosis (Neurological Lyme dsiease). It is usually custom by most Lyme experts to only do a spinal tap to rule out other diseases.
SPECT Scan. A SPECT (Single Photon Emission Computerized Tomography) scan is a type of nuclear imaging test, which means it uses a radioactive substance and a special camera to create pictures of your brain. While imaging tests such as X-rays can show what the structures inside your body look like, a SPECT scan produces three-dimensional images that show how your brain is functioning. For instance, a SPECT scan can show blood flows to your brain or what areas of your brain are more active or less active.In Lyme disease decreased blood flow to the brain is often a problem, ranging in severity from mild to severe.
Currently available blood tests yield a high percentage of false negatives due to the crafty nature of the spirochete, which is able to change into a dormant, undetectable cyst form, or hide within white blood cells... the very cells that are supposed to destroy invading bacteria.