Lyme disease

• Lyme disease is caused by causative agent:

  borrelia burgdorferi
• Diagnosis follows a two-tiered approach:

  Screening test

  Confirmatory test
• screening test for lyme disease:

  Enzyme Immunoassay

  Immunofluorescence assay
• confirmatory test for Lyme Disease

  Western blot
• In western blot, what antibodies appear in ≤30 days

  IgG

  IgM
• In western blot, what antibodies appear in >30 days

  IgG
• Western blot confirmation of lgM antibody presence includes reactivity for two of the three following bands:

  24, 39 and 41 kDa.
• Confirmation of lgG antibody presence is acceptable when five of the scored bands are present:

  18, 21, 28, 30, 39, 41, 45, 58, 66 and 93 kDa.
• If serology is negative, and symptoms are consistent with Lyme disease, a convalescent serum should be obtained and tested.