The diagnosis of Lyme disease is based on clinical presentation and history, supported by laboratory testing performed in an accredited laboratory. The interpretation of diagnostic test results can be difficult.
Lyme disease (Lyme borreliosis) is a multisystem tick-borne zoonosis caused by spirochaetes of the Borrelia burgdorferi genospecies complex. Ticks with Borrelia burgdorferi infection are found in temperate forested areas of northern Asia and Europe and North America.
Testing should be performed in NATA-accredited laboratories. It is important to include relevant clinical history on the request form, particularly travel history, date of any known tick exposure, date of onset of illness and symptoms, and any antibiotic treatment.
The recommended testing strategy follows European and US-CDC guidelines for two-step serological testing with a screening immunoassay and a confirmatory immunoblot for antigens from Borrelia burgdorferi sensu lato genospecies (including B. afzelii, B. garinii).
Direct testing for the organism by nucleic acid testing (eg PCR) and culture for biopsies of suspected skin lesions is encouraged. This testing is available through the PaLMS laboratory (02 9926 8470 or 9926 8480).
For direct testing of other clinical specimens, discuss first with the specialist testing laboratory (PaLMS).
Diagnosis should be made according to the patient's clinical presentation, their risk of exposure to infected ticks in an endemic area, and results from validated laboratory tests performed in a NATA-accredited laboratory. When interpreting testing results, advice should be sought from a specialist in infectious diseases or clinical microbiology.
The following points should also be considered when interpreting Lyme disease test results:
For further information please call your local Public Health Unit on 1300 066 055.