One dot is placed randomly within the county of residence for each confirmed case. Lyme disease cases (black dots) reported by surveillance, United States, 2005–2010. We review the rationale behind current US testing guidelines, appropriate use and interpretation of tests, and recent developments in Lyme disease diagnostics.įigure 1. Use of other diagnostic tests for Lyme disease is limited. Specificity is high (>95%) during all stages of disease. For disseminated Lyme disease, sensitivity is 70%–100%. Sensitivity of 2-tiered testing is low (30%–40%) during early infection while the antibody response is developing (window period). The recommended laboratory test in the United States is 2-tiered serologic analysis consisting of an enzyme-linked immunoassay or immunofluorescence assay, followed by reflexive immunoblotting. For all other patients, laboratory testing is necessary to confirm the diagnosis, but proper interpretation depends on symptoms and timing of illness. Patients with an erythema migrans lesion and epidemiologic risk can receive a diagnosis without laboratory testing. In the United States, Lyme disease is caused by Borrelia burgdorferi and transmitted to humans by blacklegged ticks. Disclosure: Laurie Barclay, MD, has disclosed the following relevant financial relationships: owns stock, stock options, or bonds from Pfizer.ĭisclosures: Andrew Moore Christina Nelson, MD, MPH Claudia Molins, PhD Paul Mead, MD, MPH and Martin Schriefer, PhD, have disclosed no relevant financial relationships. Laurie Barclay, MD, freelance writer and reviewer, Medscape, LLC. Gryczan, MS, has disclosed no relevant financial relationships. Gryczan, MS, Technical Writer/Editor, Emerging Infectious Diseases. Identify recent developments in Lyme disease diagnostics.Determine appropriate use and interpretation of tests for Lyme disease.Distinguish current US testing guidelines for Lyme disease, based on a review.Upon completion of this activity, participants will be able to: Release date: JExpiration date: June 15, 2017 To participate in this journal CME activity: (1) review the learning objectives and author disclosures (2) study the education content (3) take the post-test with a 75% minimum passing score and complete the evaluation at (4) view/print certificate. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Īll other clinicians completing this activity will be issued a certificate of participation. Medscape, LLC designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) TM. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit.
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