Clinical use
Diagnosis of, and confirmation of suspected Lyme disease caused by Borrelia burgdorferi.
Background
The bacteria that cause Lyme disease, Borrelia burgdorferi, are transmitted by the bite of an infected tick.
Infected ticks are found throughout the UK and Ireland, and although some areas appear to have a higher prevalence of infected ticks, prevalence data are incomplete. Particularly high-risk areas are the South of England and Scottish Highlands, but infection can occur in many areas. Lyme disease may be more prevalent in parts of central, eastern and northern Europe (including Scandinavia) and parts of Asia, the US and Canada.
The possibility of Lyme disease should be considered in patients presenting with symptoms including, but not exclusive to; an erythema migrans rash, swollen glands, fever and sweats or migratory joint muscle aches and pains.
Reference ranges
- IgG positive suggests exposure to an associated antigen at some time.
- IgM positive suggests recent exposure to an associated antigen.
- indeterminate IgG or IgM implies that we are unable to clarify the presence of these serological markers.
Patient preparation
None required
Specimen requirements
Serum only or Serum and CSF (if neuroborreliosis is suspected)
Minimum volume
Please send serum (600 µl minimum volume) for routine Lyme testing.
If CSF serology testing is required, please submit at least 600 µl CSF as well as at least 600 µl of serum taken on the same day.
Turnaround time
From receipt of the sample:
- Serum: 7 working days
- CSF: 4 weeks
Analysing Laboratory
Rare and Imported Pathogens (RIPL), UK Health Security Agency, Porton Down, Salisbury, Wiltshire, SP4 OJG
Additional information
If CSF serology testing is required, please submit at least 600 µl CSF as well as at least 600 µl of serum taken on the same day. If albumin, IgM and IgG levels on the CSF and serum are available, these should be provided on the request form. If the values are not provided by the referring laboratory, RIPL will arrange for these to be measured at University Hospital Southampton Immunology Department. Please note the CSF testing service has a turnaround of 4 weeks.
Please refer samples with as much clinical data as possible including clinical presentation, date of symptom onset, history of tick bite, and UK location or country of exposure. Please also provide the results of any Lyme screening tests you or other laboratories have performed.
Please visit the services page for the Rare and Imported Pathogens Laboratory for further information.