Sunday, 5 February 2017


Lyme disease, or Lyme borreliosis, in North America is a group of systemic infections which may be caused by Borrelia burgdorferi sensu lato (including B. mayonii) [2], B. miyamotoi [3-5], and other unnamed tick-borne borrelia strains [3, 6]. Currently the diagnosis of emerging or reemerging infectious diseases largely depends on finding evidence of the causative agents, including borrelia, in the host by nucleic acid-based tests [7]. The accuracy of any diagnostic tests must be measured against this standard of microbiological diagnosis. Using a serologic test kit developed for the detection of antibodies against the epitopes of B. burgdorferi sensu stricto strain B31 will fail to diagnose most Lyme borreliosis patients in the first two weeks of acute infection and probably all clinical Lyme borreliosis cases caused by a strain of borrelia other than B. burgdorferi sensu stricto B31 at any stages of the disease. The inherent inaccuracy of serologic tests for Lyme disease can be compared with that of the Widal test for the diagnosis of typhoid or paratyphoid fever (Salmonella infections). A comment extracted from a Centers for Disease Control and Prevention (CDC) document is copied as follows [8]. “The Widal test is unreliable but is widely used in developing countries because of its low cost. It is a serologic assay for IgM and IgG to the O and H antigens of Salmonella Typhi, but is not specific and false positives may occur. Acute- and convalescent-phase titers are more sensitive than a single serum sample. Newer serologic assays for Salmonella Typhi infection are occasionally used in outbreak situations, and are somewhat more sensitive and specific than the Widal test, but are not an adequate substitute for blood, stool, or bone marrow culture.” 

The above is an extract from Sin Hang Lee, F.R.C.P.(C) Director, Milford Molecular Diagnostics Laboratory comments on a recent published article - “The Accuracy of Diagnostic Tests for Lyme Disease in Humans, A Systematic Review and Meta-Analysis of North American Research” by Lisa A. Waddell and colleagues

My earlier post also refers to this, which was discussed by Mary Beth Pfeiffer investigative journalist in a Huffington post article

Dr Lee's detailed comments can be read in full at

Dr Lee finishes his comments by saying :-

To overcome the low sensitivity of LD diagnostic tests in patients with early LD at the spirochetemic stage, we must first acknowledge a need to develop direct detection tests for Borrelia burgdorferi and related borrelia species known to cause Lyme borreliosis in North America. To survey the existent useful direct detection tests which may not have been published due to global editorial censorship by the mainstream medical journals, it is recommended that blind-coded simulated blood samples spiked with various species of known borreliae or blank be distributed by government regulatory agencies to all clinical laboratories performing Lyme disease testing for a bacteriology proficiency survey, as routinely conducted by the College of American Pathologists for Neisseria gonorrhoeae. The laboratories which return the correct answers would be invited to further develop a generally accepted diagnostic protocol to be used by hospital laboratories located in Lyme disease-endemic areas. To be of use for timely patient care, the results must be generated within 5 working days, preferably in 48 hours. I believe this technology is already available. The first step to the Lyme disease solution is to cut out the tribalism among the scientists whose careers were built on Lyme disease research. 

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