The CDC on Lyme Disease Testing

Resource The CDC on Lyme Disease Testing

Pgrovetom

Member
The CDC convienently limits the scope of the Western Blot to a single Borrelia burgdorferi strain which has its own unique surface protein makeup and is known to fail when testing for B. garinii, B, Afzelli, B, miyamotoi, B. andersonii, B. americana, B. lusitaniae, B. valaisiana, B. bissettii, B. spielmanii, B. bavariensis, B. hermsii, B. parkerii, B. turicatae etc..

The argument made by the CDC was that B burdorferi is by far the most common ( in the US) and if the person has not traveled abroad, the single strain burgdorferi based Western Blot is sufficiently accurate. But in California, its now been shown that B. miyamotoi is nearly as common as B. burgdoferi. B. Bissettii has also been found in California while B. andersonii and B. americana have been found in the Southern States.

There is no routinely used effective technology that will allow a doctor that is supicious of Lyme to detremine the species or strain of an infection. Standard PCR does not have the senstivity. There are more advanced molecular approaches used in research labs such as Ibis's use of 1.25 mL of whole blood, a novel pre-enrichment of the entire specimen extract for Borrelia DNA prior to a multi-locus PCR and electrospray ionization mass spectrometry detection assay. bUt this will never become clinically viable.

The much maligned ALS/Sapi Lyme culture is currently in a clinical study to determines its effectiveness. https://clinicaltrials.gov/ct2/show/NCT02741609
A susessful culture would allow the easy use of PCR or sequencing to determine the infections actual species and strain. The existing culture has been claimed to have a 90% senstivity. That means for difficult cases, it would be possible to run 3-5 cultures ( similar to stool parasite testing) to achieve a near 100% detremination of an actualinfection or not. No other practical clinical test can do this.

Even the much touted C6 peptide ELISA is not recommended even though its known to catch a broader ramge of species than the B burgdorferi Western Blot and its ELISA. The CDC is utilizing semantics to claim the Western Blot is the most effective test - assuming a B. burgdorferi Infection with sufficiently similar surface proteins to the B31 strain. If the goal were to provide clinicians with the widest net for Lyme or Lyme-like infections, then the current B31 Western Blot and ELISA is a slight of hand. Its been estimated that 1/3 of California Lyme infections are either B. miyamotoi or B. Bissettii and go undetected and untreated due to this CDC slight of hand.
 

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