What is the two tier testing procedure set up by the IDSA/CDC for testing patients suspected of having Lyme disease and what are the most common problems with this procedure?
The CDC and IDSA recommends an ELISA (titer) first, which, under the best circumstances, only identifies a small percentage of infected patients. An ELISA therefore, should NOT be used as a screening test due to the notoriously unreliable results. The IDSA guidelines state, if the ELISA is positive, physicians are to perform a Western Blot test. Under the best circumstances a Western Blot only positively identifies 70-80 percent of those who have been exposed. Most labs do not report specific bands on the Western Blot tests, hindering the experienced physician and the diagnosis even further. This 2-tiered method allows many cases of Lyme disease to be missed. The CDC also dictates which specific bands on a Western Blot are to be used to consider a Lyme test positive. When the list was originally developed, certain bands specific for Lyme disease were not included; however if these bands are positive it confirms exposure even though it is incorrectly reported to the doctor and patient a
