Evaluation of the Modified Two-Tiered Testing Method for Diagnosis of Lyme Disease in Children Bacteriology
Conventional two-tiered testing (CTTT) for Lyme disease includes a first-tier enzyme immunoassay (EIA) followed by a supplemental immunoblot, and modified two-tiered testing (MTTT) relies on two different sequential EIAs without the inclusion of an immunoblot. MTTT has shown promising results as an alternative strategy for the diagnosis of Lyme disease in adults but has not yet been evaluated in children. We performed a cross-sectional study of children and adolescents ≤21 years of age undergoing clinical investigation for suspected Lyme disease. Serum specimens were analyzed with both a whole-cell sonicate (WCS) and a C6 EIA, with a supplemental immunoblot if either EIA was positive or equivocal. We compared CTTT (WCS EIA followed by supplemental immunoblot) to MTTT (WCS EIA followed by C6 EIA) using McNemar’s test to evaluate for agreement beyond chance alone. We then used a kappa statistic to measure level of the agreement between testing strategies. We included 1,066 serum specimens, of which 156 (14.6%) had a positive CTTT and 165 (15.5%) had a positive MTTT. There were no significant differences between MTTT and CTTT (P = 0.16). Although the overall agreement between MTTT and CTTT was high (kappa, 0.88; 95% confidence interval, 0.84 to 0.92), 33 children had discordant test results. In a cohort of children and adolescents undergoing investigation for suspected Lyme disease, CTTT and MTTT results agreed in most cases. Since immunoblots are time-consuming, labori...
Publication date: 19 October 2019Source: New Scientist, Volume 244, Issue 3252Author(s): Clare Wilson
Conclusions: In Slovenia, LNB in children is more often caused by B. garinii, followed by B. afzelii. The clinical picture of LNB in children caused by B. garinii is not more often suggestive of CNS involvement, but CNS inflammation is more pronounced in children infected with B. garinii, compared with children infected with B. afzelii.
The frequency of permanent staining of teeth of young children from doxycycline is thought to be lower than from older tetracyclines, but the precise risk is uncertain. Until more definitive data become available, doxycycline should not be used routinely to treat young children with erythema migrans, a manifestation of Lyme disease for which other antimicrobials are highly effective.
This study documents a high prevalence in ticks of Rickettsia spp. thought to be endosymbionts, a low prevalence of relapsing fever group Borrelia in ticks, and a lack of detection of Lyme disease-group Borrelia in both ticks and mammals in an east Texas forested recreation area. Additionally, we observed low questing tick density in areas with a history of controlled burns. These results expand knowledge of tick-borne disease ecology in east Texas which can aid in directing future investigative, modeling, and management efforts.
Publication date: Available online 16 October 2019Source: Ticks and Tick-borne DiseasesAuthor(s): Nicole E. Breuner, Shelby L. Ford, Andrias Hojgaard, Lynn M. Osikowicz, Christina M. Parise, Maria F. Rosales Rizzo, Ying Bai, Michael L. Levin, Rebecca J. Eisen, Lars EisenAbstractThe invasive, human-biting Asian longhorned tick, Haemaphysalis longicornis, was detected in New Jersey in the eastern United States in August of 2017 and by November of 2018 this tick had been recorded from 45 counties across 9 states, primarily along the Eastern Seaboard. The establishment of H. longicornis in the United States has raised the ques...
LYME disease is a bacterial infection spread to humans by infected ticks. Ticks are tiny spider-like creatures found in woodland and heath areas. They feed on the blood of birds, mammals and humans. Feeling this sensation in your head could mean you have Lyme disease.
Rapid assay for Lyme disease could lead to a practical test for use by healthcare providers.
Updated Date: Tue, 15 Oct 2019 00:00:00 EDT
DR MARTIN SCURR: Pat Toovey from Norfolk found a tick on his wife's back two years ago and she is constantly in pain and struggles to get out of bed. He fears she has Lyme disease.