Tools for the Clinic
- Recommendations for Patients after a Tick Bite pdf icon[PDF – 2 pages]
- Tickborne Diseases of the United States: A Reference Manual for Health Care Providers, Fifth Edition (2018).
- Print or save the Tickborne Diseases of the US: A Reference Manual for Health Care Providers, Fifth Edition (2018) Print only version pdf icon[PDF – 52 pages]
- Order hard copies for your office.
- Online version
- Wall poster: The Many Forms of Lyme Disease Rashes (Erythema Migrans) pdf icon[PDF – 1 page]
- Laboratory tests that are not recommended
This report describes the proper interpretation of serologic testing for B. burgdorferi and identifies best practices for reporting results to clinicians, public health agencies, and patients.
- Clinician Education Modules (CE available)
- Lyme Disease Updates and New Educational Tools for Clinicians: one-hour CDC-sponsored Clinician Outreach and Communication Activity (COCA) course helps providers learn to properly diagnose and treat Lyme disease (1.0 CE credit available):
Understanding pre-test probability
Understanding Test Results for Infectious Diseases
The illustration depicts the likelihood of false positive and false negative test results based on the prior probability of a disease occurring in a given population. Clinicians should consider the likelihood of disease before performing laboratory testing. The likelihood that a patient has a disease depends on many factors:
- Has a patient been in an area where the disease is found?
- Does the patient have signs and symptoms typical of the disease?
- Does the patient have risk factors for contracting or developing the disease?
In populations where disease is rare or unlikely, testing is likely to lead to false positives more frequently than true positives.
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Schwartz AM, Kugeler KJ, Nelson CA, et al. Use of commercial claims data for evaluating trends in Lyme disease diagnoses, United States, 2010-2018. Emerg Infect Dis. 2021;27(2):499-507.
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Pediatrics and Pregnancy
American Academy of Pediatrics. Lyme disease (Lyme borreliosis, Borrelia burgdorferi infection).external icon In: Pickering LK, Red Book: 2021.
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Branda JA, Steere AC. Laboratory diagnosis of Lyme Borreliosisexternal icon. Clin Microbiol Rev. 2021 Jan 27;34(2):e00018-19.
Branda JA, Strle F, Strle K, Sikand N, Ferraro MJ, Steere AC. Performance of United States serologic assays in the diagnosis of Lyme borreliosis acquired in Europe.external icon Clin Infect Dis 2013 Aug;57(3):333-40.
Hinckley AF, Connally NP, Meek JI, et al. Lyme disease testing by large commercial laboratories in the United States.external icon Clin Infect Dis 2014 May 30. pii: ciu397.
Johnson BJ, Pilgard MA, Russell TM. Assessment of new culture method for detection of Borrelia species from serum of Lyme disease patients.external icon J Clin Microbiol 2014;52:721–4.
Johnson, B.J. “Chapter 4: Laboratory diagnostic testing for Borrelia burgdorferi infection” in Lyme disease: An Evidence-based Approach, J.J. Halperin, Ed. (CAB International, 2011). Complete Article Reproduced with Permission [PDF – 16 pages].pdf icon
Mead P, Petersen J, Hinckley A. Updated CDC recommendation for serologic diagnosis of Lyme disease. MMWR Morb Mortal Wkly Rep. 2019 Aug 16;68(32):703.
Moore A, Nelson C, Molins C, et al. Current guidelines, common clinical pitfalls, and future directions for laboratory diagnosis of Lyme disease, United States. Emerg Infect Dis. 2016 Jul;22(7).
Notice to readers: caution regarding testing for Lyme disease. MMWR, CDC Surveillance Summary 2005;54:125.
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ClinicalTrials.govexternal icon Studies of Lyme disease / “Borrelia Infections”.