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Most Lyme disease testing performed according to recommendations
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At least 62% of the laboratory tests performed for Lyme disease at commercial laboratories were conducted as part of the two-tiered testing approach recommended by the CDC for evaluating patients suspected to have the disease, according to a report in Clinical Infectious Diseases.
“We’ve known for a long time that Lyme disease is a very big public health problem,” Alison Hinckley, PhD, an epidemiologist at CDC’s Division of Vector-borne Diseases, told Infectious Disease News. “With these new data, we now also know that clinicians frequently consider it as a cause of illness. Moreover, Lyme disease testing by these large laboratories is generally in accordance with diagnostic recommendations.”
There were approximately 3.4 million Lyme disease tests performed on 2.4 million specimens at the seven participating laboratories in 2008, with an estimated cost of $492 million, the researchers found.
The data were provided by seven laboratories that conducted more than 76% of the Lyme disease tests reported in the four endemic states in 2008. The data included the number of tests performed and the type of tests performed. The researchers determined the approximate costs of conducting the tests.
Thirty-one percent of the tests were conducted in the four endemic states (Connecticut, Maryland, Minnesota and New York). Among those, 68% were conducted as part of the two-tiered testing approach with the immunoassay followed by the Western blot reflex. Within the four endemic states, there were an estimated 288,000 infected source patients, an infection rate of approximately 12%.
“Based on the results, it appears that a fair amount of unnecessary testing occurs,” Hinckley said. “However, we weren’t able to independently compare this overtesting amount with that of other infectious diseases because this information is rare. Given the large number of tests for Lyme disease and potential for false results, it is important for clinicians to consider clinical and exposure history in conjunction with laboratory results for diagnosis of Lyme disease.”
Hinckley said that before testing a patient for Lyme disease, it is important to consider the likelihood that a patient is infected by evaluating symptoms and geographical and behavioral risk factors for tick exposure. Serologic testing should be considered if there is a reasonable chance the patient has Lyme disease based on these factors, Hinckley said. — by Emily Shafer
Disclosure: Some researchers have received funding through the CDC Cooperative Agreement/CT DPH Contract, CDC and the CDC Emerging Infections Program Grant, TickNet program.
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