Issue: July 2014
June 06, 2014
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Most Lyme disease testing performed according to recommendations

Issue: July 2014
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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.”

Approximately 3.4 million Lyme disease tests were performed on 2.4 million specimens at seven participating laboratories in 2008, with the estimated cost of $492 million, the researchers found. In addition, based on the number of tests run and the number of positive tests reported, the estimated number of annual Lyme disease infections is 288,000 per year, with a range of 240,000 to 444,000 infections.

“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 type of 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.