Early diagnostics are important. Timely diagnosed Borrelia infection can be treated with common oral antibiotics, such as doxycycline. When the disease remains unnoticed, it may lead to parts of the face becoming paralyzed, joint pains, heart palpitations and other complaints. To prevent such complaints Innatoss Laboratories is working on a test for early diagnostics.
An extensive review on diagnosis and treatment of Lyme Disease was recently published in the Journal of Autoimmunity (Borchers et al. 2014). This review outlines the complications in diagnosing Lyme disease and the many differences between Lyme Disease in the USA and in Europe.
In the Netherlands, a CBO guideline on Lyme disease was published in 2013. The guideline does not provide a solution for diagnosis of Lyme in an early stage, with the exception of a clinical diagnosis based on development of an Erythema migrans.
Without a strictly defined EM, an a priori chance estimation of active Lyme disease should be used to decide who should be tested serologically (measurement of antibodies) and who should not. For those that are not tested a ‘wait and see’ policy is followed after a tick bite. In the tested group, a positive screening test is followed by an immunoblot. Results are only to be used when both are positive. This two-tier strategy leads to very high specificity but limited sensitivity in the early stage. At Innatoss we believe that the latter leads to an unequivalently large number of false-negatives (having the disease, but not being diagnozed as such) compared to the number of false-positives one tries to prevent.