26. What is the two tier testing procedure set up by the CDC for testing patients suspected of having Lyme disease and what are the most common problems with this procedure?

Doctors have been instructed (CDC guidelines) to obtain an ELISA (titer) first, which, under the best circumstances, only identifies 40-50 percent of those who actually have Lyme disease. An ELISA should NOT be used as a screening test due to the unreliable results. The guidelines state, if the ELISA is positive, physicians are to perform a Western Blot test which, under the best circumstances, only identifies 70-80 percent of those who have been exposed. Most labs do not report specific bands on the Western Blot tests, hindering the experienced physician and the diagnosis even further. This procedure allows many cases of Lyme disease to be missed, therefore, patients are not being identified or properly treated. The CDC guidelines also state which specific bands on a Western Blot are to be used to consider a test positive. When the list was developed, certain bands specific for Lyme disease, were not included. When these bands are positive, it confirms exposure, but it is mistakenly reported to the doctor and patient as a 'negative test'. Many 'borderline tests' are reported to patients, by the physician, as being negative and many positive tests are reported to be 'false-positive' because physicians are not familiar with reading test results, nor with the multiple symptoms that can occur in a person with Lyme disease, and the connection between the two is missed. Many patients who have chronic Lyme disease will have low titers or seronegative results.

---> U.S. Senate says "that more than one third (36%) of the people with Lyme disease did not test positive on the most sophisticated tests available."

---> Pediatric tick-borne diseases specialist, Dr Charles Ray Jones explains the Western Blot test.

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