Lyme borreliosis is a tick-borne disease that predominantly occurs in temperate regions of the northern hemisphere and is primarily caused by the spirochete Borrelia burgdorferi in North America and Borrelia afzeliior Borrelia gariniiin Europe and Asia. Infection usually begins with an expanding skin lesion, known as erythema migrans (referred to as stage 1), which, if untreated, can be followed by early disseminated infection, particularly neurological abnormalities (stage 2), and by late infection, especially arthritis in North America or acrodermatitis chronica atrophicans in Europe (stage 3). However, the disease can present with any of these manifestations. During infection, the bacteria migrate through the host tissues, adhere to certain cells and can evade immune clearance. These organisms are eventually killed by both innate/adaptive immune responses. Most inflammatory manifestations of the infection resolve themselves. Except for patients with erythema migrans, Lyme borreliosis is diagnosed based on a characteristic clinical constellation of signs and symptoms with serological confirmation of infection. All manifestations of the infection can usually be treated with appropriate antibiotic regimens. Prevention of Lyme borreliosis primarily involves the avoidance of tick bites by personal protective measures.
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1.Steere AC, et al. Lyme borreliosis. Nature Reviews | Disease Primers; Vol 2, 2016