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Updated: Aug 28, 2025

Detecting the Lyme Disease Spirochete, Borrelia Burgdorferi, in Ticks Using Nested PCR
Published on: February 4, 2018
Diagnostic Testing for Lyme Disease
Takaaki Kobayashi1, Paul G Auwaerter2
1Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Abstract:
Standard 2-tier testing (STTT), incorporating a screening enzyme immunoassay (EIA) or an immunofluorescence assay (IFA) that reflexes to IgM and IgG immunoblots, has been the primary diagnostic test for Lyme disease since 1995. In 2019, the Food and Drug Administration approved a modified 2-tier test strategy using 2 EIAs: offering a faster, less expensive, and more sensitive assay compared with STTT. New technologies examine early immune responses to Borrelia burgdorferi have the potential to diagnose Lyme disease in the first weeks of infection when existing serologic testing is not recommended due to low sensitivity.
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