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Tick season: Faster, more precise testing for Lyme disease is on the way, researchers say
Some scientists are predicting a surge in the number of Lyme-carrying ticks beginning this month and lasting into early summer. Wochit
Lyme disease is so difficult to diagnose that many patients don't know they're infected weeks, months and even years after their body begins to fight it.
Now a group of scientists led by a Rutgers researcher say new testing methods promise to deliver a more precise diagnosis as Lyme disease cases in New Jersey last year reached their highest levels in 17 years.
Early diagnosis and treatment are key to combating a disease that can eventually become extremely debilitating. That's difficult to do when the current tests often come back negative in the first few weeks after infection.
LYME DISEASE: How to avoid ticks and Lyme disease
“It has been a biological hurdle for many years that we are crossing," said Dr. Steven Schutzer, a physician-scientist at Rutgers New Jersey Medical School and senior author of an academic paper detailing the advances that was written with two dozen other leading researchers.
"The key here is that the tests are better," he said. "They are more accurate. And that will help improve patient outcome."
May, June and July are peak months for deer ticks to transmit the bacteria borrelia burgdorferi that causes Lyme disease especially in the Northeast, when more people are outdoors and the ravenous arachnids feast on their blood. About 30 percent of nymph ticks are infected in a normal year after feeding on the blood of mice that carry the bacteria.
At least eight new testing methods have been approved by the federal Food and Drug Administration since 2017 that may help cut down on misdiagnoses common when testing for Lyme. When those methods will be on the market is unclear.
Lyme is a tricky disease to diagnose. Those infected may not have known they have been bitten by the minuscule tick. Symptoms appear in three to 30 days. And symptoms like fever, rash and aches could be caused by a number of ailments, making a quick diagnosis difficult.
Those who develop a rash shaped like a bulls-eye near the bite can usually begin treatment without waiting on lab tests. But about 30 percent of those infected never develop a rash. Other patients never recognize it as a telltale sign of Lyme disease.
Douglas Kahn's teenage daughter developed the rash in autumn of 2007. Neither he nor his wife knew it was a symptom of Lyme. Neither did his daughter's pediatrician, Kahn said.
The doctor thought it was a rash and recommended taking her to a dermatologist, Kahn said. The rash went away and Kahn's daughter wasn't diagnosed with Lyme until a year later after the disease took a debilitating toll on her.
Kahn said better tests are welcomed but stressed that family physicians need to be better trained at identifying Lyme symptoms.
"I'm far from an expert but the medical community seems to be very much behind when it comes to diagnosing and treating Lyme," said Kahn, of Monmouth County. "It's not just the tests. It's having doctors recognizing this disease early on."
If detected early, the disease can be treated successfully with antibiotics. Recovery is generally quicker the sooner treatment begins. Patients who aren't diagnosed early and receive treatment later can suffer long-term damage to the nervous system or joints, according to the federal Centers for Disease Control.
If left untreated, infection can spread and damage the heart, the nervous system and joints.
The current testing methods are based on technology developed in 1994, Schutzer said. It relies on detecting the antibodies produced by the infected person to fight the disease several weeks after they are first infected. Two back-to-back tests are required to confirm a diagnosis.
Two relatively new diagnostic methods - a single multiplex assay and a next-generation enzyme immunoassay - have the potential to make a more timely, accurate diagnosis without a second test, researchers say.
“New tests are more exact and are not as susceptible to the same false-positive or false-negative results associated with current tests," Schutzer said.
Phillip Baker, executive director of the American Lyme Disease Foundation, said the current two-tiered test - ELISA and the Western blot - are effective at diagnosing patients several weeks after infection. He said the new generation of tests may shave a week or two off a diagnosis. "The current method is pretty accurate but anything sooner is always better for the patient," he said.
Kahn started a support group called the New Jersey Lyme Support Group, which now has more than 500 members.
"Our whole goal is to be supportive to everyone fighting this disease," Kahn said. "I'm not a doctor. I'm just a dad who has been through a lot."
Lyme disease symptoms
- A bull's-eye-shaped rash at the site of the bite that appears about a week later.
- Severe headaches and neck stiffness.
- Arthritis with severe joint pain and swelling, particularly in the knees.
- Irregular heartbeat.
- Nerve pain.
Preventing tick bites
- Avoid wooded and brushy areas with high grass and leaf litter, especially from April through July.
- Cover exposed skin during hikes.
- Repel ticks with DEET.
- Take a shower immediately after outdoor activities.
Lyme disease cases in New Jersey
- 2017: 5,092
- 2016: 4,350
- 2015: 4,855
- 2014: 3,286
- 2013: 3,766
- 2012: 3,576
- 2011: 4,262
- 2010: 3,712