Diagnose Lyme disease if bull’s eye rash is present, says NICE

Andy

Andy

Retired committee member
People showing erythema migrans, the characteristic skin rash associated with Lyme disease, can be diagnosed without the need for blood tests, NICE says in new guidance.

Lyme disease is an infection transmitted by the bite of a tick. Prompt diagnosis and early treatment helps reduce the risk of further symptoms developing.

Laboratory tests check for antibodies in the blood however Lyme disease antibodies may first appear six to eight weeks after a person has been bitten by a tick. Early laboratory tests may not detect the disease and could slow diagnosis.
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https://www.nice.org.uk/news/article/diagnose-lyme-disease-if-bull-s-eye-rash-is-present-says-nice
 
That was, if I'm not mistaken, the standard practice in the US by 1999, ie, a bull's eye was diagnostic. Oh, they qualified it with dimensions and the like because of STARI eventually, but regardless.

Evidently 1999 may have been a banner year in Lyme mishaps. That year I had over 100 deer ticks removed in a medical clinic - and received no abx prophylacticaly because that was not yet the accepted protocol, even in Lyme endemic areas.

I look at this a a net add for UK Lyme patients, even though some of the stuff in the release is suspect, e.g. "After a diagnosis of Lyme disease, a person will receive an appropriate dosage of antibiotics based on their symptoms"
 
They're a bit late to the party! I "diagnosed" from the rash (and I'm not a doctor) a friend 10-15 years ago on the basis of a paper I read in the Scottish Medical Journal (article now behind a pay wall, wasn't then luckily!). GP of friend accepted that as sufficient evidence (the paper) and treated. Fortunately the antibiotics worked. Geez, NICE are slow and useless.
 
Andy said:
https://www.nice.org.uk/news/article/diagnose-lyme-disease-if-bull-s-eye-rash-is-present-says-nice
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Surely this is wrong from their (?)press release?

If the ELISA is positive or symptoms continue for 12 weeks of more, a more specific test called an immunoblot test should be used to confirm Lyme disease.
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Shouldn't that read "If the ELISA is negative..."? I thought if it was positive that meant patient had Lyme. Or am I misunderstanding something?
 
ladycatlover said:
Surely this is wrong from their (?)press release?

Shouldn't that read "If the ELISA is negative..."? I thought if it was positive that meant patient had Lyme. Or am I misunderstanding something?
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I suspect this is based on the CDC's 2 tier testing recommendation. If you test positive on the ELISA, and ONLY if you test positive on the ELISA, you move on to a Western Blot. If you test negative on the ELISA, no WB for you. In the US, it is very difficult because of this recommendation to ever get a Lyme WB without first getting a positive ELISA, even thought the ELISA basically sucks.
 
duncan said:
I suspect this is based on the CDC's 2 tier testing recommendation. If you test positive on the ELISA, and ONLY if you test positive on the ELISA, you move on to a Western Blot. If you test negative on the ELISA, no WB for you. In the US, it is very difficult because of this recommendation to ever get a Lyme WB without first getting a positive ELISA, even thought the ELISA basically sucks.
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Ah, so NICE is as usual taking the cheapest option. Don't bother testing further if the first test comes back negative. Oh what a surprise. :rolleyes:

Thank you @duncan for your clarification. :)
From fuming ladycatlover Grrr grrr grrrr angry argghh :emoji_rage::emoji_japanese_ogre::emoji_japanese_goblin::emoji_scream_cat:

ETA just to be totally clear @duncan, it's not you I'm angry with - very glad for your input.
 
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