Lyme disease: Toward New, More Reliable, and Multi-Species Tests?

Talking about Borreliosis in France can sometimes feel like breaking a taboo. The effectiveness of serological tests may be part of the reason… A new diagnostic strategy could shake things up.   Currently, the available tests are serological tests, and their purpose is to detect antibodies in the blood produced by white blood cells in response to infection with Borrelia burgdorferi. In the United States, 476,000 people are diagnosed this way each year. It is the most common vector-borne transmission (transmitted by tick bites) in the U.S. The ELISA and Western blot tests measure the body’s “response” to exposure to the bacteria. However, these tests reveal past or current exposure to B. burgdorferi, but do not confirm that the patient has developed Lyme disease. Furthermore, they are the subject of controversy, particularly in France, due to the high number of false negatives if the test is performed during the first two weeks of infection. A new diagnostic strategy involves detecting Borrelia DNA in the blood or cerebrospinal fluid. A positive result indicates the presence of Lyme disease. Cornell University was thus able to confirm the presence of the bacteria in the cerebrospinal fluid of a horse with the neurological form of the disease, which immediately received targeted treatment and survived. The detection of bacterial DNA confirms that the pathogen is present, and its disappearance after treatment indicates that the animal has recovered. This DNA-based technique is very promising, and this direct test should benefit many species (horses, dogs, and even humans). The effectiveness of diagnostic tests is essential for initiating treatment as early as possible—at the very first symptoms of borreliosis (fever, headache, fatigue, rash)—in order to limit the risk that the infection spreads to the joints, or even to the nervous system and the heart.