DATE: April 2, 2021
TIME: 09:00am PDT
There has been a major development in the serologic diagnosis of Lyme disease. All parties agree (as before) on the paradigm of “Two Tier Testing”. The “Old” recommendation is called STTT, or Standard Two Tier Testing (ELISA reflexed to IgG and IgM WB). There are well known drawbacks and problems with this, acknowledged by the CDC and many specialists in the field. This led to the development and adoption of an improved paradigm called MTTT, or Modified Two Tier Testing. Modified Two Tiered Testing is well validated, the associated tests have been FDA cleared and they’ve been shown to perform equal to or superior to STTT in all stages of Lyme infection.
Another change is the continued appreciation of co-infections (one tick bite transmitting multiple pathogens), with implications of the types of diagnostic tests, including the available PCR tests, to be ordered in symptomatic persons following tick bites. Finally, there continues to be new emerging TBDs, including Anaplasma, Babesia, and Ehrlichia, plus further geographic spread of the more traditional well-known agents.
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