Lyme Disease Halifax

Lyme Disease – Information on Lyme Disease- Life stories of Lyme disease

Browsing Posts tagged Elisa

VOICE OF THE PEOPLE

September 25, 2011 – 3:54am

Discredited test

It’s alarming to read that the person in charge of infectious disease control in Nova Scotia is asserting that doctors should be relying on blood tests for a diagnosis of Lyme disease (re: “Doctors blamed for mishandling Lyme disease,” Sept. 22).

The Public Health Agency of Canada quite clearly recommends: “When someone shows symptoms of Lyme disease and might have been exposed to the ticks that carry it … physicians [should] treat the illness, even if it has not been confirmed with laboratory testing.”

Furthermore, the ELISA test used here is notoriously unreliable, and at least one Lyme disease specialist has publicly urged that it be banned.

The number of Lyme cases officially recognized by the province (67) remains laughably small by comparison with the actual cases.

It’s high time that the Health Department records the number of people being treated, rather than the number of positive results on a discredited test.

Gillian Thomas, Ardoise

Deserve better

In your Sept. 22 article “Doctors blamed for mishandling Lyme disease,” Elaine Holmes, the province’s director of communicable disease prevention control, is reported as saying, “Nova Scotia uses blood tests to confirm Lyme disease” and “any clinical diagnoses in Nova Scotia must be followed up by a blood test.”

I draw to your attention an article in The Chronicle Herald in February, titled “Lyme disease tests gave false all-clear to 13 Nova Scotians — health officer.”

In this article, Dr. Robert Strang, Nova Scotia’s chief public health officer, is quoted as saying, “Often our recommendation to physicans is if somebody has been in an area of high risk or has a likely or known tick bite and then also has clinical symptoms, to go ahead and … treat the person. And we’ll continue to call them a Lyme disease case and everything regardless of what the lab tests show.”

Elaine Holmes’ statements are in direct opposition to Dr. Strang’s.

Both of these individuals are employed by the Health Department of Nova Scotia. Does the right hand not know what the left hand is doing?

With the mishandling, underdiagnosis and misdiagnosis of Lyme disease in this province, it is not the health professionals who are suffering. It is the Lyme disease victims.

We deserve better.

Paula Isenor, Bedford

When serum samples were tested for anti-Borrelia antibodies using eight commercially available ELISAs and five immunoblot assays, intertest agreement was only modest.

Current guidelines for diagnosing Lyme disease include a two-tier testing algorithm: an enzyme-linked immunosorbent assay (ELISA) for detecting anti-Borrelia antibodies, followed by immunoblot confirmation of positive ELISA results. Commercially available tests are based on sonicated whole-cell Borrelia antigens, recombinant antigens, or a mixture of the two.
To compare the performance of these assays, researchers in the Netherlands tested serum samples for anti-Borrelia antibodies using eight commercial ELISAs and five immunoblots (4 commercial, 1 investigator-made). The 89 samples were from 59 patients with suspected Lyme disease, 14 healthy controls, and 16 patients with syphilis or Mycoplasma pneumoniae infection — conditions associated with highly cross-reactive antibodies.
Of the 89 samples, 35 (39%) tested negative — and 16 (18%) tested positive — on all ELISAs. The remaining 38 (43%) tested positive on one to seven ELISAs. The proportion of samples with positive results on any one ELISA ranged from 34% to 59% for patients with suspected Lyme disease and from 0% to 38% for patients with cross-reactive antibodies. Samples from healthy controls almost always had negative ELISA results.
Thirty-one of the samples from patients with suspected Lyme disease were also tested with all immunoblots. Interblot agreement was low (IgG, 30%–84%; IgM, 0%–46%), and it was no higher for recombinant antigens than for whole-cell antigens. Some samples that tested negative on all ELISAs showed blot reactivity; some that tested positive on all ELISAs tested negative on all blots.
Comment: These findings are sobering and, unfortunately, do not facilitate diagnosis of Lyme disease. Clinicians should rely on a precise clinical determination of Lyme disease, interpreting serologic test results with great caution. Clearly, several possible ELISA/blot combinations do not work together very well. Furthermore, there are true Lyme cases with positive ELISA but negative blot results (depending on the test used), and even a few with negative ELISA but positive blot results.
— Thomas Glück, MD

Published in Journal Watch Infectious Diseases August 31, 2011

http://infectious-diseases.jwatch.org/cgi/content/full/2011/831/1

Well its August 11, 2010 and I am on route to see my first Lyme Literate Doctor. I was bit in July of 2008, removed the tick from the crater… it had now bore into my arm and I also had the tell tale bulls-eye rash. However the Elisa test came back negative and based on that … the last four Doctor’s dismissed my symptoms (over 50) and did not treat me.

So two years into this nightmare and I am finally on route. I didn’t sleep well…and I lay awake most of the night… wondering if I should write a
” If I die during treatment… I will not hold you responsible letter” to take with me… I decide against it…but would in a heartbeat.  The drive to the Doctor’s is 3.5 hours away. Exhausted already and emotionally drained I start this journey, it’s 6:30 am.  Thank You Wanda for letting me use your car.  (I can’t say Thanks enough)

I had great confidence in my new Doctor, Dr. Ben Boucher.  I had heard many good things about him from other Nova Scotian’s seeing him.  I was sure he would be able to evaluate me correctly with or without a positive Elisa test.  Surely, just in my spacey Lyme look alone.  However did wish on the way up I had one visible symptom that could prove to him, and so he could confirm to me, that I really had this. I got sick right after the bite, been sick since and had the rash.  I guess you have to be careful for what you wish for.  By the time I arrived at his office… my knees and ankles were full blown swollen and red. (Chronic Lyme Arthritis) I’m sure my Mom was trying to answer my prayers, Mom’s almost never fail.           

 Good I thought he will be able to see this. I only broke into full blown tears once on my way up, when the song “Sarah” by Rascall Flats came on.  I get out of the car behind the office in the parking lot, try to stretch my legs out so they will get me in the office.  I noticed a few cars in the parking lot…but one stuck out. It was a rather nice vehicle, (not over the top or anything)  I guessed it was my Doctors. It had a license plate that was a Canadian flag with a US flag sheen overlay on top of it.  Already emotionally drained I started to sob, tears just streaming down. I thought about my US Lymie friends that I first connected with on facebook, a border separates us, but we are all the same. We all suffer, hurt, and hope together. I really dont know how I would have gotten through this far without them.  When all (lOl @ all)I thought I had was Lyme Disease and totally clueless about much of it. And once I was complaining about my splinntering tibia’s and intensely sore soles that hurt to put weight on, one of these knowledgable souls directed me to have a look at the Bartonella symptoms. I have also connected with many Maritimers and other Canadians who are going through the exact same thing, sadly.  The names of all these people just went through my head…sickened that I could rhyme off 50 names no problem. Note: I have over 400 people with Lyme Disease on my facebook, and could easily just keep adding more and more.

I’m wondering if this Doctor could see me standing there doing this from one of the windows. He must think I have totally lost it. I re-open the door to the now locked car because I have to get myself together before I go in there. I open the door, set my glasses on the seat, wipe my eyes and then the Doctor comes out with a file. I thought great I’m busted he seen me.  He”s coming to get me! He called another patient that was also getting out of their car and called them by name and says your next.  I thought, I heard of Nova Scotia hospitality but this is surreal.  I stood there with my mouth open, stunned ! He must have noticed … he says “this doesn’t happen often .. I know these people”…and he kind of laughed and I did to. Anyway… I just wanted to get back to this license plate that had me so fixated. And I did for another couple of minutes. Then realized I had locked my glasses in the car.

I make my way into the office (I was in the waiting room when he called me in …lOl) Nothing stuffy about this guy…he introduced me with his first name.  I felt immediatly at ease.  On the sheet I had to fill out before hand, I had to check off what symptoms I had.  There is about 8 pages to this… full pages.. many, many symptoms with Lyme Disease and the nasty co-infections of Bartonella and Babasia.  I had asked other Dr.s to do this…to go over the symptom list that I downloaded from the ILADS site.  So I could go from head (which was also tender) to toes.  There is no way I could bluff having this (who would want to)…with all these symptoms… and remember when and how long I had that.. no way I could remember all this. Immediatly I showed him my legs. Look-Proof !! He wasnt so concerned with what was on the outside … he was more concerned with what was going on .. on the inside… and I knew I had the right Doctor.  I have not felt like I was under good care until now in over two years.  He diagnosed me with Lyme Disease and Bartonella… not sure on the Babasia the meds I will be taking will worsen the symptoms…we’ll find out then.  Some people are devastated to hear they have this dreadful disease … I only felt relief.  I have finally been diagnosed.  I have found a Doctor that Nova Scotia is so lucky to have. If it were not for him, I would have to go the U.S for treatment. I would never in a million years be able to do this…not a single doubt in my mind…not one !!! He risks his license to treat patients as the CDC follows the IDSA guidelines… I am so overcome with emotion that he would do this for little ole me.

At the end of my appointment, he says “Do you have any questions?”  I said “Oh ya about 40″… I also have the stunned off in space lymie look. He says “Did you forget them all?’ I said “yes”. He said “OK I’ll see you back here next appointment.” He totally understood!!!

I leave feeling incredibly blessed and with a new sense of hope.

Bless you, Dr. Boucher, Bless you !!!!! 

Bless us all…. ing XO