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Lyme Disease - Serology
SPECIMEN REQUIREMENTS
Specimen Type:

​Serum

Container/Kit:

​Blood, clotted - vacutainer tubes (SST) 

Collection information:

​Instructions for using SST tubes are found in the document titled: LAB-SD-008, Blood Collection using Serum Separator Tubes.

Minimum volume required:

​5.0 ml blood or 1.0 ml serum

Requisition:

​Complete all fields of the General Test Requisition Form.

Ensure the following fields are completed if diagnostic testing is requested:
• Clinical symptoms
• Exposure (e.g. tick bite)
• Travel history
• Onset date

When a European Lyme is suspected, European Lyme serology should be specifically stated on the requisition.

Limitation:

​Haemolysed, icteric, lipemic or microbially contaminated sera or plasma are not recommended for testing.

SPECIMEN HANDLING
Preparation prior to transport:

​Centrifuge if using SST. Label specimens with at least two identifiers; place it in biohazard bag and seal. Specimens should be stored at 2-8°C following collection and shipped to PHOL on ice packs.

Special Instructions:

​An acute (collected early after the onset of symptoms) and a convalescent (collected 6 weeks later) may be required for laboratory diagnosis. 

TEST INFORMATION

​PHL performs tests for antibody to Borrelia burgdorferi using a two-tier test method as recommended by the Canadian Public Health Laboratory Network. 

Initially, a specimen is tested for total antibodies using a C6 peptide ELISA (Enzyme Linked Immunosorbent Assay) method. A specimen that is either reactive or indeterminate by ELISA assay will be further tested for IgM and IgG specific antibodies using western blot assay.

Any C6 ELISA reactive or indeterminate specimen requesting European Lyme will be forwarded to National Microbiology Laboratory (NML) for western blot testing for antibodies to B.garinii and B. afzeli – the strains of Borrelia found in Europe. 

NML offers PCR testing for B. burgdorferi on CSF and tissue with prior approval.

ADDITIONAL INFORMATION

​None

TESTING FREQUENCY AND TURNAROUND TIME (TAT)

​• Non‐reactive results: less than seven days
• Reactive results: within 14 days
• European Lyme request requiring confirmation at NML: 21 days

REPORTING

​Results are reported to the ordering physician or health care provider as indicated on the requisition.

Specimens that are positive for Borrelia species antibodies are reported to the Medical Officer of Health as per Health Protection and Promotion Act.


Uncontrolled print copy. Valid only on day of Print: [date]
Page updated on [date/time] 14/05/2013 8:11 AM
© , Ontario Agency for Health Protection and Promotion