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Two-tiered testing is necessary because the ELISA may yield false-positive results from antibodies directed against other spirochetes, viral infections or autoimmune diseases.Figure 5) Two-tiered serological testing for Lyme disease.

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There may be central clearing or some bluish discoloration but a classic bull’s eye is uncommon. Updated by: Jane Mc Donald, Nicole Le Saux, Infectious Diseases and Immunization Committee Lyme disease, the most common tick-borne infection in Canada and much of the United States, is caused by the bacteria .Peak incidence for Lyme disease is among children five to nine years of age and older adults (55 to 59 years of age).The most common presentation is the erythema migrans rash. Some individuals experienced Early, localized (cutaneous) disease: In general, the diagnosis of LD is clinical (see EM, above), supported by a history of potential tick bite in an area where it is known or suspected that black-legged ticks have been established.However, because tick populations are expanding, it is possible that LD can be acquired outside of currently identified areas.

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