Two-Tier Lyme Disease Serology in Children with Previous Lyme Disease.
Vector Borne Zoonotic Dis
; 21(11): 839-842, 2021 11.
Article
in English
| MEDLINE | ID: covidwho-1746959
ABSTRACT
Background:
A history of Lyme disease can complicate the interpretation of Lyme disease serology in acutely symptomatic patients. Materials andMethods:
We prospectively enrolled children undergoing evaluation for Lyme disease in the emergency department of one of eight participating Pedi Lyme Net centers. We selected symptomatic children with a Lyme disease history (definite, probable, or none) as well as an available research biosample. We defined a Lyme disease case with either an erythema migrans (EM) lesion or positive two-tier serology with compatible symptoms. Using a generalized estimating equation, we examined the relationship between time from previous Lyme disease diagnosis and current Lyme disease after adjustment for patient demographics and symptoms as well as clustering by center.Results:
Of 2501 prospectively enrolled study patients, 126 (5.0%) reported a history of definite or probable Lyme disease. Of these children with previous Lyme disease, 47 met diagnostic criteria for Lyme disease at the time of enrollment (37.3%; 95% confidence interval [CI] 29.1-45.7%); 2 had an EM lesion, and 45 had positive two-tier Lyme disease serology. Over time from the previous Lyme disease diagnosis, the less likely the patient met diagnostic criteria for Lyme disease (adjusted odds ratio 0.62 per time period; 95% CI 0.46-0.84).Conclusions:
For children with a history of Lyme disease before enrollment, one-third met the diagnostic criteria for acute Lyme disease with a declining rate over time from previous Lyme disease diagnosis. Novel Lyme disease diagnostics are needed to help distinguish acute from previous Lyme disease.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Lyme Disease
Type of study:
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Child
/
Humans
Language:
English
Journal:
Vector Borne Zoonotic Dis
Journal subject:
Communicable Diseases
/
Epidemiology
Year:
2021
Document Type:
Article
Affiliation country:
Vbz.2021.0030
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