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- Title
Serodiagnosis of Lyme disease: accuracy of a two-step approach using a flagella-based ELISA and immunoblotting.
- Authors
Johnson BJB; Robbins KE; Bailey RE; Cao B; Sviat SL; Craven RB; Mayer LW; Dennis DT; Johnson, B J; Robbins, K E; Bailey, R E; Cao, B L; Sviat, S L; Craven, R B; Mayer, L W; Dennis, D T
- Abstract
An ELISA containing a purified flagellar antigen from Borrelia burgdorferi (FLA-ELISA) was evaluated. The FLA-ELISA, detecting IgM and IgG together, did not have adequate specificity by itself. Good accuracy was obtained, however, when the FLA-ELISA was the first step in a two-step protocol that used immunoblotting as a conditional second test. Samples that scored positive or equivocal by the FLA-ELISA were evaluated with separate IgM and IgG immunoblots. The sensitivity of the two-step process for patients with erythema migrans or with later manifestations of Lyme disease was 64% and 100%, respectively. The specificity for health blood donors was 100% and was 90% for the aggregate of all persons with illness that may cause serologic cross-reactivity (98% if the samples from relapsing fever patients were excluded). Test precision was 96% overall, 99% for Lyme disease case serum samples, 100% for specimens from blood donors, and 88% for samples from persons with other illness.
- Publication
Journal of Infectious Diseases, 1996, Vol 174, Issue 2, p346
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/174.2.346