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Two-Tier Lyme Disease Serology in Children with Previous Lyme Disease.

Publication ,  Journal Article
Lantos, PM; Balamuth, F; Neville, D; Garro, AC; Levas, MN; Bennett, J; Thompson, AD; Kharbanda, AB; Branda, JA; Nigrovic, LE
Published in: Vector Borne Zoonotic Dis
November 2021

Background: A history of Lyme disease can complicate the interpretation of Lyme disease serology in acutely symptomatic patients. Materials and Methods: 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.

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Published In

Vector Borne Zoonotic Dis

DOI

EISSN

1557-7759

Publication Date

November 2021

Volume

21

Issue

11

Start / End Page

839 / 842

Location

United States

Related Subject Headings

  • Tropical Medicine
  • Sensitivity and Specificity
  • Lyme Disease
  • Humans
  • Child
  • 1117 Public Health and Health Services
 

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Lantos, P. M., Balamuth, F., Neville, D., Garro, A. C., Levas, M. N., Bennett, J., … Nigrovic, L. E. (2021). Two-Tier Lyme Disease Serology in Children with Previous Lyme Disease. Vector Borne Zoonotic Dis, 21(11), 839–842. https://doi.org/10.1089/vbz.2021.0030
Lantos, Paul M., Frances Balamuth, Desiree Neville, Aris C. Garro, Michael N. Levas, Jonathan Bennett, Amy D. Thompson, Anupam B. Kharbanda, John A. Branda, and Lise E. Nigrovic. “Two-Tier Lyme Disease Serology in Children with Previous Lyme Disease.Vector Borne Zoonotic Dis 21, no. 11 (November 2021): 839–42. https://doi.org/10.1089/vbz.2021.0030.
Lantos PM, Balamuth F, Neville D, Garro AC, Levas MN, Bennett J, et al. Two-Tier Lyme Disease Serology in Children with Previous Lyme Disease. Vector Borne Zoonotic Dis. 2021 Nov;21(11):839–42.
Lantos, Paul M., et al. “Two-Tier Lyme Disease Serology in Children with Previous Lyme Disease.Vector Borne Zoonotic Dis, vol. 21, no. 11, Nov. 2021, pp. 839–42. Pubmed, doi:10.1089/vbz.2021.0030.
Lantos PM, Balamuth F, Neville D, Garro AC, Levas MN, Bennett J, Thompson AD, Kharbanda AB, Branda JA, Nigrovic LE. Two-Tier Lyme Disease Serology in Children with Previous Lyme Disease. Vector Borne Zoonotic Dis. 2021 Nov;21(11):839–842.
Journal cover image

Published In

Vector Borne Zoonotic Dis

DOI

EISSN

1557-7759

Publication Date

November 2021

Volume

21

Issue

11

Start / End Page

839 / 842

Location

United States

Related Subject Headings

  • Tropical Medicine
  • Sensitivity and Specificity
  • Lyme Disease
  • Humans
  • Child
  • 1117 Public Health and Health Services