The First At-Home Test for Infected Ticks Could Improve Lyme Disease Diagnosis(smithsonianmag.com) |
The First At-Home Test for Infected Ticks Could Improve Lyme Disease Diagnosis(smithsonianmag.com) |
The vendor claims "lab-level accuracy" (conveniently omitting the actual accuracy numbers), but the test is a lateral flow test, which means its Limit of Detection is going to be orders of magnitude worse than molecular tests. Tick tests do not require FDA clearance, so their claims are most likely unreviewed.
Existing lab tests for ticks are almost universally based on PCR.
Ticks are small (especially nymphs) and extracting enough material can be tricky even for molecular testing, so I can't imagine an LFT test working terribly well, especially for nymphs, which are responsible for a lot of Lyme infections due to being easy to miss.
The other, bigger problem is that the test result is mostly useless.
The risk of Lyme transmission from an infected tick ranges rougly from <1% for a fresh bite (<24h) to ~10-25% once the tick is engorged (72h+). A positive tick test result would be insufficiently predictive of Lyme disease transmission on its own to justify taking antibiotics in most cases in the absence of other symptoms.
And you can't trust negative results either due to limited sensitivity, so you can't rule out transmission either.
In my opinion, tests like this can lead to worse overall health outcomes due to unnecessary treatment or withholding prophylaxis from someone who otherwise qualifies.
Hey, labs have QC failures all the time.
Lyme post-exposure prophylaxis (PEP) is a single dose of doxycycline (200 mg for adults, or weight-adjusted for children) taken within 72 hours of removing a high-risk blacklegged tick bite to prevent Lyme disease.
However, most guidelines recommend against testing ticks. For instance, IDSA says this:
> Knowing tick characteristics (ie, species, life stage, and an assessment of the degree of blood engorgement) is helpful for anticipatory guidance and in determining if antibiotic prophylaxis to prevent Lyme disease is appropriate [127]. Tick identification is available in most commercial laboratories and at some local health departments. Studies from the United States and Europe have shown that detecting B. burgdorferi sensu lato in Ixodes spp. ticks, however, poorly predicts either subsequent disease (0–12.4%) [126, 128–133] or asymptomatic seroconversion (0–4.7%) [126, 129, 130, 132, 134]. This is likely due to a variety of factors that influence the likelihood of transmission and the observation that most Ixodes spp. ticks discovered by patients have been attached for <48 hours [61, 62, 135].
(https://www.idsociety.org/practice-guideline/lyme-disease/)
The point is that the test is likely not useful to reliably inform any sort of prophylactic treatment, especially if the risk of transmission is high enough to warrant prophylactic treatment in the first place, in which case the PEP is indicated regardless of the tick test.
Sure, it modifies the prior probabilities, but what's the clinical significance?
Here in the UK, Lyme traditionally been a marginal problem (tick bites aren't) but we now have such rapid climate change, along with rapidly increasing wild deer and boar populations, that some areas in the UK are becoming risk zones on more or less the same level of risk as some US regions.
Alas the difference here is that education has not caught up to the USA: very few people have any grasp of the risk of Lyme because the high risk zones are, by and large, not well known, and they don't always correlate that well with the basic risk of acquiring a tick.
I think most specialists in the UK think this is likely to lead to a pretty big increase to infections before people learn, so maybe this sort of tool will help offset that.
I walk a lot in an area with some wild deer and boar, and I would love to have one of these in my cupboard as a precaution. Would be great to see them in supermarkets in high risk areas, too.
There is a more severe risk around rabies. We basically do not have it in the UK or Ireland; it has been eliminated for over a century except a tiny incidence of a virus in the same family in bats. But because we have essentially eradicated it, doctors do not often think to ask about it, even in people who have travelled, which led to someone suffering awfully last year.
And since a dog bite or even a fox bite in the UK or Ireland carries literally zero risk of rabies, those who are bitten or scratched while travelling abroad do not have it uppermost in their mind.
> After carefully removing the tick with either tweezers or a tick-removal tool, you place it into the kit’s “Tick Crusher.” The grinder pulverizes the tick’s chitinous exterior, exposing the internal contents where the Borrelia burgdorferi is located
The article also mentions that symptoms sometimes persist after treatment with antibiotics.
Could be a very big deal if it could be made properly inexpensive. COVID tests were, after all.
If you could know as soon as you were bitten whether there was any risk of infection at all, that would be very valuable information.
I think it's only a one in ten chance that an infected tick would transmit the infection, anyway. But you would know whether you needed to even book an appointment.
Only if the test is sufficiently accurate to rule out transmission. Even molecular tests can't reliably predict that.
Or actually let's just eradicate all ticks.
Used to be a big Event Of The Year when my grandpa found one after spending all day out in their 'garden' (a few acres bordering deep woods). I remember being maybe 11 when he found one, let me try and figure out how to crush it, I couldn't. He showed me how to use the butt of a butterknife and leverage to get the fuckers
I don't live anywhere near a proper forest and we've had several close calls this year, I caught one crawling across my scalp when I was getting into bed last month. Went and got tested just to be safe
I know feeding crows is really fun, but please don't. It's very important that they get hungry enough to eat mice sometimes. Same goes for deer, the past couple of years I've had them walk _towards_ me and my dog instead of bolting, presumably because someone is feeding them (by hand, not garden raiding)
Ticks also get attached to humans in tall grass and forest edges, not from the trees. Walking through open fields is a more likely way to get a tick than walking through the woods, because that is where the deer sleep. They bed down in tall grass, and the ticks come along for the ride. So be wary of the grass, not the woods. As a matter of fact, the best thing you can do to keep ticks away from your home if you live out in the country is to keep 8-10 feet of grass cut really short at the perimeter of your property or wherever it meets the woods.
Young deer often walk towards people, too. They aren't born afraid of humans, and have natural instincts to freeze, not flee. So when their mama hides them, it is just as likely to be near humans, not in the woods with the coyotes. They'll learn the fear soon enough (definitely during hunting season), but until then they certainly have youthful curiosity.
Even so, "sign me up" is still a good answer. Home testing sounds great.
In the trees they drop down on you from above. Had them do that many times.
The general consensus is to wear a hat when mushrooming in the places I've been.
Still feeling cool, suave, experienced, and fearless?
(Also, I have the same question about the poison ivy immunotherapy pills that were common in the US before the FDA.)
This has created an intense fear of Lyme disease among people who don’t trust doctors and “do their own research”. That group overlaps a lot with anti-vax groups. You can see where this is going. Some people who got the Lyme vaccine because they saw it as the lesser of two evils and then subsequently had medical issues blamed everything on the vaccine, and it blew up into lawsuits and a belief that the vaccine causes these problems. If there was any real problem we’ll never know because the storm was such a mess that it made actual research impossible and scared so many people away from the vaccine that it was withdrawn from the market.
https://pharmaphorum.com/news/pfizer-valneva-lyme-vaccine-st...
About 20 years ago my gran got to the facial palsy stage of Lyme's before it was even considered and diagnosed by a visiting locum doctor who'd grown up in another country.
Antibiotics were given, her face recovered (albeit slowly).
It's a horrendous disease.
This exact pattern has been playing out with the COVID vaccine and the HPV vaccine. There are communities who are convinced that every medical problem they had since receiving the HPV vaccine is due to the vaccine, even though they’re all having different health problems that also occur in the overall population.
Of course you can just say they didn't investigate it enough or whatever, you aren't trying to make a reasoned argument and thus don't need to exercise reason.
But you can probably tell that there is no need to be snarky. Just your first sentence would have been more in line with how people engage with each other around here.
They have thermal sensors on their forearms and are known to climb trees. Why wouldn't they approach from above?