Lyme Disease Screen

A two-tier Lyme disease serology screen covering Anti-Borrelia burgdorferi IgG and IgM antibodies by ELISA — the first line of the CDC/EUCALB two-tier testing algorithm for Lyme borreliosis. PKBH Olomouc offers this self-pay without a referral, with results same or next working day. If the ELISA is positive or equivocal, confirmatory IgG and IgM Western blot tests are available at the same laboratory, completing the two-tier protocol without changing provider.

Lyme borreliosis is the most common tick-borne infectious disease in Central Europe, and the Czech Republic's forested terrain — including the Jeseníky range surrounding Olomouc — creates high tick exposure risk throughout spring, summer, and autumn. Accurate serological diagnosis requires a two-step testing approach endorsed by the CDC, EUCALB, and the Czech infectious disease guidelines. **The two-tier protocol:** - **Step 1 — ELISA (first line):** Anti-Borrelia IgM and IgG antibodies are measured by enzyme-linked immunosorbent assay. IgM appears from approximately 2–4 weeks after tick bite and indicates recent or acute infection; IgG develops from 4–6 weeks and persists for months to years. A negative ELISA in a patient with symptoms lasting fewer than 30 days after a tick bite does not exclude early Lyme disease — serology may not yet be positive. An equivocal or positive result on Step 1 triggers Step 2. - **Step 2 — Western blot (confirmatory):** Anti-Borrelia IgG blot and/or IgM blot run on the same or a subsequent sample. The blot identifies the specific Borrelia proteins recognised by the patient's antibodies, filtering out false positives that can occur with ELISA due to cross-reactivity with other infections (EBV, CMV, ANA). PKBH offers both IgG and IgM blots at 2,835 Kč each — available as an add-on or on a return visit. **Clinical context:** The Olomouc region is in an area of active Borrelia burgdorferi sensu lato transmission by Ixodes ricinus ticks. Erythema migrans (the characteristic expanding rash) is a clinical diagnosis requiring immediate treatment — serology adds little in early Lyme. Serology is most useful in later presentations: fatigue, joint pain, neurological symptoms, or cardiac involvement occurring weeks to months after possible tick exposure. A negative serology in these later stages makes Lyme disease very unlikely. **Who benefits:** Anyone with recent tick bite and developing symptoms; people in endemic areas with unexplained fatigue, arthralgia, facial palsy, or neuropathy weeks after outdoor exposure; individuals whose erythema migrans was treated but symptoms persist (post-treatment Lyme disease syndrome assessment). **Preparation:** No fasting required. Walk in from 07:00 at any PKBH Olomouc site — no referral needed. If your GP has ordered confirmatory blotting, bring the referral for insurance coverage; otherwise self-pay applies to all steps.