Diagnose Lyme disease if bull’s eye rash is present, says NICE

https://www.nice.org.uk/news/article/diagnose-lyme-disease-if-bull-s-eye-rash-is-present-says-nice

 

That was, if I'm not mistaken, the standard practice in the US by 1999, ie, a bull's eye was diagnostic. Oh, they qualified it with dimensions and the like because of STARI eventually, but regardless.

Evidently 1999 may have been a banner year in Lyme mishaps. That year I had over 100 deer ticks removed in a medical clinic - and received no abx prophylacticaly because that was not yet the accepted protocol, even in Lyme endemic areas.

I look at this a a net add for UK Lyme patients, even though some of the stuff in the release is suspect, e.g. "After a diagnosis of Lyme disease, a person will receive an appropriate dosage of antibiotics based on their symptoms"

 

They're a bit late to the party! I "diagnosed" from the rash (and I'm not a doctor) a friend 10-15 years ago on the basis of a paper I read in the Scottish Medical Journal (article now behind a pay wall, wasn't then luckily!). GP of friend accepted that as sufficient evidence (the paper) and treated. Fortunately the antibiotics worked. Geez, NICE are slow and useless.

 

Surely this is wrong from their (?)press release?

Shouldn't that read "If the ELISA is negative..."? I thought if it was positive that meant patient had Lyme. Or am I misunderstanding something?

 

I never knew that journal even existed!

 

I suspect this is based on the CDC's 2 tier testing recommendation. If you test positive on the ELISA, and ONLY if you test positive on the ELISA, you move on to a Western Blot. If you test negative on the ELISA, no WB for you. In the US, it is very difficult because of this recommendation to ever get a Lyme WB without first getting a positive ELISA, even thought the ELISA basically sucks.

 

Well, it's a bit like the British Medical Journal, but Scottish. Back then it wasn't paywalled, or at least the Lyme article wasn't. Or maybe I've just lost my capability of finding articles - not unlikely.

 

Ah, so NICE is as usual taking the cheapest option. Don't bother testing further if the first test comes back negative. Oh what a surprise.

Thank you @duncan for your clarification.
From fuming ladycatlover Grrr grrr grrrr angry argghh

ETA just to be totally clear @duncan, it's not you I'm angry with - very glad for your input.