Unfortunately, there are major issues with this approach.
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.
> The vendor claims "lab-level accuracy" (conveniently omitting the actual accuracy numbers)
Hey, labs have QC failures all the time.
The standard isn't to avoid antibiotics until symptoms occur. The standard for a sufficiently attached deer tick in a high risk area is PEP:
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.
CDC recommends prophylaxis only if the tick is engorged. In my country, guidelines do not recommend prophylaxis at all (for better or worse - personally, I would take a single doxycyclin dose for a >24h high-risk tick bite, Lyme is no joke).
However, guidelines universally 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 of that?
Wow, this seems a pretty big deal.
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.
Maybe it is a raise of dog ownership in UK as well. They bring ticks inside houee, and shed it in public parks. Our dog used to have like 50 ticks everytime it returned from run.
I have a friend who got a tick bite on holiday in America many years ago. Turns out they got Lyme disease but no doctors in the UK were experienced with it so they dealt with years of misdiagnosis. I really hope any education effort can get out ahead of that.
Publicly founded health systems are terrible whe. dealing with Lyme disease. It is impossible to simply and clearly diagnose, and separate ill people from "simulants". Something like "back pain" ormother chronic illnesses.
Yeah. I think we simply did not see it enough and to be honest far too few doctors ask the "have you travelled" question about unusual disease. It is better now, but I think the "could it be?" thought doesn't occur because the incidence has been low.
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.
Thats interesting, since there is a lot of research around face palsy & recovery in UK.
Yep.
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.
Certainly had to convince my gp a few years ago that indeed there is Lyme in Ireland
It certainly exists in Scotland. Wouldn't surprise me if it got there.
[flagged]
The most interesting part:
> 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
As a parent in the US northeast who likes taking their kids camping and hiking, ticks have been an ongoing conversation this year. I think this is going to sell well.
When I think about moving to the NE from out west, ticks are one of my main reservations. I think, given how many people and dogs recreate out there, I might have it blown out of proportion.
Not necessarily out of proportion, the Lyme numbers have really spiked there in recent years if you check the official stats.
I'd written a longer reply about my time last year in upstate NY, but what I wrote was "tinted"... so the shorter version: within just a 2 month stay I did find infected ticks on me (submitted to testing - I was happy with nyticks.org). Everytime the cat came into the house, first step was always to get out the tick mitt and brush off the ticks from the cat. And it felt weird how Lyme was normalised there, almost like a phase of life it's assumed you go through, having to take months off work due to crippling pain and paralysis until the meds work. Coming from Australia, none of this felt "normal".
That said: it's a truly beautiful place. Outdoor recreation seems to be "what you do" out there... but when it's that beautiful, it'd be a shame not to take advantage of it. Even though I'm not much of a nature person or a hiker.
Does diagnosis offer a better prognosis for those that are infected?
Yes, it's treatable with antibiotics and people that are treated get less sick. As stated in the article, prophylactic treatment with Doxycycline is the standard of care. Testing the tick is an alternative to that rather than something that should be expected to increase treatment...
The article also mentions that symptoms sometimes persist after treatment with antibiotics.
It also has the broader public health benefit of reducing the preventative use of that class of antibiotics, which lowers the risk of antibiotic resistance generally. (In an ideal world we'd never use them preventatively.)
Could be a very big deal if it could be made properly inexpensive. COVID tests were, after all.
Absolutely yes, because the most severe risks are associated with the bacteria reaching the heart and into the nervous system, which is a relatively slow process. There's a window of a couple of weeks.
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.
> 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.
As long as you’re not getting bitten by a tick more than once a year if you do get bitten every time take the high dose antibiotic seems simple enough that’s what we do here at at least
Yes, but this test cannot diagnose Lyme in humans.
Great. Let's get working on preventing/curing alpha-gal allergy though.
Or actually let's just eradicate all ticks.
This is great (if it's accurate) but the real gem would be a vaccine, which is apparently also coming out soon.
Sign me up.
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)
Getting a tick is no big event. It is just something that happens if you live near woods. I own a forest, and get ticks on occasion. Gross, but no big deal. Grab a tick-pulling tool and gently coax them out. Don't crush them or force them out with a blunt object, you are just as likely to tear their head off and leave it stuck in you, which just makes it more likely for you to get sick. Just remove them before 24 hours, and it is highly unlikely they'll give you a disease.
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.
I think you're being a bit strong with the "So be wary of the grass, not the woods"
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.
Ticks do not drop from trees.
Ticks can transmit Powassan and Heartland viruses within the first 15 minutes of a bite.
Still feeling cool, suave, experienced, and fearless?
Hey, thanks - I wasn't aware of that. Glad to have learned it.
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.
And tick-borne encephalitis, in regions where that is endemic.
No need to be rude, though!
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