1. RN
    Kimberly Kelley Kimberly Kelley United States says:

    Multiple strains of Borellia are loosely classified as Lyme causative agents; more accurately referred to as Borreliosis. i.e. B. burgdorferi, B. mayonii, B. afzelii, and B. garinii, etc. Lyme indirect tests have largely been unchanged for over two decades despite the 2018 Infectious Disease Society of America (IDSA) puedo retraction acknowledging flaws. 

    "Borrelia burgdorferi was discovered to be the cause of Lyme disease in 1983, leading to seroassays. The 1994 serodiagnostic testing guidelines predated a full understanding of key B. burgdorferi antigens and have a number of shortcomings. These serologic tests cannot distinguish active infection, past infection, or reinfection." (2018 October, IDSA Oxford Academy). This publication acknowledges only  B. burgdorferi as a Lyme causative agent.

    Another "indirect" Tick-borne Disease (TBD) laboratory test isn't needed or effective to prevent Borreliosis misdiagnosis, as it doesn't identify multiple strains of Borrelia including those that cause TBD Relapsing Fever. In my opinion the bias, IDSA admitted that PCR/DNA testing is needed and achievable in 2018.

    The 2018 CDC Tick-borne Diseases of the United States 5th Ed for Providers includes seven new tick germs that can cause illness in the US: Borrelia mayonii, Borrelia miyamotoi, Ehrlichia ewingii, Ehrlichia muris eauclairensis, Heartland virus, Rickettsia parkeri, and Rickettsia species 364D which are a few examples of emerging infectious diseases identified over the past two decades. I suggest the public read this 57 page document. Not acknowledging medical bias, new and expanding tick species, TBD confections, newly added spirochete illnesses and antibiotic resistance negates the existence of the CDC, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).

    Direct Diagnostic Tests for Lyme Disease. (2018 October 11, IDSA, Oxford Academy). academic.oup.com/.../5126199

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