Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

At-home test for infected ticks could improve Lyme Disease diagnosis

smithsonianmag.com

Post reply on HN
Print view View original

41–50 of 140 posts

Re: At-home test for infected ticks could improve Lyme Disease diagnosis

#41

Post by lima »

layla5alive wrote: post #39
lima wrote: post #25

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 universall…

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

(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?

Re: At-home test for infected ticks could improve Lyme Disease diagnosis

#42

Post by margalabargala »

lima wrote: post #25

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 universall…

> The vendor claims "lab-level accuracy" (conveniently omitting the actual accuracy numbers)

Hey, labs have QC failures all the time.

Re: At-home test for infected ticks could improve Lyme Disease diagnosis

#43

Post by dermacentor »

lima wrote: post #40
_puk wrote: post #35

Earlier quoted context omitted.

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.

Where is your proof?

They have thermal sensors on their forearms and are known to climb trees. Why wouldn't they approach from above?

Re: At-home test for infected ticks could improve Lyme Disease diagnosis

#44

Post by codingdave »

dermacentor wrote: post #34
codingdave wrote: post #32

Earlier quoted context omitted.

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 hou…

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.

Re: At-home test for infected ticks could improve Lyme Disease diagnosis

#45

Post by SyneRyder »

beej71 wrote: post #24
jensensbutton wrote: post #3

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.

Re: At-home test for infected ticks could improve Lyme Disease diagnosis

#46

Post by lima »

dermacentor wrote: post #43
lima wrote: post #40

Earlier quoted context omitted.

Ticks do not drop from trees.

Where is your proof? They have thermal sensors on their forearms and are known to climb trees. Why wouldn't they approach from above?

Ticks climb low vegetation (not just grass) and wait for a host to pass by ("questing").

If you're going to disagree with basic textbook biology knowledge, the burden of proof is on you.

Re: At-home test for infected ticks could improve Lyme Disease diagnosis

#47

Post by codingdave »

dermacentor wrote: post #43
lima wrote: post #40

Earlier quoted context omitted.

Ticks do not drop from trees.

Where is your proof? They have thermal sensors on their forearms and are known to climb trees. Why wouldn't they approach from above?

https://www.cdc.gov/ticks/about/index.html

https://projectlyme.org/ticks-debunking-common-myths-and-mis...

Re: At-home test for infected ticks could improve Lyme Disease diagnosis

#48

Post by lima »

dermacentor wrote: post #34
codingdave wrote: post #32

Earlier quoted context omitted.

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 hou…

Ticks can transmit Powassan and Heartland viruses within the first 15 minutes of a bite. Still feeling cool, suave, experienced, and fearless?

And tick-borne encephalitis, in regions where that is endemic.

No need to be rude, though!

Re: At-home test for infected ticks could improve Lyme Disease diagnosis

#50

Post by throw93949990 »

afavour wrote: post #5
dofm wrote: post #2

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 hav…

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.
Post reply on HN