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Test ID: TICKS Tick-Borne Disease Antibodies Panel, Serum

Reporting Name

Tick-Borne Ab Panel, S

Useful For

Evaluation of the most common tick-borne diseases found in the United States, including Lyme disease, human monocytic and granulocytic ehrlichiosis, and babesiosis

 

Evaluation of patients with a history of, or suspected, tick exposure who are presenting with fever, myalgia, headache, nausea, and other nonspecific symptoms

 

Seroepidemiological surveys of the prevalence of the infection in certain populations

Clinical Information

In North America, ticks are the primary vectors of infectious diseases.(1) Worldwide, ticks rank second only to mosquitoes in disease transmission. In the United States, tickborne diseases include Lyme disease, Rocky Mountain spotted fever, human monocytic and granulocytic ehrlichiosis, babesiosis, tularemia, relapsing fever, and Colorado tick fever.

 

Symptoms of the various tick-vectored diseases range from mild to life-threatening and significantly overlap. Early symptoms, which include fever, aches, and malaise, do not aid in distinguishing the various diseases. Because early treatment can minimize or eliminate the risk of severe disease, early detection is essential, yet patients may not have developed distinctive symptoms to help in the differential diagnosis. A tickborne panel can assist in identifying the pathogen, allowing treatment to be initiated.

 

For information on the specific diseases, see the individual test IDs.

Interpretation

Ehrlichia chaffeensis:

A positive immunofluorescence assay result (titer ≥1:64) suggests current or previous infection. In general, the higher the titer, the more likely the patient has an active infection. Four-fold rises in titer also indicate active infection.

 

Previous episodes of ehrlichiosis may produce a positive serology result although antibody levels decline significantly during the year following infection.

 

Anaplasma phagocytophilum:

A positive immunofluorescence assay result (titer ≥1:64) suggests current or previous infection. In general, the higher the titer, the more likely the patient has an active infection. Four-fold rises in titer also indicate active infection.

 

Previous episodes of ehrlichiosis may produce a positive serology result although antibody levels decline significantly during the year following infection.

 

Babesia microti:

A positive result of an indirect fluorescent antibody test (titer ≥1:64) suggests current or previous infection with Babesia microti. In general, the higher the titer, the more likely it is that the patient has an active infection. Patients with documented infections have usually had titers ranging from 1:320 to 1:2560.

 

Lyme disease:

Negative: No evidence of antibodies to Borrelia burgdorferi detected. False-negative results may occur in recently infected patients (≤2 weeks) due to low or undetectable antibody levels to B burgdorferi. If recent exposure is suspected, a second sample should be collected and tested in 2 to 4 weeks.

 

Equivocal or Positive: Not diagnostic. Supplemental testing by immunoblot has been ordered by reflex.

Profile Information

Test ID Reporting Name Available Separately Always Performed
EHRC Ehrlichia Chaffeensis (HME) Ab, IgG Yes Yes
ANAP Anaplasma phagocytophilum Ab, IgG,S Yes Yes
BABG Babesia microti IgG Ab, S Yes Yes
LYME Lyme Disease Serology, S Yes Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
LYWB Lyme Disease Ab, Immunoblot, S Yes No

Testing Algorithm

If the Lyme disease screen result is positive or equivocal, then Lyme disease antibody confirmation by immunoblot will be performed at an additional charge.

 

For more information see Acute Tick-Borne Disease Testing Algorithm

Report Available

2 to 4 days

Day(s) Performed

Monday through Friday

Clinical Reference

1. Centers for Disease Control and Prevention (CDC), Division of Vector-Borne Diseases. Tickborne Diseases of the United States: A Reference Manual for Healthcare Providers. 6th ed. US Department of Health and Human Services; 2022. Accessed September 29, 2022. Available at www.cdc.gov/ticks/tickbornediseases/TickborneDiseases-P.pdf

2. Diaz JH. Ticks, including tick paralysis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:3505-3526

Method Name

EHRC, ANAP, BABG: Immunofluorescence Assay (IFA)

LYME: Enzyme-Linked Immunosorbent Assay (ELISA)

Specimen Type

Serum


Ordering Guidance


During the acute phase of an Anaplasma phagocytophilum, Ehrlichia chaffeensis or Babesia infection, serologic tests are often nonreactive; polymerase chain reaction (PCR) testing is available to aid in the diagnosis of these cases; see TIKLB / Tick-Borne Panel, Molecular Detection, PCR, Blood.



Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 10 days
  Frozen  14 days

Reference Values

Ehrlichia chaffeensis (HME) ANTIBODY, IgG

<1:64

Reference values apply to all ages.

 

Anaplasma phagocytophilum ANTIBODY, IgG

<1:64

Reference values apply to all ages.

 

Babesia microti IgG ANTIBODIES

<1:64

Reference values apply to all ages.

 

LYME DISEASE SEROLOGY

Negative

Reference values apply to all ages.

Test Classification

See Individual Test IDs

CPT Code Information

86618

86666 x 2

86753

86617 x 2-Lyme disease Western blot (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TICKS Tick-Borne Ab Panel, S 87547-6

 

Result ID Test Result Name Result LOINC Value
81157 Anaplasma phagocytophilum Ab, IgG,S 23877-4
81128 Babesia microti IgG Ab, S 16117-4
81478 Ehrlichia Chaffeensis (HME) Ab, IgG 47405-6
LYME Lyme Disease Serology, S 20449-5

Forms

If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.

Mayo Clinic Laboratories | Neurology Catalog Additional Information:

mml-CNS-Infections, mml-Pediatric