Tick-Borne Disease 3 (TBD-3) & Tick-Borne Disease 4 (TBD-4)

Healthcare providers often encounter patients in Lyme endemic areas presenting with a recent or acute febrile illness or flu-like symptoms, in the late spring/summer. The question arises whether these symptoms represent a recent Lyme infection or possibly another common tick-borne infection. Co-infections occur frequently yet are often undiagnosed. For example, patients with obvious well-documented early Lyme disease may unknowingly be co-infected with Babesia microti, Anaplasma phagocytophilum, or Human Monocytic Ehrlichia (HME). The clinician may not be aware of this unless the appropriate tests are ordered. Evaluating exposure to multiple tick-borne pathogens in parallel provides a comprehensive analysis resulting in a more rapid diagnosis. IMUGEN's TBD-3 and TBD-4 analyses are optimized for identifying acute tick-borne infections.

TBD-3 includes testing for acute or recent exposure to Borrelia burgdorferi, Babesia microti and Anaplasma phagocytophilum.

TBD-4 includes testing for acute or recent exposure to Borrelia burgdorferi, Babesia microti , Anaplasma phagocytophilum and Ehrlichia chaffeensis. Consider TBD-4 testing in recently symptomatic patients residing in areas where HME is endemic.

LYME TESTING (B. burgdorferi) by capture EIA:
TBD-3 and TBD-4 testing utilizes antibody capture EIA for the detection of IgM, IgG, and IgA antibody isotypes to B. burgdorferi. Performance characteristics of the capture EIA are very good for identifying early immune response following infection. By the time patients are symptomatic with a B. burgdorferi infection, most are seropositive. PCR testing of whole blood is not useful or recommended for diagnosing acute or recent Lyme infection due to the fact it is not a blood-borne infection.

BABESIA TESTING (B. microti) by PCR:
TBD-3 and TBD-4 testing utilizes PCR testing of whole blood for the detection of B. microti, which is a blood-borne intra-erythrocytic pathogen. PCR is significantly more sensitive than thick smears for diagnosis, and B. microti DNA may be detected before an infected patient has developed a serologic immune response.

ANAPLASMA TESTING (A. phagocytophilum) by PCR:
TBD-3 and TBD-4 testing utilizes PCR testing of whole blood for the detection of A. phagocytophilum, which is a blood-borne intra-granulocytic pathogen. PCR is significantly more sensitive than thick smears for diagnosis, and A. phagocytophilum DNA may be detected before an infected patient has developed a serologic immune response.

EHRLICHIA TESTING (E. chaffeensis) by PCR:
TBD-4 testing utilizes PCR testing of whole blood for the detection of E. chaffeensis, which is a blood-borne intra-monocytic pathogen. PCR is significantly more sensitive than thick smears for diagnosis, and E. chaffeensis DNA may be detected before an infected patient has developed a serologic immune response.

The staff at IMUGEN is highly trained in performing and interpreting these assays, has decades of experience in analyzing these test results in the context of various clinical situations, and is available to assist healthcare providers in interpreting tests and answering questions about the diagnosis of tick-borne infections.