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HelpTest ID: STICK Tick-Borne Antibodies, Modified 2-Tier, ELISA, Serum
Ordering Guidance
During the acute phase of an Anaplasma phagocytophilum, Ehrlichia chaffeensis, or Babesia infection, serologic tests are often nonreactive and detection by molecular assays is recommended. Polymerase chain reaction (PCR) testing is available to aid in the diagnosis of these cases; see EPCRB / Ehrlichia/Anaplasma, Molecular Detection, PCR, Blood and BABPB / Babesia species, 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: 1.35 mL Serum
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Useful For
Diagnosis of Lyme disease and later stages of anaplasmosis, ehrlichiosis, and babesiosis
Sero-epidemiological surveys of the prevalence of the infection in certain populations
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ANAP | Anaplasma phagocytophilum Ab, IgG,S | Yes | Yes |
| EHRC | Ehrlichia Chaffeensis (HME) Ab, IgG | Yes | Yes |
| BABG | Babesia microti IgG Ab, S | Yes | Yes |
| SLYME | Lyme Ab Modified 2-Tier w/Reflex, S | Yes | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| TLYME | Lyme IgM/IgG, WCS, EIA, S | Yes | No |
Testing Algorithm
If the Lyme antibody result is positive or equivocal, then Lyme disease antibody confirmation will be performed at an additional charge.
For more information see Acute Tickborne Disease Testing Algorithm.
Special Instructions
Method Name
ANAP, EHRC, BABG: Immunofluorescence Assay (IFA)
SLYME: Enzyme-Linked Immunosorbent Assay (ELISA)
Reporting Name
Tick-Borne Abs w/ Lyme MTTTA, SSpecimen Type
SerumSpecimen Minimum Volume
Serum: 1.1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 10 days |
| Frozen | 14 days |
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, tick-borne 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 tick-borne panel can assist in identifying the pathogen, allowing treatment to be initiated.
For information on specific diseases, see the individual test IDs.
Reference Values
ANAPLASMA PHAGOCYTOPHILUM ANTIBODY, IGG
<1:64
Reference values apply to all ages.
EHRLICHIA CHAFFEENSIS (HME) ANTIBODY, IGG
<1:64
Reference values apply to all ages.
BABESIA MICROTI IGG ANTIBODIES
<1:64
Reference values apply to all ages.
LYME ANTIBODY
Negative
Reference values apply to all ages.
Interpretation
Anaplasma phagocytophilum, Ehrlichia chaffeensis, and Babesia microti:
A positive immunofluorescence assay (titer ≥1:64) suggests current or previous infection. Seroconversion or a four-fold rise in titer is indicate active infection.
Lyme disease:
Negative:
Negative for antibodies to Borrelia (Borreliella) species causing Lyme disease. Negative results may occur in patients recently infected (≤14 days) with Borrelia burgdorferi. If recent infection is suspected, repeat testing on a new sample collected in 7 to 14 days is recommended.
Equivocal or positive:
Not diagnostic. Supplemental testing in accordance with the modified two-tiered testing algorithm for Lyme disease has been ordered by reflex.
Clinical Reference
1. Centers for Disease Control and Prevention (CDC). Tick-borne diseases of the United States: A Reference Manual for Health Care Providers. 5th ed. CDC; 2018. Available at www.cdc.gov/ticks/tickbornediseases/index.html
2. Theel ES. The past, present and (possible) future of serologic testing for Lyme disease. J Clin Microbiol. 2016;54(5):1191-1196. doi:10.1128/JCM.03394-15
Day(s) Performed
Monday through Friday
Report Available
2 to 4 daysTest Classification
See Individual Test IDsCPT Code Information
86618
86666 x 2
86753
86617 x 2 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| STICK | Tick-Borne Abs w/ Lyme MTTTA, S | 103603-7 |
| 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 |
| SLYME | Lyme Ab Modified 2-Tier w/Reflex, S | 83081-0 |
Forms
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.
mml-tickborne