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 universally based on PCR.
Ticks are small (especially nymphs) and extracting enough material can be tricky even for molecular testing, so I can't imagine an LFT test working terribly well, especially for nymphs, which are responsible for a lot of Lyme infections due to being easy to miss.
The other, bigger problem is that the test result is mostly useless.
The risk of Lyme transmission from an infected tick ranges rougly from <1% for a fresh bite (<24h) to ~10-25% once the tick is engorged (72h+). A positive tick test result would be insufficiently predictive of Lyme disease transmission on its own to justify taking antibiotics in most cases in the absence of other symptoms.
And you can't trust negative results either due to limited sensitivity, so you can't rule out transmission either.
In my opinion, tests like this can lead to worse overall health outcomes due to unnecessary treatment or withholding prophylaxis from someone who otherwise qualifies.
The infected unfed ticks have few spirochetes in them. The numbers grow by two orders of magnitude as they feed - the reason why old bites are much more dangerous than the fresh bites.
"so I can't imagine an LFT test working terribly well, especially for nymphs, which are responsible for a lot of Lyme infections due to being easy to miss."
Even smaller and less noticeable are the larvae. And I know I learned that they cannot transmit the disease, because they only do so, if they have biten an infected animal before - so I never worried about small ticks, but apparently new research indicates, that this is wrong.
"However, newer research suggests that some pathogens, including Borrelia miyamotoi, may be transmitted from the adult female tick directly to her offspring.
This means larval ticks may already be infected before their first bite."
It's been 15 years since I worked on open source PCR machines, but has someone not figured out how to build a "one time use" disposable type qPCR test? A single test, not an instrument. There's no way these types of tests should be left up to lateral flow etc.
Lucira did that, but IMO it's quite wasteful. LAMP reactions don't need much, so it's best to make a cheap reader like Metrix or Pluslife so the tests can be less expensive.
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 <48 hours [61, 62, 135].
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?
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 have any grasp of the risk of Lyme because the high risk zones are, by and large, not well known, and they don't always correlate that well with the basic risk of acquiring a tick.
I think most specialists in the UK think this is likely to lead to a pretty big increase to infections before people learn, so maybe this sort of tool will help offset that.
I walk a lot in an area with some wild deer and boar, and I would love to have one of these in my cupboard as a precaution. Would be great to see them in supermarkets in high risk areas, too.
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.
Yeah. I think we simply did not see it enough and to be honest far too few doctors ask the "have you travelled" question about unusual disease. It is better now, but I think the "could it be?" thought doesn't occur because the incidence has been low.
There is a more severe risk around rabies. We basically do not have it in the UK or Ireland; it has been eliminated for over a century except a tiny incidence of a virus in the same family in bats. But because we have essentially eradicated it, doctors do not often think to ask about it, even in people who have travelled, which led to someone suffering awfully last year.
And since a dog bite or even a fox bite in the UK or Ireland carries literally zero risk of rabies, those who are bitten or scratched while travelling abroad do not have it uppermost in their mind.
About 20 years ago my gran got to the facial palsy stage of Lyme's before it was even considered and diagnosed by a visiting locum doctor who'd grown up in another country.
Antibiotics were given, her face recovered (albeit slowly).
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.
Nothing really to do with public healthcare. It is literally that there is almost no medical or social experience in the UK of actually seeing developed Lyme disease up close, because it has historically been so unusual, so there are no protocols.
A few thousand cases every year now, when the first indigenous case ever properly recorded in the UK was only in 1986, and it's not like in the USA where really wide areas are high risk. Some of the pockets of highest risk Lyme in the UK are no more than a few miles across.
Nurse stations and pharmacy clinics are great at properly removing ticks if you know you have been bitten, and from there you will now get good advice about Lyme.
But a system that has no endemic experience of Lyme is just not going to test for it. Because it's remote, and people are usually unaware they have been in risk areas, and often unaware they've even been bitten.
1986 is forty years ago. We have Lymes disease in Scotland (I know someone who has it), and a large deer population which has not been properly controlled with substantial remote areas. (Much smaller than the USA but big enough to be reservoirs for the disease.)
One thing pointing out is that deer aren’t really the disease reservoir for Lyme disease (it’s primarily mice) - but deer are key for tick population growth.
(There are more voles in the UK than mice, as it goes. Outnumber them by about thirty million or something. Fairly recently acquired trivia for me, but it turns out that if you see a mouse scurrying in the wild in the UK, away from houses, it's a bit more likely to actually be a vole.)
Ticks are much more common in Scotland thanks to deer population and high rainfall. Ticks prefer damp conditions to drought conditions, so this last summer wouldn't have been good for them. The damp makes it easier to survive while they are waiting for passing hosts. They also like long grass and overgrown areas.
England in comparison is much more built up.
We do have Lyme disease here unfortunately. I know someone who has it.
It started around Connecticut in the 70s and has been spreading out radially since then. I believe it’s still not a huge problem in the western United States (there are other tick borne diseases there however). Soon it will spread across the world and tick bites will be serious business everywhere.
Correct. The outbreak was first recognized in 1975 in Old Lyme, Connecticut, directly across the Long Island Sound from the Plum Island Animal Disease Center (a lab which had been doing explicitly offensive biological weapons research until at least 1969), which led to an unverified theory about an escaped bioweapon.
Genetic studies and museum tick specimens prove the bacteria existed in North America for thousands of years before the lab was built. Whether there was gain of function done on it is not publicly verified.
I live near Plum Island. Just look at the Google Map reviews to get an idea of the sentiment. Camp Hero, Plum Island…lotta material for Netflix series coming out of Long Island.
Maybe it is a raise of dog ownership in UK as well. They bring ticks inside houee, and shed it in public parks. Our dog used to have like 50 ticks everytime it returned from run.
People are more aware of ticks because of dog ownership, I think, but I don't know if this is a real risk because of the widespread use of tick repellent treatments for dogs (which are their own little eco-disaster).
COVID lockdowns changed us and we're a bit more outdoorsy.
But mostly it is the deer population. There are now four times as many wild deer in the UK as there were before the first indigenous case of Lyme was detected. From under half a million to well over two million over that timeframe.
In the south east around where I am, wild boar are now a potentially significant vector in the high risk areas, too — we've gone from literally zero to a couple of thousand wild boar in the same forty-year period of time just in the 20 miles around me. They apparently can carry upwards of a hundred without suffering.
Ah, yes, climate change, which also explains how Lyme disease, first diagnosed in the US in the northern midwest and northeast, later spread southward. I'm sure it works in mysterious ways in your neighborhood as well.
LymeAlert, which will sell for about $50, is designed to detect the presence of Borrelia burgdorferi, the pathogen known to cause Lyme disease, in a tick.
The test kit, which remains effective for up to 12 months, is simple to use. After carefully removing the tick with either tweezers or a tick-removal tool, you place it into the kit’s “Tick Crusher.” The grinder pulverizes the tick’s chitinous exterior, exposing the internal contents where the Borrelia burgdorferi is located. A patent-pending buffer solution readies the sample for testing. The user then inserts a test strip into a slot in the grinder. The strip’s chemically treated nitrocellulose paper functions as an immunochromatographic assay that can detect the presence of Borrelia burgdorferi.
There are MANY facebook groups filled with people fully convinced that they have Lyme disease. These groups teach that virtually any and every symptom is caused by the infection and that basically everyone has it. As if this wasn’t insane enough, the people in the group will push each other to go on antibiotics - via so called lyme literate doctors - until they are on the verge of death due to the side effects. Worse: if a lab test is negative they say you should treat by symptom (referring people back to the massive list of virtually every known symptom as proof that they have lyme). It gets worse: even if you get really bad reactions to the treatment, they say you are having a herxheimer reaction and to keep pushing. It gets worse: having followed many of those groups for years, it’s rare that anyone actually gets better from whatever symptom they were having that led them down the self destructive path of lyme self-diagnosis. Well, it actually is a bit worse: even if by some chance you did had a positive lyme test, and if by chance you did got years worth of antibiotics, SOT treatments, etc etc etc… and now you have finally a clean test- well actually it’s bartonella, or parasites, or babesia, or EBV or whatever … so you must carry on. And, it’s not that these people are idiots, it’s just that they fall into a very specific category: 1) have real symptoms, 2) have no real answers from medicine, 3) have internet access, 4) have no notion, not even a tiny spec, of the existence of a concept called falsifiability. So when i read that there’s a new at home test for lyme… on tics(!) i can only imagine the massive amount of suffering this will cause on these poor people… and i imagine many if them will put their blood on the test and come up with all kinds of ways to use this to find yet another proof that they have it
We are quickly entering a medical dark age due to the conspiracy theorists, “Do Your Own Research-ers,” YouTube influencers, and other kinds of Internet-borne DIY self diagnosis.
What didn't help was the response to the pandemic by governments and the scientific establishment, that supplied an unfortunate and pretty devastating blow to public trust in these institutions.
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.
I live in the NE and just picked up Lyme for the second time in 3 years. My child and several friends have had it in the past few years. The problem is that some tick species are unbelievably small and easy to miss. With winters not being as cold, they don't die off as much as they traditionally would. I'd hate to move, but if we keep getting infected, it's not out of the question.
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.
Not only Lyme... In the seaside Finland the tick-borne encephalitis cases are going up. And that's no joke either, but at least you get a vaccine for that... if you remember to take it three times before the ticks wake up in springtime.
I saw a commercial for this. I am not sure it makes much sense unless you literally are 100% sure that was the only tick. And it is like I think $40 or $50 a test. I am sure the women I saw discussing the satisfaction they got enjoyed crushing up those little bad guys, and maybe some placebo-like relief, but the truth of the matter is the only really reliable tests for Lyme Disease are blood tests.
A really accurate blood test for tick borne disease would be much more useful that would allow you to know you have something in a time frame you could treat the diseases early.
> After carefully removing the tick with either tweezers or a tick-removal tool, you place it into the kit’s “Tick Crusher.” The grinder pulverizes the tick’s chitinous exterior, exposing the internal contents where the Borrelia burgdorferi is located
I live in Finland, and if I would be following this advice;
> "If you have an embedded tick where there’s a chance of infection, then go to your doctor and get a dose of antibiotics as a prophylactic, just to be on the safe side."
...I would be eating antibiotics 5 months per year each year of my life. I've had 13 ticks this summer, and it's the least I've ever had in a summer ever I think. I sometimes go over a 100 on a summer. But I've just had Lyme's disease once confirmed, but before that I had anti-bodies (which I got to know through a research project i participated in).
There's a lot of research on ticks going on in Finland, and I participate in two citizen science projects* this summer; for one I collect the ticks and send them to the researchers, the other project I just post observations.
I quickly realized it was a hassel to submit to both projects every time I found a tick on me or the cats. So I used Claude Code to build my own self-hosted app that stores my profile, location etc and submits my findings to both of the projects. Simple and nice litte project. I have a thought of publishing the app in some form, but haven't thought about it much.
Like others, I was interested in the article because of Lyme and other diseases. Ticks really do suck.
I appreciate all the science-y comments though I understand very little. I appreciate comments about personal experiences with ticks, getting bitten, and getting sick.
I’m left with this: If this test is not really a viable solution (or at least one solution) to the problem of the unaffordability of visits to the doctor, what is a better solution. I would put all options on the table and move things like universal health care to the “working on it but not helpful right now” pile of solutions.
Growing up near the epicenter of Lyme disease (which is awful) - it’s not that hard to deal with on a regular basis (I probably take half a dozen plus attached ticks off me year. When your pre-in-post shower - tick check. Take them off, worried they were on for a while, doxycycline as prophylactic. Feel crappy afterwards doctor+blood test / maybe antibiotics. It sucks but it’s manageable. Bourbon virus and alpha gal are super scary. When you k ow about them it’s easier to manage - when you’re oblivious it’s when it’s really dangerous.
What would be way more useful is a quick blood test (pin prick type à la thernos) that could diagnose early for treatment.
According to evidence based medicine, infected tick's bite is not equal to infection of the patient. It means that the test can be false positive and based solely on it, people would start exhausting treatment for nothing
Yes, it's treatable with antibiotics and people that are treated get less sick. As stated in the article, prophylactic treatment with Doxycycline is the standard of care. Testing the tick is an alternative to that rather than something that should be expected to increase treatment...
The article also mentions that symptoms sometimes persist after treatment with antibiotics.
It also has the broader public health benefit of reducing the preventative use of that class of antibiotics, which lowers the risk of antibiotic resistance generally. (In an ideal world we'd never use them preventatively.)
Could be a very big deal if it could be made properly inexpensive. COVID tests were, after all.
Absolutely yes, because the most severe risks are associated with the bacteria reaching the heart and into the nervous system, which is a relatively slow process. There's a window of a couple of weeks.
If you could know as soon as you were bitten whether there was any risk of infection at all, that would be very valuable information.
I think it's only a one in ten chance that an infected tick would transmit the infection, anyway. But you would know whether you needed to even book an appointment.
As long as you’re not getting bitten by a tick more than once a year if you do get bitten every time take the high dose antibiotic seems simple enough that’s what we do here at at least
I developed alpha-gal allergy. I've gotten many tick bites over the years, though none from 'lone star' tick afaik. I don't eat meat normally, so it was only a rare chance occasion when I ate something that triggered an allergic reaction: hives all over, tightness in the throat. It wasn't full anaphylaxis though, fortunately. After some research I thought it might be this allergy, but it wasn't until ~12 years later and an encounter with some pork dumplings which led to a similar reaction that I became convinced and got the blood test.
There is a long, sad history here. Lyme disease is a popular topic into alternative medicine as an explanation for unexplained symptoms. There is a belief in these communities that the standard tests for Lyme disease are not accurate, so people diagnose themselves by vague symptoms like feeling tired or having headaches. It’s a sad situation where people who aren’t finding an explanation for their symptoms get drawn into forums or Facebook groups where groups of people confidently tell them that their symptoms sound like Chronic Lyme Disease and that normal doctors can’t help them.
This has created an intense fear of Lyme disease among people who don’t trust doctors and “do their own research”. That group overlaps a lot with anti-vax groups. You can see where this is going. Some people who got the Lyme vaccine because they saw it as the lesser of two evils and then subsequently had medical issues blamed everything on the vaccine, and it blew up into lawsuits and a belief that the vaccine causes these problems. If there was any real problem we’ll never know because the storm was such a mess that it made actual research impossible and scared so many people away from the vaccine that it was withdrawn from the market.
All those people who claimed to get autoimmune problems after the vaccine, must have been people who went to quite a bit of trouble to get the vaccine in the first place, so I'm not so sure it can all be written off as health panic.
Lyme disease has a long, storied history in alternative medicine and anti-vax communities. I would not be surprised if many of the people seeking the vaccine early were in those communities and entered with a distrust of vaccines, but thought the risk of Lyme disease outweighed their perceived risk of the vaccine. Once they got the vaccine they fixated on it as the source of their problems.
This exact pattern has been playing out with the COVID vaccine and the HPV vaccine. There are communities who are convinced that every medical problem they had since receiving the HPV vaccine is due to the vaccine, even though they’re all having different health problems that also occur in the overall population.
It's a bit of a stretch to describe These claims were investigated by the FDA and the Centers for Disease Control, which found no connection between the vaccine and the autoimmune complaints. as "written off as a health panic".
Of course you can just say they didn't investigate it enough or whatever, you aren't trying to make a reasoned argument and thus don't need to exercise reason.
A problem with vaccines and the public is that when you perform any intervention on many many people, some will happen to (randomly) suffer some issue. To them, it is obviously causation, regardless of what the math (that they do t understand) says.
Used to be a big Event Of The Year when my grandpa found one after spending all day out in their 'garden' (a few acres bordering deep woods). I remember being maybe 11 when he found one, let me try and figure out how to crush it, I couldn't. He showed me how to use the butt of a butterknife and leverage to get the fuckers
I don't live anywhere near a proper forest and we've had several close calls this year, I caught one crawling across my scalp when I was getting into bed last month. Went and got tested just to be safe
I know feeding crows is really fun, but please don't. It's very important that they get hungry enough to eat mice sometimes. Same goes for deer, the past couple of years I've had them walk _towards_ me and my dog instead of bolting, presumably because someone is feeding them (by hand, not garden raiding)
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 hours, and it is highly unlikely they'll give you a disease.
Ticks also get attached to humans in tall grass and forest edges, not from the trees. Walking through open fields is a more likely way to get a tick than walking through the woods, because that is where the deer sleep. They bed down in tall grass, and the ticks come along for the ride. So be wary of the grass, not the woods. As a matter of fact, the best thing you can do to keep ticks away from your home if you live out in the country is to keep 8-10 feet of grass cut really short at the perimeter of your property or wherever it meets the woods.
Young deer often walk towards people, too. They aren't born afraid of humans, and have natural instincts to freeze, not flee. So when their mama hides them, it is just as likely to be near humans, not in the woods with the coyotes. They'll learn the fear soon enough (definitely during hunting season), but until then they certainly have youthful curiosity.
Even so, "sign me up" is still a good answer. Home testing sounds great.
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.
Deer ticks are hard to crush too. And I'd say typically closer to the size of a sesame than a poppy seed. I like to pinch them between the tips of two fingernails, but lighting them on fire is also an enjoyable way to end them.
Looks like there are clinical trials of a new vaccine, maybe demand will be higher this time around. The link also mentions a PrEP-type of treatment, which would be given seasonally. My bet is on that one, big pharma loves nothing more than a treatment that isn't quite a cure, but requires constant maintenance.
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 universally based on PCR.
Ticks are small (especially nymphs) and extracting enough material can be tricky even for molecular testing, so I can't imagine an LFT test working terribly well, especially for nymphs, which are responsible for a lot of Lyme infections due to being easy to miss.
The other, bigger problem is that the test result is mostly useless.
The risk of Lyme transmission from an infected tick ranges rougly from <1% for a fresh bite (<24h) to ~10-25% once the tick is engorged (72h+). A positive tick test result would be insufficiently predictive of Lyme disease transmission on its own to justify taking antibiotics in most cases in the absence of other symptoms.
And you can't trust negative results either due to limited sensitivity, so you can't rule out transmission either.
In my opinion, tests like this can lead to worse overall health outcomes due to unnecessary treatment or withholding prophylaxis from someone who otherwise qualifies.
Yeah, I would be vary of accuracy of such tests.
The infected unfed ticks have few spirochetes in them. The numbers grow by two orders of magnitude as they feed - the reason why old bites are much more dangerous than the fresh bites.
"so I can't imagine an LFT test working terribly well, especially for nymphs, which are responsible for a lot of Lyme infections due to being easy to miss."
Even smaller and less noticeable are the larvae. And I know I learned that they cannot transmit the disease, because they only do so, if they have biten an infected animal before - so I never worried about small ticks, but apparently new research indicates, that this is wrong.
"However, newer research suggests that some pathogens, including Borrelia miyamotoi, may be transmitted from the adult female tick directly to her offspring.
This means larval ticks may already be infected before their first bite."
https://danielcameronmd.com/larval-ticks-borrelia-miyamotoi/
It's been 15 years since I worked on open source PCR machines, but has someone not figured out how to build a "one time use" disposable type qPCR test? A single test, not an instrument. There's no way these types of tests should be left up to lateral flow etc.
Lucira did that, but IMO it's quite wasteful. LAMP reactions don't need much, so it's best to make a cheap reader like Metrix or Pluslife so the tests can be less expensive.
> The vendor claims "lab-level accuracy" (conveniently omitting the actual accuracy numbers)
Hey, labs have QC failures all the time.
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 <48 hours [61, 62, 135].
(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?
CDC recommendation is more interested in preventing antibiotic resistance than in preventing Lyme disease for the patient. Obey CDC at your own risk
Antibiotics aren't free of risks to the patient either, including doxycycline. There's always a risk tradeoff.
100%. CDC is not a replacement for a trusted doctor
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 have any grasp of the risk of Lyme because the high risk zones are, by and large, not well known, and they don't always correlate that well with the basic risk of acquiring a tick.
I think most specialists in the UK think this is likely to lead to a pretty big increase to infections before people learn, so maybe this sort of tool will help offset that.
I walk a lot in an area with some wild deer and boar, and I would love to have one of these in my cupboard as a precaution. Would be great to see them in supermarkets in high risk areas, too.
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.
Yeah. I think we simply did not see it enough and to be honest far too few doctors ask the "have you travelled" question about unusual disease. It is better now, but I think the "could it be?" thought doesn't occur because the incidence has been low.
There is a more severe risk around rabies. We basically do not have it in the UK or Ireland; it has been eliminated for over a century except a tiny incidence of a virus in the same family in bats. But because we have essentially eradicated it, doctors do not often think to ask about it, even in people who have travelled, which led to someone suffering awfully last year.
And since a dog bite or even a fox bite in the UK or Ireland carries literally zero risk of rabies, those who are bitten or scratched while travelling abroad do not have it uppermost in their mind.
Thats interesting, since there is a lot of research around face palsy & recovery in UK.
Yep.
About 20 years ago my gran got to the facial palsy stage of Lyme's before it was even considered and diagnosed by a visiting locum doctor who'd grown up in another country.
Antibiotics were given, her face recovered (albeit slowly).
It's a horrendous disease.
May I ask: Did the muscles on the side of the face with the affection also restore or does she have an muscle-atrophy until today on that side?
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.
Nothing really to do with public healthcare. It is literally that there is almost no medical or social experience in the UK of actually seeing developed Lyme disease up close, because it has historically been so unusual, so there are no protocols.
A few thousand cases every year now, when the first indigenous case ever properly recorded in the UK was only in 1986, and it's not like in the USA where really wide areas are high risk. Some of the pockets of highest risk Lyme in the UK are no more than a few miles across.
Nurse stations and pharmacy clinics are great at properly removing ticks if you know you have been bitten, and from there you will now get good advice about Lyme.
But a system that has no endemic experience of Lyme is just not going to test for it. Because it's remote, and people are usually unaware they have been in risk areas, and often unaware they've even been bitten.
1986 is forty years ago. We have Lymes disease in Scotland (I know someone who has it), and a large deer population which has not been properly controlled with substantial remote areas. (Much smaller than the USA but big enough to be reservoirs for the disease.)
One thing pointing out is that deer aren’t really the disease reservoir for Lyme disease (it’s primarily mice) - but deer are key for tick population growth.
Mice and voles, yes.
(There are more voles in the UK than mice, as it goes. Outnumber them by about thirty million or something. Fairly recently acquired trivia for me, but it turns out that if you see a mouse scurrying in the wild in the UK, away from houses, it's a bit more likely to actually be a vole.)
Ticks are much more common in Scotland thanks to deer population and high rainfall. Ticks prefer damp conditions to drought conditions, so this last summer wouldn't have been good for them. The damp makes it easier to survive while they are waiting for passing hosts. They also like long grass and overgrown areas.
England in comparison is much more built up.
We do have Lyme disease here unfortunately. I know someone who has it.
Certainly had to convince my gp a few years ago that indeed there is Lyme in Ireland
It certainly exists in Scotland. Wouldn't surprise me if it got there.
It started around Connecticut in the 70s and has been spreading out radially since then. I believe it’s still not a huge problem in the western United States (there are other tick borne diseases there however). Soon it will spread across the world and tick bites will be serious business everywhere.
Correct. The outbreak was first recognized in 1975 in Old Lyme, Connecticut, directly across the Long Island Sound from the Plum Island Animal Disease Center (a lab which had been doing explicitly offensive biological weapons research until at least 1969), which led to an unverified theory about an escaped bioweapon.
Genetic studies and museum tick specimens prove the bacteria existed in North America for thousands of years before the lab was built. Whether there was gain of function done on it is not publicly verified.
I live near Plum Island. Just look at the Google Map reviews to get an idea of the sentiment. Camp Hero, Plum Island…lotta material for Netflix series coming out of Long Island.
Maybe it is a raise of dog ownership in UK as well. They bring ticks inside houee, and shed it in public parks. Our dog used to have like 50 ticks everytime it returned from run.
People are more aware of ticks because of dog ownership, I think, but I don't know if this is a real risk because of the widespread use of tick repellent treatments for dogs (which are their own little eco-disaster).
COVID lockdowns changed us and we're a bit more outdoorsy.
But mostly it is the deer population. There are now four times as many wild deer in the UK as there were before the first indigenous case of Lyme was detected. From under half a million to well over two million over that timeframe.
In the south east around where I am, wild boar are now a potentially significant vector in the high risk areas, too — we've gone from literally zero to a couple of thousand wild boar in the same forty-year period of time just in the 20 miles around me. They apparently can carry upwards of a hundred without suffering.
Ah, yes, climate change, which also explains how Lyme disease, first diagnosed in the US in the northern midwest and northeast, later spread southward. I'm sure it works in mysterious ways in your neighborhood as well.
Buried way way down:
LymeAlert, which will sell for about $50, is designed to detect the presence of Borrelia burgdorferi, the pathogen known to cause Lyme disease, in a tick.
The test kit, which remains effective for up to 12 months, is simple to use. After carefully removing the tick with either tweezers or a tick-removal tool, you place it into the kit’s “Tick Crusher.” The grinder pulverizes the tick’s chitinous exterior, exposing the internal contents where the Borrelia burgdorferi is located. A patent-pending buffer solution readies the sample for testing. The user then inserts a test strip into a slot in the grinder. The strip’s chemically treated nitrocellulose paper functions as an immunochromatographic assay that can detect the presence of Borrelia burgdorferi.
There are MANY facebook groups filled with people fully convinced that they have Lyme disease. These groups teach that virtually any and every symptom is caused by the infection and that basically everyone has it. As if this wasn’t insane enough, the people in the group will push each other to go on antibiotics - via so called lyme literate doctors - until they are on the verge of death due to the side effects. Worse: if a lab test is negative they say you should treat by symptom (referring people back to the massive list of virtually every known symptom as proof that they have lyme). It gets worse: even if you get really bad reactions to the treatment, they say you are having a herxheimer reaction and to keep pushing. It gets worse: having followed many of those groups for years, it’s rare that anyone actually gets better from whatever symptom they were having that led them down the self destructive path of lyme self-diagnosis. Well, it actually is a bit worse: even if by some chance you did had a positive lyme test, and if by chance you did got years worth of antibiotics, SOT treatments, etc etc etc… and now you have finally a clean test- well actually it’s bartonella, or parasites, or babesia, or EBV or whatever … so you must carry on. And, it’s not that these people are idiots, it’s just that they fall into a very specific category: 1) have real symptoms, 2) have no real answers from medicine, 3) have internet access, 4) have no notion, not even a tiny spec, of the existence of a concept called falsifiability. So when i read that there’s a new at home test for lyme… on tics(!) i can only imagine the massive amount of suffering this will cause on these poor people… and i imagine many if them will put their blood on the test and come up with all kinds of ways to use this to find yet another proof that they have it
We are quickly entering a medical dark age due to the conspiracy theorists, “Do Your Own Research-ers,” YouTube influencers, and other kinds of Internet-borne DIY self diagnosis.
What didn't help was the response to the pandemic by governments and the scientific establishment, that supplied an unfortunate and pretty devastating blow to public trust in these institutions.
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.
I live in the NE and just picked up Lyme for the second time in 3 years. My child and several friends have had it in the past few years. The problem is that some tick species are unbelievably small and easy to miss. With winters not being as cold, they don't die off as much as they traditionally would. I'd hate to move, but if we keep getting infected, it's not out of the question.
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.
Not only Lyme... In the seaside Finland the tick-borne encephalitis cases are going up. And that's no joke either, but at least you get a vaccine for that... if you remember to take it three times before the ticks wake up in springtime.
I saw a commercial for this. I am not sure it makes much sense unless you literally are 100% sure that was the only tick. And it is like I think $40 or $50 a test. I am sure the women I saw discussing the satisfaction they got enjoyed crushing up those little bad guys, and maybe some placebo-like relief, but the truth of the matter is the only really reliable tests for Lyme Disease are blood tests.
A really accurate blood test for tick borne disease would be much more useful that would allow you to know you have something in a time frame you could treat the diseases early.
The most interesting part:
> After carefully removing the tick with either tweezers or a tick-removal tool, you place it into the kit’s “Tick Crusher.” The grinder pulverizes the tick’s chitinous exterior, exposing the internal contents where the Borrelia burgdorferi is located
I live in Finland, and if I would be following this advice;
> "If you have an embedded tick where there’s a chance of infection, then go to your doctor and get a dose of antibiotics as a prophylactic, just to be on the safe side." ...I would be eating antibiotics 5 months per year each year of my life. I've had 13 ticks this summer, and it's the least I've ever had in a summer ever I think. I sometimes go over a 100 on a summer. But I've just had Lyme's disease once confirmed, but before that I had anti-bodies (which I got to know through a research project i participated in).
There's a lot of research on ticks going on in Finland, and I participate in two citizen science projects* this summer; for one I collect the ticks and send them to the researchers, the other project I just post observations.
I quickly realized it was a hassel to submit to both projects every time I found a tick on me or the cats. So I used Claude Code to build my own self-hosted app that stores my profile, location etc and submits my findings to both of the projects. Simple and nice litte project. I have a thought of publishing the app in some form, but haven't thought about it much.
*https://www.punkkilive.fi/en and https://punkkipankki.fi
If not this, then what?
Like others, I was interested in the article because of Lyme and other diseases. Ticks really do suck.
I appreciate all the science-y comments though I understand very little. I appreciate comments about personal experiences with ticks, getting bitten, and getting sick.
I’m left with this: If this test is not really a viable solution (or at least one solution) to the problem of the unaffordability of visits to the doctor, what is a better solution. I would put all options on the table and move things like universal health care to the “working on it but not helpful right now” pile of solutions.
Growing up near the epicenter of Lyme disease (which is awful) - it’s not that hard to deal with on a regular basis (I probably take half a dozen plus attached ticks off me year. When your pre-in-post shower - tick check. Take them off, worried they were on for a while, doxycycline as prophylactic. Feel crappy afterwards doctor+blood test / maybe antibiotics. It sucks but it’s manageable. Bourbon virus and alpha gal are super scary. When you k ow about them it’s easier to manage - when you’re oblivious it’s when it’s really dangerous.
What would be way more useful is a quick blood test (pin prick type à la thernos) that could diagnose early for treatment.
According to evidence based medicine, infected tick's bite is not equal to infection of the patient. It means that the test can be false positive and based solely on it, people would start exhausting treatment for nothing
The "exhausting treatment" is a single pill, once.
Only some kinds ticks carry Lyme disease. Sadly I tried the e-Tick identification system and it was beyond useless.
Does diagnosis offer a better prognosis for those that are infected?
Yes, it's treatable with antibiotics and people that are treated get less sick. As stated in the article, prophylactic treatment with Doxycycline is the standard of care. Testing the tick is an alternative to that rather than something that should be expected to increase treatment...
The article also mentions that symptoms sometimes persist after treatment with antibiotics.
It also has the broader public health benefit of reducing the preventative use of that class of antibiotics, which lowers the risk of antibiotic resistance generally. (In an ideal world we'd never use them preventatively.)
Could be a very big deal if it could be made properly inexpensive. COVID tests were, after all.
Absolutely yes, because the most severe risks are associated with the bacteria reaching the heart and into the nervous system, which is a relatively slow process. There's a window of a couple of weeks.
If you could know as soon as you were bitten whether there was any risk of infection at all, that would be very valuable information.
I think it's only a one in ten chance that an infected tick would transmit the infection, anyway. But you would know whether you needed to even book an appointment.
> But you would know whether you needed to even book an appointment.
Only if the test is sufficiently accurate to rule out transmission. Even molecular tests can't reliably predict that.
As long as you’re not getting bitten by a tick more than once a year if you do get bitten every time take the high dose antibiotic seems simple enough that’s what we do here at at least
Not everyone is in a position to take that approach so freely, alas.
So one more tool in the toolbox is a very good thing.
Yes, but this test cannot diagnose Lyme in humans.
Great. Let's get working on preventing/curing alpha-gal allergy though.
Or actually let's just eradicate all ticks.
I developed alpha-gal allergy. I've gotten many tick bites over the years, though none from 'lone star' tick afaik. I don't eat meat normally, so it was only a rare chance occasion when I ate something that triggered an allergic reaction: hives all over, tightness in the throat. It wasn't full anaphylaxis though, fortunately. After some research I thought it might be this allergy, but it wasn't until ~12 years later and an encounter with some pork dumplings which led to a similar reaction that I became convinced and got the blood test.
I’m in.
Why test ticks for Lyme Disease? Make a cheap, accurate test for Lyme disease in humans!
Jeez! Chasing ticks, c'mon, really, my f*ing intelligence is insulted by the suggestion.
Yeah - I just want to know early that I need to start treatment not “I might be infected”
I think so that you can take antibiotics early and prevent actually getting Lyme disease.
But honestly what are the odds that you would find and successfuly test the very tick that infects you with Lyme disease? Gotta be pretty slim!
If there are areas where the chance of getting Lyme per bite is 10% then...about that?
Why can't the government or a generic drug manufacturer just produce the Lyme Disease vaccine? It is safe and the patent has expired!
(Also, I have the same question about the poison ivy immunotherapy pills that were common in the US before the FDA.)
There is a long, sad history here. Lyme disease is a popular topic into alternative medicine as an explanation for unexplained symptoms. There is a belief in these communities that the standard tests for Lyme disease are not accurate, so people diagnose themselves by vague symptoms like feeling tired or having headaches. It’s a sad situation where people who aren’t finding an explanation for their symptoms get drawn into forums or Facebook groups where groups of people confidently tell them that their symptoms sound like Chronic Lyme Disease and that normal doctors can’t help them.
This has created an intense fear of Lyme disease among people who don’t trust doctors and “do their own research”. That group overlaps a lot with anti-vax groups. You can see where this is going. Some people who got the Lyme vaccine because they saw it as the lesser of two evils and then subsequently had medical issues blamed everything on the vaccine, and it blew up into lawsuits and a belief that the vaccine causes these problems. If there was any real problem we’ll never know because the storm was such a mess that it made actual research impossible and scared so many people away from the vaccine that it was withdrawn from the market.
https://en.wikipedia.org/wiki/Lyme_disease#Vaccination
All those people who claimed to get autoimmune problems after the vaccine, must have been people who went to quite a bit of trouble to get the vaccine in the first place, so I'm not so sure it can all be written off as health panic.
Lyme disease has a long, storied history in alternative medicine and anti-vax communities. I would not be surprised if many of the people seeking the vaccine early were in those communities and entered with a distrust of vaccines, but thought the risk of Lyme disease outweighed their perceived risk of the vaccine. Once they got the vaccine they fixated on it as the source of their problems.
This exact pattern has been playing out with the COVID vaccine and the HPV vaccine. There are communities who are convinced that every medical problem they had since receiving the HPV vaccine is due to the vaccine, even though they’re all having different health problems that also occur in the overall population.
It's a bit of a stretch to describe These claims were investigated by the FDA and the Centers for Disease Control, which found no connection between the vaccine and the autoimmune complaints. as "written off as a health panic".
Of course you can just say they didn't investigate it enough or whatever, you aren't trying to make a reasoned argument and thus don't need to exercise reason.
A problem with vaccines and the public is that when you perform any intervention on many many people, some will happen to (randomly) suffer some issue. To them, it is obviously causation, regardless of what the math (that they do t understand) says.
There was a link on HN some years ago which reported entering a phase-III trial for a vaccination created by one of the big pharma.
Downvoters shouldnt be allowed to vote if they cant use Google:
Here is the link for all downvoters :-D
https://news.ycombinator.com/item?id=32465108
(Aug 2022, exactly what I said with "some years ago")
There is potentially a new Lyme vaccine coming out in about a year. The review process in Europe just started.
https://pharmaphorum.com/news/pfizer-valneva-lyme-vaccine-st...
Sign me up.
Used to be a big Event Of The Year when my grandpa found one after spending all day out in their 'garden' (a few acres bordering deep woods). I remember being maybe 11 when he found one, let me try and figure out how to crush it, I couldn't. He showed me how to use the butt of a butterknife and leverage to get the fuckers
I don't live anywhere near a proper forest and we've had several close calls this year, I caught one crawling across my scalp when I was getting into bed last month. Went and got tested just to be safe
I know feeding crows is really fun, but please don't. It's very important that they get hungry enough to eat mice sometimes. Same goes for deer, the past couple of years I've had them walk _towards_ me and my dog instead of bolting, presumably because someone is feeding them (by hand, not garden raiding)
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 hours, and it is highly unlikely they'll give you a disease.
Ticks also get attached to humans in tall grass and forest edges, not from the trees. Walking through open fields is a more likely way to get a tick than walking through the woods, because that is where the deer sleep. They bed down in tall grass, and the ticks come along for the ride. So be wary of the grass, not the woods. As a matter of fact, the best thing you can do to keep ticks away from your home if you live out in the country is to keep 8-10 feet of grass cut really short at the perimeter of your property or wherever it meets the woods.
Young deer often walk towards people, too. They aren't born afraid of humans, and have natural instincts to freeze, not flee. So when their mama hides them, it is just as likely to be near humans, not in the woods with the coyotes. They'll learn the fear soon enough (definitely during hunting season), but until then they certainly have youthful curiosity.
Even so, "sign me up" is still a good answer. Home testing sounds great.
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?
https://www.cdc.gov/ticks/about/index.html
https://projectlyme.org/ticks-debunking-common-myths-and-mis...
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.
Can you explain how short grass on the perimeter helps?
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.
I'd argue it's perfectly fine to have some snark reacting to a comment spreading a potentially dangerous sentiment.
I have at least one serious regret about trusting someone on the internet saying something incorrect confidently.
And tick-borne encephalitis, in regions where that is endemic.
No need to be rude, though!
The tick you're talking about here (hard to crush) is a wood tick, the types that carry lyme are deer ticks.
They're much, much smaller. The size of a poppy seed.
Deer ticks are hard to crush too. And I'd say typically closer to the size of a sesame than a poppy seed. I like to pinch them between the tips of two fingernails, but lighting them on fire is also an enjoyable way to end them.
This is great (if it's accurate) but the real gem would be a vaccine, which is apparently also coming out soon.
There was a vaccine over 20 years ago. It was discontinued due to low demand.
https://www.cdc.gov/lyme/about/lyme-disease-vaccine.html
Looks like there are clinical trials of a new vaccine, maybe demand will be higher this time around. The link also mentions a PrEP-type of treatment, which would be given seasonally. My bet is on that one, big pharma loves nothing more than a treatment that isn't quite a cure, but requires constant maintenance.
Another step towards a vaccine, I hope.