The Igenex Lyme Test
This test incorporates a Western Blot for both IgM and IgG antibodies. IgM antibodies are present in an active or recent infection. IgG antibodies are produced once the infection has been present for a while, typically 6 weeks or longer. This test is more sensitive than the CDC’s version in that it only wants to see 2 or more IgG anti-body bands as opposed to the CDC who want to see 5 or more IgG anti-body bands. This lab also ranks the intensity of the bands from none-low-medium-high so if there is only one band present but it is high than there is still a chance the bacterium is present.
Whole Blood & Serum PCR
This test uses a DNA Polymerase Chain Reaction to look for parts of the Bb organism throughout the blood. This helps complete the testing as the immune system may be too weak or tricked by the spirochete organism and may not be able to produce anti-bodies. This test is actually looking for the real DNA pieces of Bb.
How to send blood to IGeneX for testing for Lyme Disease & associated co-infections.
1. Contact IGeneX (www.igenex.com) & ask them to send you a testing kit (this is a free service).
2. In consultation with IGeneX, decide which blood tests are most appropriate (included with the test kit from IGeneX is a full list of tests available)
3. Complete the IgeneX pathology request form (including getting the patient to include credit card details to pay for the test). Do not fill in the Medicare section of your form, as this relates to Medicare USA (not Medicare Australia) and will slow down your testing whilst this is sorted out.
4. Contact the local pathology collection centre that will be doing the blood draw & ensure that they are able to do this (most are, but some have difficulty, so it is best to check ahead of time)
5. Contact the FEDEX office closest to your major airport (or the office you will be delivering the blood to). Check what time their cut off is for receiving a package to go to the US.
6. The blood draw needs to be done on a Monday or Tuesday (if in Sydney – if in other capital cities the blood can only be drawn on a Monday).
7. Arrive at the blood collection centre early (up to 15+ mins before the collection centre opens, to ensure you are the first patient). Sometimes there will be a small collection fee for taking the blood sample (usually $20 to $30 – sometimes this will need to be paid in cash on the day, and sometimes this will be invoiced to the
patient)
8. Collect the blood & place it into the tubes provided by IGeneX. Some of these will need to be spun & rested (the blood collection centre will know what to do with each tube, depending on the colour on the top of the tube).
9. Once the blood is spun & has rested for the required amount of time, place it in the foam box & place this inside the IGeneX box with the IGeneX pathology request form, inside the FedEx container.
10. Take the blood to the FedEx office your major capital city airport. Make sure it arrives by the time you were advised in step 5 (if you are late this will delay your blood by 24 hours & may mean you have to go through this whole process again)
11. Pay for your FedEx shipping, fill in the required paperwork. An important note is - do not say that the blood requires extra refrigeration, or it will slow your blood down by 24 hours & cost $100- $200 extra – normal shipping is around $50-$100). You need to select the box “non hazardous Human Blood”.
12. After the blood has been tested, the results will be returned to the requesting Doctor – this may take up to 6 weeks.
www.IGeneX has recently set up three “Australian Lyme Panel’s” for patients that may have been infected in Australia. You must state on the form which Australian Lyme Panel test that you are requesting. These panels may be appropriate for some patients, however clinical judgement should be used to decide which tests should be ordered, depending on the patients medical history and symptoms, especially in regard to co-infections. For more information on co- infections,
please see www.lymedisease.org.au/about-lyme-disease/co-infections/ and www.lymesymptoms.com/LymeCoinfectionChart.html
If in doubt about what tests to order, physicians can contact IGeneX directly or the Lyme Disease Association of
Australia’s medical advisor – Dr Nicola McFadzean (please contact the association for her details).
Igenex Test Panels Available:
The 3 Australian Panels and their respective prices are as follows (Current as of September 2012):
7010 AUSTRALIAN TICK-BORNE DISEASE PANEL 1 (Requires Serum 5ml ) Cost: $1010US
Lyme Western Blot IgM, Lyme Western Blot IgG, Babesia microti IgG & IgM, Babesia duncani IgG & IgM , HME IgG &
IgM, HGA IgG & IgM, Bartonella IgG & IgM , Rickettsia rickettsii/typhi IgG Ab
7020 AUSTRALIAN TICK-BORNE DISEASE PANEL 2 (Requires Serum 7ml and EDTA Whole Blood 4ml) Cost: $1220USDContains all tests in Panel 1 with the addition of Lyme PCR Serum and Lyme PCR Whole Blood
Lyme Western Blot IgM, Lyme Western Blot IgG, Lyme PCR -Serum, Lyme PCR- Whole Blood, Babesia microti I gG & IgM, Babesia duncani IgG & IgM , HME IgG & IgM, HGA IgG & IgM, Bartonella IgG & IgM , Rickettsia rickettsii/typhi IgG Ab
7030 AUSTRALIAN TICK-BORNE DISEASE PANEL 3 (Requires Serum 7ml and EDTA Whole Blood 8ml) Cost: $1460USDContains all tests in Panel 2 with the addition of Babesia FISH and Bartonella FISH
Lyme Western Blot IgM, Lyme Western Blot IgG, Lyme PCR-Serum, Lyme PCR- Whole Blood, Babesia microti IgG & IgM, Babesia duncani IgG & IgM , Babesia FISH, HME IgG & IgM, HGA IgG & IgM, Bartonella IgG & IgM , Bartonella FISH, Rickettsia rickettsii/typhi IgG Ab
Further information with regards to testing at Igenex:
Please note with regards to the above, whilst it is "Australian Panel", this does not mean that it is testing for an Australian species of borrelia (as one has not yet been discovered - this is not yet possible), rather it is that the Panels are more appropriate for those that are more likely to have a European, rather than American species of borrelia infection.
Additional Tests
Other tests available include the Eli spot test, a test that assesses the immune response to Borellia.
This can be useful to monitor the patient’s reaction to treatment as well as active effect from the bacteria.
The GLD test from Global Lyme diagnostics is also available to measure antibodies against stealth pathogens such as Borellia.
This test is able to identify a wide range of pathogens that cause Lyme, not just Borrelia burgdorferi.
The detail in the test assists with reducing the occurrences of false negatives.