Guidance

Lyme disease services

Diagnostic and advisory services for Lyme disease.

Diagnostic services

First line laboratory testing for suspected Lyme disease may be available through local NHS service providers. Where this is not available, and for all confirmatory testing, the Rare and Imported Pathogens Laboratory (RIPL) at Public Health England Porton, provides a Lyme disease diagnostic service.

Lyme disease is usually diagnosed by serology. RIPL uses a modified 2-tier testing approach. The initial screening test is a C6 antigen based ELISA (combined IgG and IgM), followed for positive or indeterminate results by a confirmatory immunoblot (separate IgG and IgM).

PCR is also available and may be useful in testing joint fluid and biopsies of skin rashes. It has poor sensitivity on CSF and antibody detection is the preferred first line test on CSF. PCR is not usually performed on blood as the duration of bacteraemia is short.

See sample testing advice for information on the tests available, how to submit samples for Lyme disease testing, and guidance on test interpretation.

RIPL can also perform further tests for other tick-borne diseases. Please contact the laboratory to discuss.

Clinical advice

There is extensive clinical and diagnostic advice available from PHE online.

RIPL clinical staff are available to discuss Lyme disease cases with medical professionals during working hours. See RIPL contact details below.

There is no clinic at Public Health England Porton and we are unable to see patients or give phone advice to members of the public.

Lyme service user manual

For information about turnaround times and test charges, see RIPL user manual, Appendix 1.

Contact information

Lyme disease diagnostic service

Rare and imported pathogens laboratory (RIPL)
PHE, Manor Farm Road
Porton Down
Wiltshire
SP4 0JG

Published 1 July 2014
Last updated 31 July 2018 + show all updates
  1. Updated guidance on Lyme disease services.
  2. First published.