Diagnostic and advisory services for Lyme disease.
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 UK Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory (RIPL) at Porton Down, 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 combined IgG and IgM ELISA that detects antibodies against 2 Borrelia burgdorferi antigens – VlsE1 and pepC10. For positive or indeterminate results this is followed by separate IgG and IgM confirmatory assays using ViraChip microarray immunoblots.
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 and diagnostic advice is available from UKHSA.
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 UKHSA 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.
Lyme disease diagnostic service