Removal · field guidance

ELISA Lyme test: sensitivity by stage

First-tier Lyme ELISA sensitivity is roughly 30-40% in the first weeks of infection but reaches 90-100% in late disseminated disease.

Steps

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01
In the first 1-2 weeks after a bite, sensitivity is often under 40% — antibodies have not formed.
02
By week 4-6, sensitivity rises to 70-90% as IgG develops.
03
In late disease (arthritis, neuroborreliosis), sensitivity approaches 99%.
04
Specificity is typically 95-99% but false positives occur with other spirochetes and autoimmune conditions.
05
A negative ELISA does not rule out early Lyme; clinical diagnosis with EM rash is sufficient.

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