Removal · field guidance

Modified two-tier testing with two ELISAs

FDA-cleared modified algorithm using two sequential EIAs instead of EIA-then-Western-blot, endorsed by CDC in 2019.

Steps

schema.org/HowTo

01
Run a first-tier EIA (commonly whole-cell sonicate).
02
If positive or equivocal, run a second FDA-cleared EIA (often C6 or VlsE-based).
03
Report positive only when both EIAs are positive or equivocal-positive.
04
Sensitivity is similar to standard two-tier in late disease and improved in early disease.
05
No Western blot is required when an FDA-cleared two-EIA pairing is used.

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