Modified Microscopy for Lyme Disease Found Unreliable Interview with:

Audun Aase, PhD Department Director, Infectious Disease Immunology Norwegian Institute of Public Health Oslo, Norway

Dr. Audun Aase

Audun Aase, PhD
Department Director, Infectious Disease Immunology
Norwegian Institute of Public Health
Oslo, Norway What is the background for this study?

Response: Controversies related to Lyme disease and tick transmitted diseases have gained much attention in the public media in Norway, both regarding treatment regimens and diagnostics. People with long-lasting disease may relate their symptoms to previous tick bite and/or suboptimal-treated Lyme disease and have adopted the diagnosis chronic Lyme disease. As many of these patients lack objective proof of Lyme disease, they look for alternative test to signify their suspicion.

A modified microscopy method for detection of the Borrelia burgdorferi s.l. (the causative agent of Lyme disease) in human blood was published in 2013. The authors behind the method examined blood from suspected chronic Lyme disease patients, and the results showed presence of Borrelia spirochetes in most of the specimens. Using the same method, they also claimed to detect the Babesia parasites in many of the samples. The method gained much publicity and the patients advocated strongly for this method as most other laboratory tests had failed to prove their diagnosis. What are the main findings?

Response: To test the validity of this microscopy method we conducted a study where we compared blood from a group of patients who attributed their symptoms to chronic Lyme disease, to a group of healthy volunteers who never had experienced tick bite. The inventors (authors) applied their microscopy method, and five microbiological laboratories used different methods (PCR, microscopy and serology), to look for Borrelia and Babesia in the blood specimens.

The results showed that the modified microscopy method could not discriminate patients from healthy subjects. Indeed, by this microscopy method, more Borrelia and Babesia like structures were found in blood from the healthy volunteers than in blood from the patients. What should readers take away from your report?

Response: Laboratory tests may help to confirm suspected clinical diagnoses. However, many tests available may not be as good as they do claim to be. Particular care should be taken when in-house methods are launched that cannot document proper clinical validation, e.g. using representative control group. A false positive test result may result in treatment failure and discourage further clinical and laboratory examination. What recommendations do you have for future research as a result of this study?

Response: As within science literature in general, some of the papers on Lyme disease and related topics, are hampered by low quality, in spite of being published in peer review journals. The readers and referees of scientific papers must be critical and do their own interpretation with great care Thank you for your contribution to the community.

Infect Dis (Lond). 2016;48(6):411-9. doi: 10.3109/23744235.2016.1144931. Epub 2016 Feb 23.
Validate or falsify: Lessons learned from a microscopy method claimed to be useful for detecting Borrelia and Babesia organisms in human blood.
Aase A1, Hajdusek O2, Øines Ø3, Quarsten H4, Wilhelmsson P5, Herstad TK1, Kjelland V6,7, Sima R2, Jalovecka M2, Lindgren PE5,8, Aaberge IS1.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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