Synonyms:  Borrelia Antibodies Why It Is Done A Lyme disease blood test detects antibodies to the Lyme disease bacteria Borrelia burgdorferi. It is spread by certain kinds of ticks. A test for Lyme disease is done to help confirm a diagnosis of Lyme disease. Initial symptoms of Lyme disease include an expanding red skin rash at the site of the tick bite. The rash may look like a bull's-eye, with a pale center area surrounded by a bright red rim. The rash usually fades in 3 to 4 weeks, but it may return. Initial symptoms may also include fatigue, headache, stiff neck, fever, chills, and muscle and joint pain. Symptoms of chronic Lyme disease infection include joint pain, stiffness, and problems with the heart, brain, or nerves. Testing is most accurate when you have risk factors for Lyme disease or symptoms of the disease. • Enzyme-linked immunosorbent assay (ELISA). This common and rapid test to detect Lyme disease antibodies is considered the most sensitive screening test for Lyme disease. • Indirect fluorescent antibody (IFA). This test also screens for Lyme disease antibodies, but it may produce false results more often than ELISA. • Western blot test. This test also detects Lyme disease antibodies and can confirm the results of an ELISA or IFA test. It is most often done to detect a chronic Lyme disease infection. •  Enzyme immunoassay (EIA) with pretreatment of specimen to eliminate rheumatoid factor and IgG antibodies which reduce nonspecific cross reactions.  This is the earliest serological detection of Lyme disease.  Can detect seroconversion between 3 and 8 weeks postinfection.  It is best to test when the tick bite is first noted.  Confirmation of an EIA positive with Western blot is strongly recommended.  Antibody testing should be done in a two-step process, using either the ELISA or IFA followed by the Western blot test. ELISA is considered a more reliable and accurate test than IFA, but IFA may be used if ELISA is not available. The Western blot test (which is a more specific test) should be done in all people who have tested positive or borderline positive (equivocal) in an ELISA or IFA test. Test Overview Finding antibodies to the Lyme disease bacteria does not indicate whether you were infected recently or sometime in the past. Antibody tests are the most commonly used tests to help confirm a diagnosis of Lyme disease and monitor its treatment. Antibody testing may also be done on fluid from the spine or from a joint. How To Prepare There is no special preparation for this test.