Antibodies should never be substituted for Clinical Judgment

"Antibodies should never be substituted for Clinical Judgment. There are NO Antibody Tests at all for the newest Borrelia pathogen Miyamotoi borrelia. It is in New Jerseey, so it is also in Pennsylvania too! B31 is the Burgdorferi strain sub-name of ONE STRAIN of LYME disease causing borrelia in the USA. Actually, it came from a tick gut, and B31 never saw human blood before it was recruited by the CDC to represent ALL POSSIBLE strains of Borrelia. This was a disastrous decision because of the huge limitations of using only one Strain for ALL Testing of human blood ,when more than 100 strainswhich are genetically distinct from B31 are actually out therecausing human disease. Positive blood tests are great, but Negative blood tests do not exclude the other 99 strain Genotypes which can cause human disease. The "31" in B31 does not refer to the 31kd protein which is OspA,. Instead it is a tribute to the three names beginning with "B;" Burgdorfer, Barbour, Benach - all key players in thediscovery of the microbe. I do not have primers for the 100 strains. Primers are a different issue. Each primer pair "set" is designed toamplify a small segment [up to 500-1000 bases] of the target. The Chromosome contains about 1 million bases, and each of themini-chromosome plasmids contains several thousand bases. Genotypes are strains in which the DNA entire may vary from the B31 by at least one base or more- [usually more bases are different in each of the "geno-vars". So since Dna-Rna-Protein synthesis is inked, the proteins produced by each of the Geno-vars is different from the proteins of the B31 clone.Ergo, One "geno-var"[ B31 strain] is ineffective in screening for patient antibodies for 99 out of 100 "geno-vars". The actual number of Geno-varsin the USA a worldwide is unknown. We do know that the USA test kit missesmany patients with Borrelia infection, because it is only capable of detecting a very limited set of antibodies, and because it will missmany of the "wild " Borrelia which infect humans. So ,Take home message" The Negatives in USA Lyme test kits are not a good diagnostic tool. A recent paper has further underscored the point that when patients have European borrelia infections [Afzelii, garinii, or European burgdorf variants] that USA Test kits frequently will fail to find evidence of the antibodies which patients produced because the test kit proteins are different for European borrelia when compared with USA borrelia.Remember that in the USA according to Dr Benjamin Luft, Dr Mark Eshoo, and Dr Eva Sapi that in excess of 100 different DNAs are recorded. so use of One Strain of Borrelia [B31} for ALL USA Test kits to detect ALL possible burgdorferi geno type variants is an exercise in futility. We need a kit or method which adequately represents ALL of the borrelia DNAs {plural} which are out there causing disease. Best, Alan MacDonald MD, FCAP, FASCP August 1,2013"