Lyme Disease/Borrelia burgdorferi

Lyme disease, or Lyme borreliosis, is a bacterial infection spread to humans if bitten by an infected tick. The ongoing rise in Lyme disease cases in the UK – thought to be driven by climate change, leading to warmer winters – has been recognised by public health officials for some time. Reported cases in England and Wales rose from 268 in 2001 to 959 in 2011, but is probably higher. Current estimates put the actual figure at around 3,000 new cases a year in England and Wales. 


Presence of antibodies confirms infection with the Lyme Disease spiral bacterium (spirochaete) known as Borrelia burgdorferi by a bite from an infected tick. Patients bitten by an infected tick which is not removed within a day or so may develop Lyme disease. An expanding rash usually appears at the site of the bite within 3 to 30 days in a large proportion of those infected. The rash spreads and often develops a ‘bulls-eye’ appearance. Many also develop flu-like symptoms with aching joints and muscles. The disease can later affect the nervous system, joints and other body systems. 


Borrelia Antibodies IgM (BORM): Detectable after 2-3 weeks increasing up to 6 weeks.


Borrelia Antibodies IgG/IgM (BORR): Detectable after several weeks increasing to maximum at 4-6 months and may remain at high levels for many years.


Borrelia Confirmation (Immunoblot) (BORC): The ELISA test is sensitive but has a well-documented and well understood high false positive rate giving positive results in conditions such as glandular fever, rheumatoid arthritis and other autoimmune conditions. If the IgG/IgM or IgM result is positive testing by Immunoblot will confirm a diagnosis by Lyme disease. IgM and IgG antibodies are tested separately with this test. Results from the serology need to be given with a request for the Immunoblot test.


TestCodeSample TypeTurnaround Time
Borrelia Antibodies IgM BORM B 2 days
Borrelia Antibodies IgG/IgM BORR B 2 days
Borrelia Confirmation (Immunoblot) BORC B (provide travel history) 10 days