Impact of Revised Diagnostic Testing Algorithms and Case Definitions on Lyme Disease Surveillance in a Low-Incidence State: An Interrupted Time Series Analysis

Clin Infect Dis. 2024 Nov 26:ciae545. doi: 10.1093/cid/ciae545. Online ahead of print.

Abstract

We evaluated the impact of the endorsement of modified 2-tiered testing and its inclusion in updated Lyme disease case definitions in North Carolina using surveillance data from 2017-2023. After the implementation of modified 2-tiered testing, confirmed cases increased by 117%, with comparable decreases in probable cases compared with prior periods.

Keywords: Lyme disease; case definition; diagnostic testing; modified 2-tiered testing; surveillance.