At-home Lyme disease tests latest effort against tick threats

It’s a question Long Islanders regularly grapple with: Is that tick I just pulled off me going to give me Lyme disease?

A new at-home test available later this month could help provide an answer.

The product allows people to test ticks they find by placing them into a "crusher" with solution and inserting a test strip that will detect the presence of Borrelia burgdorferi, the bacterium that causes Lyme disease, in about 30 minutes. While there are currently services that test ticks dropped off or sent by mail, this appears to be the first that can be done at home, according to the makers of the test, LymeAlert.

As ticks continue to expand their territory, public health concerns about diseases they carry are growing. The test represents the latest effort to combat Lyme — the most common tick-borne disease in the United States — with Long Island identified as among its epicenters. Other tick-borne diseases of concern are babesiosis, Rocky Mountain spotted fever and ehrlichiosis, as well as the meat allergy known as alpha-gal syndrome.

About half the blacklegged ticks, also known as deer ticks, collected in Suffolk County carry the pathogen that causes Lyme disease, according to surveys the county conducts. Suffolk also had the highest number of Lyme cases in the state with 3,152 in 2024, the latest data available. There were 3,299 Lyme cases in the county in 2023, and 2,668 in 2022, when the definition of how Lyme cases are counted changed. In recent years, the ticks have been moving in greater numbers to western Suffolk and Nassau County, as deer they travel on have spread.

Erin Dawicki, a physician associate in Massachusetts who co-developed the idea for LymeAlert during a fellowship at the Massachusetts Institute of Technology, was besieged by parents who didn't know what to do when they found a tick on their children.

"About 54% of the ticks in Massachusetts carry Lyme disease so I just put everyone on [the antibiotic] doxycycline, which is not great," she said. "I wondered why we couldn’t just test the tick at home and know which ones are carrying Lyme and only treat those patients." 

Currently, there are tests approved by the U.S. Food and Drug Administration that measure antibodies in a person's blood to look for Lyme disease. Antibodies can take weeks to be detected. And testing too early can give false-negative results.

The early weeks after infection are also when antibiotics are most effective, experts said.

Working in pediatric orthopedics in Massachusetts, which is also a hot spot for tick-borne diseases, Dawicki saw the results of what could happen if Lyme disease is not diagnosed early on.

"I saw kids with huge swollen joints who already have cartilage damage because they're a few months into it and nobody thought to look for Lyme disease," she said.

Worry over 'unnecessary alarm'

Knowing if a tick is carrying Borrelia burgdorferi is only part of the equation. Doctors also factor in how long the tick has been on a person before it was removed and if they live in an area that is endemic to Lyme disease, like parts of Massachusetts and Long Island. 

A blacklegged tick generally needs to be attached to a person for at least 24 to 36 hours to transfer the bacteria that causes Lyme disease, said Dr. Andrew Handel, a pediatric infectious disease specialist at Stony Brook Children's Hospital who has a focus on tick-borne illness.

"Any innovation we can make to have better diagnostics for Lyme disease or risk of Lyme disease is very important," Handel said. "Cases are increasing each year and infections are widespread."

However, he worries people may see a positive result and think they urgently need to get a dose of doxycycline that may not be necessary — rather than consulting with a doctor, as the test suggests.

"Although many blacklegged ticks in our area carry Lyme disease, ticks that are removed within 24 hours pose a low risk of transmitting the infection to humans," he said. "A positive test could cause unnecessary alarm when the risk of infection is actually quite low." 

There are also different views among clinicians about when to administer antibiotics after a tick bite. Some will prescribe a preventive dose just in case they were infected, while others suggest waiting and looking for symptoms.

Dawicki, whose position is akin to a physician assistant in New York, said it's better to "err on the side of caution" with her patients.

"At least in New England, if somebody has an embedded tick that has started to feed and is positive on LymeAlert, I would strongly encourage them to consider antibiotics," she said. "Not every healthcare provider is going to agree."

The test took over two years to develop while Dawicki and her team researched how to identify different levels of Borrelia. Then they injected the bacteria into ticks to make sure they could be identified after they were ground up.

Researchers checked the accuracy of the test by cutting ticks in half and comparing their strips against the current lab standard.

There is no agreement on how much bacteria needs to get into a person's bloodstream and over how long a period of time to cause Lyme disease — so they focused on detecting small amounts.

About half the first batch of tests, which cost $50, have been sold during the current preorder period, and orders are expected to ship by the end of the month. Dawicki said they are looking into expanding the test to include other tick-borne diseases.