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

Lee, Gayoung; Hollingsworth, Brandon D; Giandomenico, Dana A; Fisher, Teresa G; Williams, Carl; Boyce, Ross M · Clin Infect Dis · 2025

retrospective_cohort · Level III

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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.

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