Effective Date: 
Tue, 06/01/2004
Tue, 12/22/2015
Sat, 01/02/2016

Lyme Disease: This disease is spread by the bite of ticks of the genus Ixodes that are infected with Borrelia burgdorferi. On the Pacific Coast, this bacteria is transmitted by the western black-legged tick, Ixodes pacificus. The early stage of Lyme disease is usually marked by one or more of the following symptoms and signs:

Chills and Fever
Muscle and Joint Pain
Swollen lymph nodes
A characteristic skin rash, called Erythema migrans

Tick Testing:  

Nursing staff gives any student with concerns about tick bites a coy of State of California Department of Public Health pamphlet "Lyme Disease in California" to review prior to seeing a clinician.  

Clinician staff evaluates patient for tick removal and removes tick if possible. 

If tick is alive (or recently dead and not dried out) and appears to be of Ixodes species, the entire tick may be sent to Santa Clara County Health Department for identification of the type of tick and presence or absence of Borrelia.  Nursing staff should place tick in a small Ziploc bag with a cotton ball moistened with water.  Tick must not be crushed.  If the mid-section of the tick is missing or too dried, the county lab will no be able to perform testing.  

Clinician staff submits an order for tick testing in the EMR and sends the specimen to the laboratory. 

Laboratory logs and then sends the specimen to the Santa Clara County Health Department using a pre-printed mailer and requisition provided by SCCPH.  The mailer needs to be sent by certified mail - return receipt to ensure that the specimen arrived at SCCPH.  (See Medical Records is certified mail form is needed).  The patient's account will be charged $15 for testing and a reference lab handling fee.  

Santa Clara County Public Health Laboratory

2220 Moorpark Avenue, Rm 204L

San Jose, CA   95128

Phone:  (408) 885-4272

Fax:  (408) 885-4275

Results will come through our lab and will be scanned into the EMR for acknowledgement by the ordering clinician and follow-up treatment if necessary.

Blood Testing (ELISA): In rare instances when it is necessary, collect 5-10 ml of blood in a SST tube, 4-6 weeks after the tick bite. Centrifuge for 15 min at 2000 RPM and send to Quest Lab in San Jose for analysis.