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<p>Lyme disease is a complex infection where challenges in understanding of disease
progression, and consequently diagnosis and treatment, remain.</p><p> </p><p>The National
Health Service and Public Health England (PHE) use well established validated diagnostic
tests for Lyme disease that are highly reproducible between laboratories. International
External Quality Assurance schemes are in place to ensure consistency between different
test centres. Commercial manufacturers and international academic groups have research
programmes into improved tests and PHE continuously reviews new Lyme serology tests
and will validate and implement new tests if appropriate.</p><p> </p><p>All treatment
for Lyme disease within the NHS should be evidence based, and targeted at the disease
mechanisms underlying those symptoms. Most cases are diagnosed in primary care and
PHE has published a referral pathway for general practitioners to follow to ensure
problem cases are seen by an appropriate NHS specialist.</p><p> </p><p>To further
strengthen the evidence base we have commissioned the National Institute for Health
and Care Excellence to develop a new clinical guideline on Lyme disease, for both
primary and secondary care, for publication in 2018. The Department is also commissioning
three Systematic Reviews by independent academic groups to cover</p><p> </p><p>― diagnosis
and diagnostic tests;</p><p>― treatment; and</p><p>― epidemiology/transmission routes.</p>
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