Where to send a blood test after a tick bite?

Understanding Tick-Borne Diseases

Common Tick-Borne Pathogens

Lyme Disease (Borrelia burgdorferi)

Lyme disease, caused by Borrelia burgdorferi, is the most common tick‑borne infection in temperate regions. After a suspected tick bite, serologic testing determines exposure and guides treatment decisions.

Specimens must reach a laboratory equipped for Borrelia antibody detection using standardized two‑tier algorithms (ELISA followed by Western blot or immunoblot). Reliable results depend on proper collection, preservation, and transport.

Key considerations for specimen dispatch:

Use serum or plasma collected in clot‑activator or heparin tubes; avoid hemolyzed samples.
Maintain a temperature of 2‑8 °C during transit; refrigerate but do not freeze.
Include a completed requisition form specifying the assay (ELISA + Western blot) and patient’s exposure history.
Ship via overnight courier with a biohazard label; ensure delivery within 24 hours of collection.

Preferred destinations include:

Certified reference laboratories accredited by the College of American Pathologists or equivalent bodies.
State public health laboratories that offer Lyme disease testing as part of surveillance programs.
Commercial diagnostic companies recognized for FDA‑cleared Borrelia serology kits.

When selecting a facility, verify accreditation status, turnaround time, and compliance with the two‑tier testing protocol. Proper routing of the blood sample enables accurate diagnosis and timely initiation of appropriate antimicrobial therapy.

Anaplasmosis

Anaplasmosis is a bacterial infection caused by «Anaplasma phagocytophilum», transmitted through the bite of infected ticks. Early symptoms include fever, headache, muscle aches, and leukopenia; prompt diagnosis reduces the risk of severe complications.

Testing is indicated for individuals with a recent tick bite who develop compatible clinical signs, especially when exposure occurred in endemic regions or during peak tick activity seasons.

Appropriate destinations for the blood specimen include:

Hospital‑affiliated clinical laboratories equipped for polymerase chain reaction (PCR) or serologic testing.
State or regional public health laboratories that offer standardized Anaplasma assays.
Accredited reference laboratories specializing in tick‑borne diseases and providing detailed antimicrobial susceptibility reports.

Specimen handling requires collection in EDTA tubes, refrigeration at 2‑8 °C, and shipment within 24 hours. Duplicate samples—one for PCR, another for serology—enhance diagnostic accuracy.

Results should be communicated directly to the ordering clinician, with positive findings prompting immediate initiation of doxycycline therapy and notification of public health authorities for surveillance purposes.

Ehrlichiosis

Ehrlichiosis is a bacterial infection transmitted by tick bites, most commonly caused by Ehrlichia chaffeensis. Prompt diagnosis relies on detecting the organism’s DNA or specific antibodies in a blood sample.

For accurate results, the specimen should be sent to a laboratory equipped for molecular or serologic testing of tick‑borne pathogens. Recommended facilities include:

• State or provincial public health laboratories that offer Ehrlichiosis PCR or immunofluorescence assays.
• CLIA‑certified clinical laboratories with a dedicated infectious‑disease panel, such as Quest Diagnostics or Labcorp.
• Centers for Disease Control and Prevention (CDC) reference laboratory, accessible through a physician’s request for confirmatory testing.

Specimens must be collected in EDTA tubes, stored at 2‑8 °C, and shipped with a cold‑chain package within 24 hours of collection. Documentation should include patient history of tick exposure, date of bite, and any antimicrobial therapy initiated. Laboratories provide electronic reporting of results to the ordering clinician, enabling timely treatment decisions.

Rocky Mountain Spotted Fever

A tick bite that could transmit Rocky Mountain spotted fever necessitates prompt serologic testing. Early detection relies on directing the specimen to laboratories equipped to perform indirect immunofluorescence assay (IFA) or polymerase chain reaction (PCR) for Rickettsia rickettsii.

Typical destinations for the blood sample include:

Hospital‑affiliated clinical laboratories with validated IFA or PCR platforms.
State or regional public health laboratories that specialize in vector‑borne disease diagnostics.
The Centers for Disease Control and Prevention (CDC) reference laboratory, accessed through a physician’s referral or a public health request.

Specimen requirements are specific. Collect whole blood in an EDTA tube, store at 2‑8 °C, and dispatch within 24 hours. If a delay is unavoidable, freeze plasma at –20 °C for PCR or maintain serum at –20 °C for serology, avoiding repeated freeze‑thaw cycles.

Submission procedure:

Obtain a requisition form from the ordering clinician, indicating suspicion of Rocky Mountain spotted fever.
Verify the receiving laboratory’s preferred shipping method and packaging guidelines.
Use a certified courier service that provides temperature‑controlled transport.
Include a brief clinical summary, exposure details, and patient identifiers to facilitate accurate interpretation.

Coordination with the ordering clinician ensures that results are reported directly to the treating physician, enabling timely initiation of doxycycline therapy when indicated.

Babesiosis

After a tick bite, a blood sample intended to detect Babesiosis should be directed to a laboratory equipped for intra‑erythrocytic parasite identification. Preferred facilities include:

State or regional public‑health laboratories that perform FDA‑cleared PCR assays for Babesia spp.
Hospital or academic medical center laboratories with validated blood smear microscopy and molecular testing capabilities.
Commercial reference laboratories offering comprehensive tick‑borne disease panels, such as those that provide simultaneous testing for Babesia, Borrelia and Anaplasma.

Specimen handling requirements are consistent across these destinations: collect 5 mL of whole blood in an EDTA tube, maintain refrigeration at 2–8 °C, and ship within 24 hours. Documentation must include patient identifiers, date of tick exposure, and a request for Babesiosis testing.

If the exposure occurred in an area with known endemic Babesia species, contacting the local health department can confirm the nearest accredited laboratory and arrange expedited transport. In cases where immediate results are critical, selecting a reference laboratory with a rapid‑turnaround PCR service reduces diagnostic delay.

Accurate diagnosis hinges on timely submission of the specimen to a qualified testing center. Failure to follow the outlined logistics may compromise detection of low‑level parasitemia and impede appropriate clinical management.

Symptoms to Look For

Early Localized Symptoms

Early localized symptoms appear within days of a tick attachment and often indicate the initial stage of infection. Typical manifestations include a circular erythematous rash that expands from the bite site (commonly referred to as erythema migrans), mild pruritus, localized pain or tenderness, and low‑grade fever. Occasionally, the area may exhibit swelling, a sense of warmth, or a brief headache. These signs usually develop within 3‑7 days and resolve spontaneously if untreated, but they signal the need for serological evaluation to confirm pathogen exposure.

When early localized signs are present, the appropriate action is to obtain a blood sample for Lyme‑disease serology and transmit it to a laboratory equipped for tick‑borne disease testing. Suitable facilities include:

Primary‑care laboratory networks that participate in regional public‑health reporting.
State or provincial health department reference laboratories specializing in vector‑borne infections.
Accredited private diagnostic centers with validated ELISA and Western‑blot protocols for Borrelia burgdorferi.

Selection of the laboratory should consider turnaround time, compliance with local reporting requirements, and the availability of confirmatory testing. Prompt submission of the specimen to any of the listed facilities facilitates early diagnosis and timely initiation of therapy.

Early Disseminated Symptoms

Early disseminated symptoms typically appear weeks to months after a tick bite and may include facial palsy, meningitis, heart rhythm disturbances, and widespread skin lesions. These manifestations indicate that the pathogen has spread beyond the initial bite site and requires prompt laboratory confirmation.

Blood analysis is essential for detecting antibodies or pathogen DNA, guiding treatment decisions, and preventing complications. Samples must reach facilities equipped with validated serologic or molecular assays for tick‑borne infections.

Recommended destinations for submitting the specimen:

Specialized infectious‑disease laboratories accredited by national health authorities
Hospital pathology departments with dedicated tick‑borne disease panels
Regional public‑health reference centers offering free testing for confirmed exposures
Commercial diagnostic companies that provide FDA‑cleared kits for Lyme disease and related pathogens

Selection should consider assay availability, turnaround time, and the laboratory’s participation in external quality‑assessment programs. Prompt referral to any of the listed facilities ensures accurate diagnosis and timely therapeutic intervention.

Late Disseminated Symptoms

Late disseminated symptoms appear weeks to months after a tick bite and indicate systemic spread of the pathogen. Common manifestations include arthritis of large joints, peripheral facial palsy, cardiac conduction abnormalities, and neurocognitive deficits such as memory loss or concentration difficulties. Dermatological signs may persist as erythema migrans‑like lesions or develop into chronic skin changes.

Accurate laboratory confirmation guides appropriate therapy and prevents progression. Blood specimens should be dispatched to facilities equipped for serologic and molecular analysis of tick‑borne infections. Recommended destinations are:

State or provincial public health laboratories that perform standardized enzyme‑linked immunosorbent assays (ELISA) and Western blot confirmation for Borrelia species.
Certified reference centers specializing in polymerase chain reaction (PCR) testing for early and late‑stage pathogens.
Accredited commercial diagnostic companies offering comprehensive panels for Lyme disease, anaplasmosis, and babesiosis.

Specimen handling protocols require serum separation within two hours of collection, refrigeration at 2‑8 °C, and inclusion of a requisition form specifying suspected late‑stage disease. Prompt submission enables timely interpretation of IgG antibody patterns and PCR results, facilitating targeted antimicrobial regimens.

Where to Get Tested

Consulting Your Doctor

Importance of Early Diagnosis

Early detection of tick‑borne infections dramatically reduces the risk of severe outcomes. Laboratory analysis performed within the first two weeks after exposure can confirm the presence of pathogens before symptoms fully develop. Prompt identification enables targeted antimicrobial therapy, which halts bacterial spread and minimizes tissue damage.

Delays in testing increase the probability of:

Persistent joint inflammation
Neurological complications such as facial palsy
Cardiac involvement, including conduction abnormalities
Chronic fatigue and cognitive impairment

Timely serological assessment also guides public‑health monitoring, allowing health authorities to track emerging infection patterns and allocate resources efficiently. Laboratories equipped for tick‑bite diagnostics typically offer rapid turnaround, standardized assay panels, and validated interpretation criteria, ensuring reliable results for clinicians.

In summary, initiating blood testing soon after a tick bite safeguards patient health, reduces treatment complexity, and supports broader disease‑control efforts.

Types of Tests Available

After a tick bite, a blood specimen may be directed to a clinical laboratory that offers diagnostic assays for tick‑borne pathogens. The choice of analysis determines the laboratory’s specialization and the turnaround time for results.

Typical examinations include:

Serologic screening for antibodies against Borrelia burgdorferi using an enzyme‑linked immunosorbent assay (ELISA). Positive screens are confirmed with a Western‑blot test.
Polymerase chain reaction (PCR) assays that detect bacterial DNA in blood, useful during early infection when antibodies may be absent.
Culture of Borrelia species, performed in specialized reference centers; yields are low but provide definitive organism recovery.
Antigen detection kits for other tick‑borne agents such as Anaplasma or Ehrlichia; often combined with serology for comprehensive coverage.
Complete blood count and differential to identify leukocytosis or thrombocytopenia that may accompany systemic infection.
Inflammatory markers (C‑reactive protein, erythrocyte sedimentation rate) that support clinical assessment of disease activity.

Selection of the appropriate test depends on the time elapsed since the bite, clinical presentation, and geographic prevalence of specific pathogens. Laboratories equipped for molecular diagnostics typically handle PCR, while serology is widely available in standard hospital labs. For definitive organism isolation, referral to a public health or academic reference laboratory is required.

Interpretation of Results

After a tick bite, a blood specimen is forwarded to a laboratory equipped to detect tick‑borne pathogens. The laboratory report provides the basis for clinical decision‑making.

Result categories include:

Negative serology or molecular assay: no detectable antibodies or pathogen DNA. Indicates low probability of infection; routine monitoring recommended.
Positive IgM only: recent exposure, possible early infection. Requires confirmation with a second sample after 2–4 weeks to differentiate true positivity from false‑positive reactions.
Positive IgG only: past exposure or late‑stage infection. Evaluation of clinical signs determines need for treatment.
Positive IgM + IgG: active infection, most likely early disseminated disease. Prompt antimicrobial therapy indicated.
Positive PCR for specific agents (e.g., Borrelia burgdorferi, Anaplasma phagocytophilum): confirms presence of pathogen DNA. Guides targeted therapy and may supersede serology in early infection.

Interpretation must consider assay sensitivity, timing of sample collection, and patient symptoms. A single negative result obtained within the first week after exposure does not exclude infection; repeat testing after the seroconversion window is advisable. Positive results should trigger a treatment plan consistent with current guidelines for the identified pathogen. Follow‑up testing after completion of therapy confirms eradication or identifies persistent infection.

Choosing a Laboratory

Accredited Laboratories

When a tick bite raises concern for Lyme disease or other tick‑borne infections, the blood sample must be processed by a laboratory that meets recognized accreditation standards. Accredited laboratories guarantee that testing procedures follow validated protocols, that equipment is calibrated, and that personnel maintain competency through regular evaluation.

Key attributes of accredited facilities include:

Certification by agencies such as the College of American Pathologists (CAP) or the Joint Commission International (JCI).
Participation in external quality‑assessment programs that monitor assay performance.
Use of FDA‑approved or CE‑marked diagnostic kits for Borrelia, Anaplasma, Ehrlichia, and related pathogens.
Documentation of traceability for reagents, equipment, and results.

Choosing an accredited laboratory reduces the risk of false‑negative or false‑positive outcomes, ensuring reliable interpretation for clinical decision‑making. Health‑care providers should verify accreditation status through the laboratory’s public records or accreditation body databases before dispatching specimens.

For patients seeking guidance, the following steps are recommended:

Consult the treating physician to obtain a requisition specifying the required tests.
Request the laboratory’s accreditation credentials and confirm alignment with the relevant regulatory authority.
Arrange specimen transport in compliance with biosafety and temperature‑control guidelines to preserve sample integrity.
Retain the laboratory’s report identifier for follow‑up with the health‑care professional.

By adhering to these practices, the diagnostic pathway after a tick encounter remains robust, accurate, and compliant with established quality standards.

Specialized Testing Facilities

After a tick bite, the recommended course of action includes submitting a blood sample to a laboratory that offers specialized testing for tick‑borne pathogens. Such facilities possess the necessary accreditation, validated assays, and expertise to detect organisms such as Borrelia, Anaplasma, Ehrlichia, Rickettsia, and related viruses.

Key attributes of appropriate testing centers include:

Certification by national health authorities for infectious‑disease diagnostics.
Availability of polymerase‑chain‑reaction (PCR) assays and enzyme‑linked immunosorbent tests (ELISA) targeting specific tick‑borne agents.
Capacity for reflex testing, enabling confirmation of ambiguous results through additional methodologies.
Established protocols for sample handling, storage, and transport to preserve specimen integrity.

Typical venues for sending the specimen are:

Public health laboratories that operate regional surveillance programs for vector‑borne illnesses.
University‑affiliated research hospitals with dedicated infectious‑disease departments.
Commercial reference laboratories that specialize in molecular diagnostics and provide online result portals.

Selection of a facility should prioritize turnaround time, reporting clarity, and the laboratory’s experience with the geographic tick species prevalent in the exposure area. Prompt submission to a qualified center enhances diagnostic accuracy and informs timely therapeutic decisions.

Turnaround Times and Costs

After a tick bite, physicians often request serologic analysis to identify potential infections. The laboratory selected determines both the speed of result delivery and the financial outlay.

Typical «turnaround time» varies by facility:

Hospital‑based laboratory: 1–2 days for standard Lyme disease IgM/IgG assay.
Regional reference laboratory: 3–5 days for expanded tick‑borne pathogen panels.
National specialty center: 7–14 days for comprehensive testing, including emerging agents.
Urgent or STAT processing: 24 hours, available at limited centers for an additional surcharge.

«Cost» depends on test complexity and service level:

Basic Lyme IgM/IgG panel: $50–$150.
Extended panel covering multiple tick‑borne diseases: $150–$400.
Expedited processing fee: $30–$100.
Specimen shipping and handling: $10–$30, varying with distance and carrier.
Insurance reimbursement: often covers basic tests; specialty panels may require out‑of‑pocket payment.

Selection criteria focus on urgency and budget. For immediate clinical decisions, a hospital laboratory provides the fastest «turnaround time» with moderate «cost». When broader pathogen coverage is required, a regional or national reference lab offers comprehensive panels at higher expense and longer processing periods. Insurance verification before ordering can reduce unexpected financial burden.

When to Seek Immediate Medical Attention

Severe Symptoms

After a tick bite, certain clinical manifestations demand immediate laboratory evaluation and prompt medical referral. Recognizing these severe symptoms prevents complications such as Lyme disease, anaplasmosis, or babesiosis.

High fever persisting beyond 48 hours
Severe headache or neck stiffness
Rapidly expanding erythema with central necrosis
Persistent chills, sweats, or rigors
Joint swelling or intense arthralgia, especially in large joints
Neurological deficits: facial palsy, numbness, or weakness
Cardiac irregularities: palpitations, chest pain, or shortness of breath

When any of these signs appear, blood specimens should be dispatched to a certified microbiology laboratory capable of performing polymerase chain reaction (PCR) and serologic testing for tick‑borne pathogens. Facilities typically include hospital‑based labs, regional public‑health laboratories, and specialized reference centers. Contact the local health department or the attending physician to confirm the appropriate destination and required test panels. Rapid processing and accurate interpretation are essential for effective treatment.

Rash Progression

Rash progression after a tick bite follows a recognizable pattern that guides diagnostic decisions. Initial erythema may appear within hours, often localized and non‑specific. Within 24–48 hours, the lesion can enlarge, develop a central clearing, or exhibit a target‑like appearance. Persistent expansion beyond 48 hours, the emergence of a necrotic center, or the appearance of vesicles suggests possible infection with Borrelia burgdorferi or other tick‑borne pathogens. Systemic symptoms—fever, headache, arthralgia—accompanying the rash increase the urgency for serologic evaluation.

Selecting an appropriate laboratory for the blood test depends on test availability, turnaround time, and accreditation. Recommended destinations include:

State or provincial public health laboratories, which provide standardized Lyme disease panels and report results to clinicians.
Certified reference laboratories specializing in tick‑borne disease diagnostics, offering multiplex PCR and immunoblot assays.
Hospital‑affiliated clinical laboratories with CLIA certification, capable of rapid enzyme‑linked immunosorbent assay (ELISA) processing.
Accredited private laboratories that partner with infectious‑disease specialists for comprehensive testing.

Referral should be based on the laboratory’s ability to perform both ELISA screening and confirmatory Western blot, ensure quality control, and deliver results within a clinically relevant timeframe. Prompt submission of the specimen to one of these facilities facilitates early detection and appropriate treatment.

Neurological Signs

Neurological manifestations after a tick bite often signal early dissemination of infection and guide the selection of a diagnostic laboratory. Recognizing these signs promptly improves the accuracy of serologic testing and informs clinical decisions.

Typical neurological signs include:

Facial nerve palsy, often unilateral
Meningeal irritation such as headache, neck stiffness, photophobia
Radicular pain radiating from the spine
Peripheral neuropathy presenting as numbness, tingling, or burning sensations
Cognitive disturbances, including memory lapses and concentration difficulties

When such symptoms appear, blood should be directed to a laboratory equipped for Borrelia‑specific assays. Preferred facilities possess the capability to perform:

Enzyme‑linked immunosorbent assay (ELISA) for IgM and IgG antibodies
Western blot confirmation following positive ELISA results
Polymerase chain reaction (PCR) testing for direct pathogen detection, especially in cerebrospinal fluid samples

Choosing a certified reference laboratory ensures compliance with current guidelines and reduces the risk of false‑negative outcomes. Laboratories accredited by national health authorities or recognized infectious‑disease networks meet these criteria.