Reporting & Investigation of Lyme Disease

Table of Contents

A. Purpose of Surveillance and Reporting

  • To identify where Lyme disease occurs in Iowa.

  • To recognize areas in Iowa where Lyme disease incidence has changed (increased or decreased).

  • To focus preventive education.
  • To target tick control measures.

B. Laboratory and Healthcare Provider Reporting Requirements

Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and the healthcare provider must report. The preferred method of reporting is by utilizing IDSS.  However, if IDSS is not available, the reporting number for the IDPH Center for Acute Disease Epidemiology (CADE) is (800) 362-2736; fax number (515) 281-5698, mailing address:

Iowa Department of Public Health, CADE
Lucas State Office Building, 5th Floor
321 E. 12th St.
Des Moines, IA 50319-0075

Laboratory Testing Services Available

Laboratory confirmation of infection with B. burgdorferi is established when a laboratory isolates the spirochete from tissue or body fluid, detects diagnostic levels of IgM or IgG antibodies to the spirochete in serum or cerebrospinal fluid, or detects a significant change in antibody levels in paired acute and convalescent serum samples. Since the immune response to spirochetes is relatively slow, serological tests often remain negative for several weeks after exposure. The Centers for Disease Control and Prevention (CDC) recommends that, initially, serum specimens be tested by a sensitive test such as an enzyme immunoassay (EIA) or immunofluorescent assay (IFA). Samples with positive or equivocal results from these tests should be re-tested using a standardized Western blot procedure.

The University of Iowa State Hygienic Laboratory (SHL) will perform Lyme disease confirmatory testing by Western blot assay on either acute or convalescent sera that are either positive or equivocal by a Lyme-specific test, such as EIA or IFA.  Finally, the State Hygienic Laboratory will also refer samples to the CDC for testing.  For more information about submitting sera for testing, contact the SHL at (319) 335-4500.

C.  Local Public Health Agency Follow-up Responsibilities

Case Investigation: The Iowa Disease Surveillance System (IDSS) is the preferred method of completing disease investigations.  

If the patient is unable or unwilling to be interviewed during the investigation, in IDSS select the appropriate reason under the Event tab in the Event Exception field.