Lyme Disease in Canada

Tests and guidance available from public health reference laboratories across Canada are well aligned with international and Canadian guidelines. Diagnosis is primarily clinical in early disease and based on serologic testing in later disease. Polymerase chain reaction is less reliable outside of certain clinical specimens such as erythema migrans biopsy and synovial fluid. Family physicians should be aware of non-evidence-based assays available to patients from private laboratories in the United States and Europe.