About This Test: What It Is, Why It's Done, and What to Expect
This blood test detects early immune response to Lyme disease by measuring IgM antibodies against Borrelia burgdorferi bacteria.
{"Detects IgM antibodies produced in early Lyme disease infection (usually within 2-4 weeks after tick bite)","A positive result suggests recent or current infection with Borrelia burgdorferi","Results should be interpreted with clinical symptoms and exposure history","A follow-up test (IgG) may be needed to confirm late-stage infection","Testing is typically done using ELISA followed by Western blot for confirmation"}
Key facts at a glance
- LOINC
- 107008-5
- Short code
- LYMEVIM
- Synonyms
- B.burgdorferi.VIsE IgM Ser Ql IA
- Category
- chemistry
- Sample
- serum
- Container
- Serum separator tube (SST, gold-top) or red-top clot tube; serum aliquot transferred to a sterile transport vial if testing is performed at a reference laboratory.
- Units
- N/A
- Fasting
- false
- Population
- adult
- Sex
- all
- Age range
- 0–120 years
- Method
- Enzyme-linked immunosorbent assay (ELISA) or chemiluminescence immunoassay (CLIA) detecting IgM antibodies directed against the VlsE (Vmp-like sequence, expressed) lipoprotein antigen of Borrelia burgdorferi
- CPT
- 86618
- SNOMED
- 448591000124101
- Specimen volume
- 1.0 mL serum (minimum 0.5 mL); adequate volume required for reflex to confirmatory second-tier testing if applicable.
- Stability
- Serum stable for 7 days at 2-8°C; for extended storage, freeze at -20°C or colder for up to 30 days. Avoid repeated freeze-thaw cycles, which may degrade IgM immunoglobulins.
- Hemolysis max
- 100
- Lipemia max
- 100
- Icterus max
- 40
- TAT
- 24–72 hours
- Order
- routine
What is this test, and why might my healthcare provider recommend it for me?
The Borrelia burgdorferi VIsE IgM Antibody test is a blood test that detects IgM (immunoglobulin M) antibodies against the VIsE protein of Borrelia burgdorferi, the bacterium that causes Lyme disease. VIsE (Variable major protein-like sequence, exposed) is a surface protein of the bacteria that triggers an early immune response. IgM antibodies are the first type of antibodies your body produces when fighting a new infection, typically appearing within 2 to 4 weeks after being bitten by an infected tick.
This test uses immunoassay techniques to identify whether IgM antibodies specific to the VIsE antigen are present in your blood serum. The presence of these antibodies indicates that your immune system has responded to a possible Lyme disease infection.
Lyme disease is transmitted through the bite of infected blacklegged ticks (Ixodes scapularis in the northeastern and north-central United States, and Ixodes pacificus on the Pacific Coast). Early detection and treatment are important to prevent the disease from progressing to more serious, late-stage complications affecting joints, the heart, and the nervous system.
Reference range
Negative (no IgM antibodies to Borrelia burgdorferi VlsE antigen detected). Equivocal or positive results require confirmation with Western blot or a second-tier immunoassay per modified two-tier testing (MTTT) algorithm.N/A
No fasting or special preparation is required. Patients should inform their clinician of recent antibiotic therapy, recent tick exposure, travel history to endemic areas, and current symptom profile (e.g., erythema migrans rash, arthralgia, neurological symptoms).
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
The primary clinical significance of the VIsE IgM test lies in its ability to detect early Lyme disease infection. A positive or indeterminate IgM result, combined with clinical symptoms (such as the characteristic erythema migrans rash, fever, headache, fatigue, and muscle aches) and a history of potential tick exposure, supports the diagnosis of early Lyme disease. Early treatment with antibiotics is highly effective.
It is important to note that IgM antibodies may persist for several months even after successful treatment. Therefore, the test result should always be interpreted in the context of clinical symptoms, the timing of symptom onset relative to the potential exposure, and other laboratory findings. In many cases, testing protocols involve a two-step approach: an initial ELISA or immunoassay, followed by Western blot testing if the initial result is positive or equivocal, to confirm the presence of antibodies specific to Borrelia burgdorferi.
A negative IgM result does not completely rule out Lyme disease, especially if the test was performed very early in the infection (before antibodies have developed) or in the late stages of the disease where IgM may have transitioned to IgG antibodies. Clinical judgment is essential in these situations.
Frequently asked questions
Do I need to fast before this test?
How long does it take to get the results?
What do positive IgM results mean?
Can I have Lyme disease if the test is negative?
Should I be tested if I found a tick on my skin?
Sources
- 1
- 2
Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 15, 2026. · Read our editorial policy