FIG 7.

Modified two-tiered serologic testing for the diagnosis of Lyme borreliosis, using one polyvalent (total antibody) EIA, one IgM-specific EIA, and one IgG-specific EIA. The polyvalent assay can be used in the first tier, followed by orthogonal IgM- and IgG-specific assays in the second tier (panel A) or, alternatively, the IgM- and IgG-specific assays can be used in the first tier, followed by an orthogonal polyvalent assay (panel B). If desired, all three tests could be performed in parallel (concurrently) rather than sequentially (not shown).