The best Lyme tests — DualDur, ELISA, Western Blot, ELISpot compared

Hungary

DualDur (Microscopy with DualDur technology)

Method: Live blood dark-field microscopy + staining as addon when wanted
Sensitivity: ~95% (published)
Detects: Active spirochetes, persister forms
Detects coinfections: Yes — Babesia, Bartonella, Anaplasma, Mycoplasma, Erlichia, Chlamydia Pneumoniae
Cost: €€€

Direct visualization of motile Borrelia plus confirmation with patented DualDur technology. Bypasses the antibody window. The DualDur technology was used for the largest clinical trial for Lyme in the EU, with great results - and were paid by the EU, since it is a very promising approach to find hard to find cases of Lyme as well as Coinfections.

USA / EU standard

ELISA (CDC two-tier, step 1)

Method: Antibody screening (IgM/IgG)
Sensitivity: 35–50% early disease
Detects: Past immune response only
Detects coinfections: No
Cost: €

Misses seronegative patients and early infection. Required as gatekeeper test in most insurance systems. Can not prov an actual infection, only the body's immune reaction towards a potential infection (both past and present infection)

Hungary

Bozsik Western Blot (Borrelia)

Method: Multi-strain Western Blot developed by Dr. Béla P. Bozsik (Lyme Borreliosis Foundation, Budapest)
Sensitivity: ~75% more sensitive than standard WB
Detects: Broader band pattern across multiple Borrelia genospecies, including 4 specific strains - Borrelia Burgdorferii, Borrelia Garinii, Borrelia Spielmanii and Borelia Afzelii
Detects coinfections: No
Cost: €€

Uses a multi-strain antigen preparation that picks up antibodies the standard single-strain blot misses. Research summary and references at lymerick.net/BozsikBP.html.

USA / EU

Standard Western Blot (Borrelia)

Method: Antibody confirmation against B. burgdorferi lysate (band pattern)
Sensitivity: ~50–70%
Detects: IgM/IgG bands to a single Borrelia strain (usually B31)
Detects coinfections: No
Cost: €€

The classic confirmatory test after a positive ELISA. Uses one Borrelia strain, so it misses patients infected with other genospecies (B. afzelii, B. garinii, B. spielmanii) common in Europe.

Germany / Switzerland

ELISpot (LTT)

Method: T-cell cytokine response
Sensitivity: ~70–84%
Detects: Active cellular immune response
Detects coinfections: No
Cost: €€

Used for indicating secondary markers for past vs active infection; standard in German/Swiss labs (Infectolab, ArminLabs).

Worldwide

PCR (blood / tissue)

Method: DNA amplification
Sensitivity: 10–30% in blood
Detects: Borrelia DNA
Detects coinfections: No
Cost: €€

High specificity, low sensitivity in blood — better in synovial fluid or CSF.

UK / EU

iSpot / T-SpotLyme

Method: Interferon-gamma release
Sensitivity: ~84%
Detects: T-cell response to Borrelia antigens
Detects coinfections: No
Cost: €€

Available through Armin Schwarzbach and Pharmasan labs. Can also be ordered through ParasiteClinic.Co.Uk

Why DualDur outperforms the standard tests

DualDur (developed in Hungary) offers high-resolution dark-field microscopy of live blood. Unlike ELISA or Western Blot, it doesn't depend on the patient producing measurable antibodies.

01Direct detection — sees live spirochetes instead of relying on the patient's (often suppressed) antibody response.

02Catches seronegative patients that ELISA + Western Blot systematically miss.

03Identifies persister and round-body (cystic) forms involved in chronic disease.

04Combines microscopy with DualDur technology for confirmation — a very sensitive and highly specific analysis.

05Effective from day 1 of infection — no 4–6 week antibody window.

06Reveals common coinfections (Babesia, Bartonella, Anaplasma, Mycoplasma, Ehrlichia and sometimes even blood clots) in the same blood sample.

How the EU & UK test for Lyme

🇪🇺 EU + 🇬🇧 UK · Available to everyone

EU + UK — DualDur

The DualDur test is available to anyone in the EU, the UK and Switzerland through ParasiteClinic.co.uk. This means every patient — regardless of what their national health system offers — can access the most sensitive Lyme test actually showing an active infection - in comparison to all other tests showing indirect indications of the infection.

Book at ParasiteClinic.co.uk →

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USA

CDC two-tier (ELISA → Western Blot). Strict band criteria. IGeneX offers expanded panels privately.

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UK

NHS uses ELISA + immunoblot via Porton Down. Private patients turn to ParasiteClinic, that used DualDur and also have access to Armin Labs when preferred..

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Germany

ELISA + immunoblot + LTT/ELISpot routinely reimbursed in private medicine.

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Switzerland

Two-tier serology plus advanced cellular tests (Spiez, Melisa). Some cantons cover ELISpot. DualDur is offered through the ParasiteClinic.co.uk.

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Sweden

Public labs run ELISA + immunoblot only; cellular testing not recognized. Most chronic patients test abroad. The public health sector has access to Western Blot, but it very rarely uses this, maybe due to the costs of the test. ParasitKliniken.se offers provate testing with DualDur for second opinions.

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The Netherlands

Public healthcare follows the CBO/RIVM guideline: ELISA + immunoblot only, with strict interpretation. The Lyme Centrum Apeldoorn (LCA) closed in 2021, leaving few specialist options inside the public system. Coinfections (Babesia, Bartonella, Anaplasma, Mycoplasma, Ehrlichia) are rarely tested for and almost never treated — most chronic patients turn to private clinics in Germany, Belgium, or use DualDur via ParasiteClinic.co.uk for direct detection of Borrelia and coinfections.

The best Lyme tests, compared objectively