To the Editor Ms Ajamian and colleagues1 quoted our work2,3 that found an association between autism spectrum disorder (ASD) and Lyme disease in their research letter on serological markers of Lyme disease in children with autism. Their study used the Centers for Disease Control and Prevention (CDC) testing criteria with enzyme-linked immunosorbent assays (ELISAs) followed by Western blotting. These assays, provided by Euroimmun, have only a 45% to 49% sensitivity.4 In addition, the patients were aged 2 to 18 years and developed autism as much as 18 years before the blood samples were drawn. A low sensitivity ELISA performed years later does not prove these patients were not exposed to an immune process triggered by Borrelia burgdorferi at the time the pathological process began.
Bransfield RC, Kuhn M. Autism and Lyme Disease. JAMA. 2013;310(8):856-857. doi:10.1001/jama.2013.194747