Final answer:
The diagnosis of Lyme disease is based on characteristic clinical findings, history of exposure in endemic areas, and laboratory tests like ELISA and Western blot for antibodies against Borrelia burgdorferi.
Step-by-step explanation:
The diagnosis of Lyme disease in the United States is based on several criteria, which include:
- Characteristic clinical findings such as the distinctive bull's-eye rash known as erythema migrans.
- A history of exposure in areas where Lyme disease is endemic.
- Laboratory tests such as the enzyme immunoassay (EIA) and immunoblot tests like the Western blot that detect an antibody response to Borrelia burgdorferi.
Therefore, the correct answer is D. All of the above. Diagnoses can start with clinical observation of symptoms, especially the erythema migrans rash. Further confirmation is sought through serological tests like ELISA to detect antibodies. The initial positives frequently require additional tests such as Western blot to account for potential false positives and improve diagnostic specificity. An accurate early diagnosis is crucial for prompt treatment with antibiotics which are very effective against the bacterial infection.