The point also is that most people whom we hear from do not know they have had a tick attachment; they are completely unaware that they have encountered a tick.
If you look at the biology of the tick and what they're capable of, you learn that if a tiny little nymph tick crawls on you—they are already only the size of a poppy seed, and as you see, the larvae are much smaller than that—the first thing they do when they find a place to feed on you is inoculate you with a freezing, and so you don't know they're there. The next thing they do, once they stick their nose parts in and find a blood source, is secrete a bonding cement, and so they're not brushed off easily. Then they sit there and feed, and they can feed for days unnoticed, because quite often they're heading to private areas, under hair or in areas you're just not looking at, such as behind the knee. Most people don't recognize it.
The ELISA is not a good first test, especially if we're only going to use an ELISA that is still just looking for Borrelia burgdorferi strain B31. If we're going to stay on that strategy, then we have to devise better ELISAs, because the one we have currently is missing most cases.