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Chan KR, Ismail AA, Thergarajan G, Raju CS, Yam HC, Rishya M, Sekaran SD. Serological cross-reactivity among common flaviviruses. Front Cell Infect Microbiol 2022; 12:975398. [PMID: 36189346 PMCID: PMC9519894 DOI: 10.3389/fcimb.2022.975398] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/22/2022] [Indexed: 11/23/2022] Open
Abstract
The Flavivirus genus is made up of viruses that are either mosquito-borne or tick-borne and other viruses transmitted by unknown vectors. Flaviviruses present a significant threat to global health and infect up to 400 million of people annually. As the climate continues to change throughout the world, these viruses have become prominent infections, with increasing number of infections being detected beyond tropical borders. These include dengue virus (DENV), West Nile virus (WNV), Japanese encephalitis virus (JEV), and Zika virus (ZIKV). Several highly conserved epitopes of flaviviruses had been identified and reported to interact with antibodies, which lead to cross-reactivity results. The major interest of this review paper is mainly focused on the serological cross-reactivity between DENV serotypes, ZIKV, WNV, and JEV. Direct and molecular techniques are required in the diagnosis of Flavivirus-associated human disease. In this review, the serological assays such as neutralization tests, enzyme-linked immunosorbent assay, hemagglutination-inhibition test, Western blot test, and immunofluorescence test will be discussed. Serological assays that have been developed are able to detect different immunoglobulin isotypes (IgM, IgG, and IgA); however, it is challenging when interpreting the serological results due to the broad antigenic cross-reactivity of antibodies to these viruses. However, the neutralization tests are still considered as the gold standard to differentiate these flaviviruses.
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Affiliation(s)
- Kai Rol Chan
- Faculty of Medical and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Amni Adilah Ismail
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Gaythri Thergarajan
- Faculty of Medical and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Chandramathi Samudi Raju
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- *Correspondence: Shamala Devi Sekaran, ; Chandramathi Samudi Raju,
| | - Hock Chai Yam
- Faculty of Medical and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Manikam Rishya
- Department of Trauma and Emergency Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Shamala Devi Sekaran
- Faculty of Medical and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
- *Correspondence: Shamala Devi Sekaran, ; Chandramathi Samudi Raju,
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Lima MRQ, Nunes PCG, Dos Santos FB. Serological Diagnosis of Dengue. Methods Mol Biol 2022; 2409:173-196. [PMID: 34709642 DOI: 10.1007/978-1-0716-1879-0_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A reliable and specific diagnosis is imperative in viral diagnosis, both for clinical management and surveillance, and to ensure that early treatment and control measures are carried out. The number of days of illness is important to choose the most appropriate method to be used and for the correct interpretation of the results obtained. Specific IgM is elicited after that period, indicating an active infection and usually lasts up to 3 months. However, in DENV secondary infections, IgM levels may be significantly lower or undetectable. After 10-12 days, a lifetime specific IgG is produced. Routinely, the laboratory diagnosis of DENV infections can be performed by viral isolation and/or detection of viral nucleic acid, serological assays for the detection of specific antibodies (IgM/IgG), antigen (NS1) and the detection of viral antigens in tissues, which are suitable during certain phases of the disease. For serological diagnosis, serum, plasma, or cerebrospinal fluid (CSF) samples may be investigated. If the test is carried out a few days after collection, the specimens can be stored at 4 °C, since the immunoglobulins are stable in serum or plasma. If the storage period is extended, the material must be kept at -20 °C or -70 °C. In serology, several methods can be used to detect specific viral antigens and/or antibodies, produced by the host in response to DENV infection. Routinely, serological tests include the hemagglutination inhibition (HI) assay, the plaque reduction neutralizing test (PRNT), the gold standard assay for dengue immune response characterization, and ELISAs to detect IgM (MAC-ELISA) and IgG (IgG-ELISA).
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Affiliation(s)
- Monique R Q Lima
- Laboratório Estratégico de Diagnóstico (LED), Centro de Desenvolvimento Científico, Instituto Butantan, São Paulo, Brazil
| | - Priscila C G Nunes
- Laboratório Municipal de Saúde Pública (LASP), Laboratório de Virologia e Biotério, Subsecretaria de Vigilância, Fiscalização Sanitária e Controle de Zoonoses, Rio de Janeiro, Brazil
- Superintendência de Informações Estratégicas de Vigilância em Saúde (SIEVS/RJ), Secretaria Estadual de Saúde, Rio de Janeiro, Brazil
| | - Flávia B Dos Santos
- Laboratório de Imunologia Viral (LIV), Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
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Eltom K, Enan K, El Hussein ARM, Elkhidir IM. Dengue Virus Infection in Sub-Saharan Africa Between 2010 and 2020: A Systematic Review and Meta-Analysis. Front Cell Infect Microbiol 2021; 11:678945. [PMID: 34113579 PMCID: PMC8186319 DOI: 10.3389/fcimb.2021.678945] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/09/2021] [Indexed: 11/20/2022] Open
Abstract
Dengue virus (DENV) infection has garnered a global interest in the past few decades. Nevertheless, its epidemiology in certain developing and low-income regions remains poorly understood, due to the absence of comprehensive surveillance and reporting systems. This systematic review and meta-analysis aimed to determine the prevalence of DENV infection in the population of Sub-Saharan Africa using DENV infection markers, and to track any changes in its prevalence during the past ten years. It was conducted in accordance with the PRISMA guidelines, targeting the literature available at MEDLINE/PubMed, ScienceDirect, Cochrane library and Google Scholar. All articles published in English language between January 2010 and June 2020 were screened for eligibility. Random effects model was used to calculate the pooled prevalence of all infection markers. The Inconsistency Index (I2) was used to assess the level of heterogeneity between studies. Subgroup analysis according to country and time-frame of studies was conducted to provide possible explanations to substantial heterogeneity. The critical appraisal tool for prevalence studies designed by the Joanna Briggs Institute (JBI) was used to assess the risk of bias in all included studies. A total of 84 articles, covering 21 countries, were included in this review. Quantitative meta-analysis estimated a pooled IgG prevalence of 25% (95% CI: 21-29%, I2 = 99%), a pooled IgM prevalence of 10% (95% CI: 9-11%, I2 = 98%) and a pooled DENV RNA prevalence of 14% (95% CI: 12-16%, I2 = 99%). Evidence for possible publication bias was also found in all three meta-analyses. Subgroup analysis according to the time of sample collection was performed to closely track the changing prevalence of DENV infection markers between 2010 and 2019. This meta-analysis estimates a high prevalence of DENV infection in Sub-Saharan Africa. More cost-efficient vector control strategies should be designed and implemented in order to adapt to the low-resource nature of this region.
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Affiliation(s)
- Khalid Eltom
- Department of Microbiology and Parasitology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.,Department of Virology, Central Laboratory, Ministry of Higher Education and Scientific Research, Khartoum, Sudan
| | - Khalid Enan
- Department of Virology, Central Laboratory, Ministry of Higher Education and Scientific Research, Khartoum, Sudan
| | - Abdel Rahim M El Hussein
- Department of Virology, Central Laboratory, Ministry of Higher Education and Scientific Research, Khartoum, Sudan
| | - Isam M Elkhidir
- Department of Microbiology and Parasitology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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Wang WH, Urbina AN, Chang MR, Assavalapsakul W, Lu PL, Chen YH, Wang SF. Dengue hemorrhagic fever - A systemic literature review of current perspectives on pathogenesis, prevention and control. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2020; 53:963-978. [PMID: 32265181 DOI: 10.1016/j.jmii.2020.03.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/26/2020] [Accepted: 03/08/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Dengue is an arboviral disease caused by dengue virus. Symptomatic dengue infection causes a wide range of clinical manifestations, from mild dengue fever (DF) to potentially fatal disease, such as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). We conducted a literature review to analyze the risks of DHF and current perspectives for DHF prevention and control. METHODS According to the PRISMA guidelines, the references were selected from PubMed, Web of Science and Google Scholar database using search strings containing a combination of terms that included dengue hemorrhagic fever, pathogenesis, prevention and control. Quality of references were evaluated by independent reviewers. RESULTS DHF was first reported in the Philippines in 1953 and further transmitted to the countries in the region of South-East Asia and Western Pacific. Plasma leakages is the main pathophysiological hallmark that distinguishes DHF from DF. Severe plasma leakage can result in hypovolemic shock. Various factors are thought to impact disease presentation and severity. Virus virulence, preexisting dengue antibodies, immune dysregulation, lipid change and host genetic susceptibility are factors reported to be correlated with the development of DHF. However, the exact reasons and mechanisms that triggers DHF remains controversial. Currently, no specific drugs and licensed vaccines are available to treat dengue disease in any of its clinical presentations. CONCLUSION This study concludes that antibody-dependent enhancement, cytokine dysregulation and variation of lipid profiles are correlated with DHF occurrence. Prompt diagnosis, appropriate treatment, active and continuous surveillance of cases and vectors are the essential determinants for dengue prevention and control.
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Affiliation(s)
- Wen-Hung Wang
- Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Center for Tropical Medicine and Infectious Disease, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.
| | - Aspiro Nayim Urbina
- Program in Tropical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, 80708, Taiwan.
| | - Max R Chang
- Program in Tropical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, 80708, Taiwan.
| | - Wanchai Assavalapsakul
- Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok, 10330, Thailand.
| | - Po-Liang Lu
- Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Center for Tropical Medicine and Infectious Disease, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.
| | - Yen-Hsu Chen
- Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Center for Tropical Medicine and Infectious Disease, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.
| | - Sheng-Fan Wang
- Center for Tropical Medicine and Infectious Disease, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.
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Flavivirus infection—A review of immunopathogenesis, immunological response, and immunodiagnosis. Virus Res 2019; 274:197770. [DOI: 10.1016/j.virusres.2019.197770] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 12/20/2022]
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Deza-Cruz I, Mill A, Rushton S, Kelly P. Comparison of the Use of Serum and Plasma as Matrix Specimens in a Widely Used Noncommercial Dengue IgG ELISA. Am J Trop Med Hyg 2019; 101:456-458. [PMID: 31190684 PMCID: PMC6685565 DOI: 10.4269/ajtmh.19-0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 03/05/2019] [Indexed: 11/07/2022] Open
Abstract
Although sera are most commonly used in serological diagnostic tests for dengue, sometimes only plasma containing ethylenediaminetetraacetic acid (EDTA) may be available. When we studied the performance of a widely used noncommercial dengue ELISA in the detection of reactive IgG in sera and plasma from the same individuals, we found no significant differences in the diagnostic performance of the assay. The inter-specimen coefficient of variation (CV) of the optical density was 0.081 and the concordance correlation coefficient (CCC) was 0.92, showing a very strong agreement between the two matrix specimens. The intra-specimen CV and CCC were higher for plasma than for serum at low dilutions, but similar at high dilutions. Overall, our results show that the performance of a widely used in-house ELISA using plasma containing EDTA is equivalent to serum with the recommendation to assay the plasma specimens in duplicate to reduce variability of results at lower dilutions.
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Affiliation(s)
- Iñaki Deza-Cruz
- Modelling Evidence and Policy Group, School of Natural and Environmental Sciences, Newcastle University, Newcastle-upon-Tyne, United Kingdom
- Ross University School of Veterinary Medicine, Basseterre, St. Kitts and Nevis
| | - Aileen Mill
- Modelling Evidence and Policy Group, School of Natural and Environmental Sciences, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Steven Rushton
- Modelling Evidence and Policy Group, School of Natural and Environmental Sciences, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Patrick Kelly
- Ross University School of Veterinary Medicine, Basseterre, St. Kitts and Nevis
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A case of mixed infections in a patient presenting with acute febrile illness in the tropics. Case Rep Infect Dis 2013; 2013:562175. [PMID: 23533853 PMCID: PMC3600219 DOI: 10.1155/2013/562175] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 02/03/2013] [Indexed: 12/13/2022] Open
Abstract
Concurrent infections with more than one etiological agent can result in an illness with overlapping symptoms, resulting in a situation where the diagnosis and management of such a patient could be challenging. We report a case of vivax malaria in a patient who was also serologically positive for leptospirosis and dengue.
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Dutra NR, de Paula MB, de Oliveira MD, de Oliveira LL, De Paula SO. The laboratorial diagnosis of dengue: applications and implications. J Glob Infect Dis 2011; 1:38-44. [PMID: 20300385 PMCID: PMC2840934 DOI: 10.4103/0974-777x.52980] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The diagnosis of infection by the dengue virus relies, in most cases, on the clinical judgment of the patient, since only a few major centers have clinical laboratories that offer diagnostic tests to confirm the clinical impressions of an infection. At present, routine laboratory diagnosis is done by different kinds of testing. Among them are the methods of serological research, virus isolation, detection of viral antigens, and detection of viral genomes. The continued development of diagnostic tests, which are cheap, sensitive, specific, easy to perform, and capable of giving early diagnosis of the dengue virus infection is still a need. There are also other obstacles that are not specifically related to the technological development of diagnostic methods. For instance, infrastructure of the laboratories, the training of personnel, and the capacity of research of these laboratories are still limited in many parts of Brazil and the world, where dengue is endemic. Clinical laboratories, especially the ones that serve regions with a high incidence of dengue, should be aware of all the diagnostic methods available for routine these days, and choose the one that best suit their working conditions and populations served, in order to save lives.
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Affiliation(s)
- Nina Rocha Dutra
- Laboratory of Molecular Immunovirology, Department of General Biology, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
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Hunsperger EA, Yoksan S, Buchy P, Nguyen VC, Sekaran SD, Enria DA, Pelegrino JL, Vázquez S, Artsob H, Drebot M, Gubler DJ, Halstead SB, Guzmán MG, Margolis HS, Nathanson CM, Rizzo Lic NR, Bessoff KE, Kliks S, Peeling RW. Evaluation of commercially available anti-dengue virus immunoglobulin M tests. Emerg Infect Dis 2009; 15:436-40. [PMID: 19239758 PMCID: PMC2681117 DOI: 10.3201/eid1503.080923] [Citation(s) in RCA: 153] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Anti–dengue virus immunoglobulin M kits were evaluated. Test sensitivities were 21%–99% and specificities were 77%–98% compared with reference ELISAs. False-positive results were found for patients with malaria or past dengue infections. Three ELISAs showing strong agreement with reference ELISAs will be included in the World Health Organization Bulk Procurement Scheme.
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Affiliation(s)
- Elizabeth A Hunsperger
- Serology Diagnostics and Viral Pathogenesis Research Section, Centers for Disease Control and Prevention, San Juan, Puerto Rico
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Hussain H, Omer SB, Khan AJ, Bhurgri A, Memon A, Halsey NA. Endemic measles in Karachi, Pakistan and validation of IMCI criteria for measles. Acta Paediatr 2009; 98:720-4. [PMID: 19133869 DOI: 10.1111/j.1651-2227.2008.01174.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To estimate the incidence of measles in Karachi, Pakistan and to determine the proportion of children with measles based on the WHO integrated management of childhood illness (IMCI) criteria with a positive IgM for measles or dengue. METHODS Patients up to 14 years old were screened for febrile rash illnesses at five Karachi hospitals. Active measles cases were classified as measles, measles with eye and mouth complications, or severe complicated measles using IMCI criteria. RESULTS Screening 1,219,061 patients over a 39-month period identified 3503 qualified children. Most (76.8%) measles cases occurred in children under five years of age. The average annual incidence rate was 0.68 per 1000 in year 1; 0.19 in year 2 and 0.08 in year 3 of surveillance. Pneumonia and diarrhoea were the most common complications. Of 18.1% hospitalized, 1.6% died. Of 2286 children tested, 1599 (69.9%) were measles IgM positive. Of 542 measles IgM negative children, 66 (12%) were dengue IgM positive. The predictive positive value for the IMCI case definition was 75%. CONCLUSION The IMCI case definitions for measles is reasonable but may overestimate measles incidence. Measles continues to be a public health problem in Pakistan; increased efforts to control measles are urgently needed.
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Affiliation(s)
- Hamidah Hussain
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Barbazan P, Palabodeewat S, Nitatpattana N, Gonzalez JP. Detection of host virus-reactive antibodies in blood meals of naturally engorged mosquitoes. Vector Borne Zoonotic Dis 2008; 9:103-8. [PMID: 18973442 DOI: 10.1089/vbz.2007.0242] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although serosurvey in human or animals is a useful and straightforward strategy routinely used for public health, it often faces different types of impediments: ethics, beliefs, limitation by animal owners, hazard of access to wild animals. To survey virus circulation, we applied the enzyme-linked immunosorbent assay (ELISA) technique to detect Dengue and Japanese encephalitis (JE) virus-reactive antibodies in blood meals collected from mosquitoes without regard to the potential of mosquito species to be a virus vector. ELISA was performed on mosquito colonies and wild specimens collected from farms and urban areas. Blood meals from Aedes aegypti freshly fed on naturally infected volunteers showed the same levels of dengue immunoglobulin (Ig)G and IgM as the sera directly collected from volunteers. A significant clearance of antibodies during the digestion process started from 13 hours after blood meal, and a negative baseline was reached after 30 hours. The ELISA test performed on wild mosquitoes showed that 37% of Culex quinquefasciatus mosquitoes that engorged on humans in a dengue urban endemic area tested positive for dengue IgG, and in a JE virus-endemic area, 88% of Culex tritaeniorhynchus mosquitoes that engorged on pigs from a large pig farm tested positive for JE virus antibodies versus 11% in a small farm. The main limitation of the ELISA method is the antibody cross-reactivity among flaviviruses; also, sampling strategy should be adjusted to take into account that the actual host from which the blood meal was taken may not be determined. Nevertheless, ELISA performed on recently (1-2 days) engorged mosquito, or any other hematophagous arthropod species, could potentially be used as a "wild phlebotomist" to monitor the prevalence or emergence of a variety of pathogens, with less of the practical, ethical, or risk limitations due to direct blood collection from humans and wild or domestic animals.
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Affiliation(s)
- Philippe Barbazan
- Department of Center for Vectors and Vector-Borne Diseases, Mahidol University, Bangkok, Thailand
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Vazquez S, Hafner G, Ruiz D, Calzada N, Guzman MG. Evaluation of immunoglobulin M and G capture enzyme-linked immunosorbent assay Panbio kits for diagnostic dengue infections. J Clin Virol 2007; 39:194-8. [PMID: 17521960 DOI: 10.1016/j.jcv.2007.04.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2006] [Revised: 03/15/2007] [Accepted: 04/03/2007] [Indexed: 11/28/2022]
Abstract
BACKGROUND Serological assays are widely used to confirm dengue virus infections and to differentiate between a primary and a secondary infection. OBJECTIVE Two commercial dengue diagnostic kits, Panbio Dengue IgM Capture and Dengue IgG Capture ELISA (Brisbane, Australia) were evaluated. STUDY DESIGN Three hundred and seventy-three serum samples were tested. Panel sera included samples from dengue confirmed cases (representing both primary and secondary infections), from non-dengue infectious diseases, and from healthy individuals. The MAC-ELISA/Dengue IPK was used for the detection of anti-dengue virus IgM antibody in the sera and the ELISA inhibition method (EIM/Dengue IPK) was used to differentiate between primary and secondary infections. Both these reference assays, which were previously developed in the Arbovirus Laboratory at the "Pedro Kouri" Tropical Medicine Institute, were employed as the gold standard. RESULTS High sensitivity (96.8%) and specificity (99.4%) were found with the commercial diagnostics when compared to the reference methods. Furthermore, high concordance 95.5% in classifying dengue infection types (primary or secondary infections) was observed. CONCLUSIONS The Panbio Dengue IgM and IgG assays offer a good alternative for dengue diagnosis. They are easy to perform and results can be obtained in less than 3h.
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Affiliation(s)
- Susana Vazquez
- "Pedro Kourí" Tropical Medicine Institute, PAHO/WHO Collaborating Center for the Study of Dengue and its Vector, Havana City, Cuba
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Schilling S, Ludolfs D, Van An L, Schmitz H. Laboratory diagnosis of primary and secondary dengue infection. J Clin Virol 2004; 31:179-84. [PMID: 15465409 DOI: 10.1016/j.jcv.2004.03.020] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2004] [Accepted: 03/25/2004] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dengue fever is routinely detected in many laboratories using commercial tests for the specific detection of dengue IgM antibodies. OBJECTIVES We have studied the sensitivity of IgM antibody detection in paired serum samples of 43 patients with either with primary dengue (PD) or secondary dengue (SD). STUDY DESIGN Two consecutive samples were drawn from 23 Vietnamese and 20 German patients. All patients were selected for a positive PCR and for the fact that consecutive serum samples were available. The diagnosis of PD was based on seroconversion to dengue antigen and in SD on the detection of virus RNA in the presence of anti-dengue IgG antibodies. RESULTS In samples of patients with PD fever taken during days 1-3 of the disease no IgM antibody could be detected. During days 4-7 and after day 7, IgM antibody was detected in 55% and 94%, respectively. In patients with SD fever, even less positive IgM samples were found in samples taken during days 4-7 (47%) and after day 7 (78%). IgG titers were significantly higher in SD compared to PD patients, although high (>1280) titers were also found in some PD patients. CONCLUSION In numerous acute dengue fever patients an early diagnosis will be obtained only by combining IgM antibody detection with detection of virus or virus RNA using RT-PCR.
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Affiliation(s)
- Stefan Schilling
- Department of Virology, Bernhard Nocht Institute for Tropical Medicine, Bernhard Nocht Strasse 74, 20359 Hamburg, Germany
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Vázquez S, Lemos G, Pupo M, Ganzón O, Palenzuela D, Indart A, Guzmán MG. Diagnosis of dengue virus infection by the visual and simple AuBioDOT immunoglobulin M capture system. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2003; 10:1074-7. [PMID: 14607869 PMCID: PMC262456 DOI: 10.1128/cdli.10.6.1074-1077.2003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2002] [Revised: 12/03/2002] [Accepted: 08/12/2003] [Indexed: 11/20/2022]
Abstract
The Dengue IgM Capture ELISA (MAC-ELISA) is the immunoenzymatic system recommended by the Pan American Health Organization and the World Health Organization for the serological diagnosis of dengue virus infection due to its high sensitivity, ease of performance, and use of a single acute-phase serum sample. However, tests with this enzyme-linked immunosorbent assay (ELISA) system are time-consuming and require equipment for washing, incubation, and reading of the results. AuBioDOT is a multistep visual diagnostic immunoassay that uses technology based on the immunoglobulin M (IgM) capture ELISA principle. This system uses white polyethylene opaque plates as the solid phase, colloidal gold as the marker, and silver ion amplification. It does not require special equipment, it is totally manually operated, and it can be performed in less than 1 h. The sensitivity and specificity of AuBioDOT for the detection of anti-dengue virus IgM antibodies were studied with a panel of 336 serum samples (150 serum samples from patients with suspected or serologically confirmed dengue virus infection, 186 serum samples from healthy blood donors and patients without dengue virus infection). The results were compared with those obtained by the MAC-ELISA. A sensitivity of 97.7% and a specificity of 97.1% were obtained. The concordance of the two tests was 97.3%, with a kappa index of 0.94. The application of AuBioDOT for the detection of anti-dengue virus IgM antibodies is recommended as an alternative method for the diagnosis of dengue virus infection, both for clinical diagnosis and for seroepidemiological surveillance. The system is useful under field conditions and in laboratories and requires little equipment.
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Affiliation(s)
- Susana Vázquez
- Pedro Kourí Institute, PAHO/WHO Collaborating Center for Viral Diseases, Havana City, Cuba.
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Affiliation(s)
- Aric Gregson
- University of Maryland School of Medicine, Baltimore, USA
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