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The use of serum spotted onto filter paper for diagnosing and monitoring Chikungunya virus infection. J Clin Virol 2015; 71:89-92. [PMID: 26339948 DOI: 10.1016/j.jcv.2015.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/10/2015] [Accepted: 08/14/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND The recent emergence of Chikungunya Virus (CHIKV) in the Americas constitutes a major public health problem on this continent, where the mosquito vector is widespread. The rapid diagnosis of suspected cases is essential for the monitoring and control of this ongoing outbreak. However, this requires reliable tools that are difficult to establish in areas without specialized laboratories. OBJECTIVES The aim was to evaluate the performances of serum samples spotted onto filter paper for molecular and serological diagnosis of Chikungunya infection. STUDY DESIGN Analyses were performed from frozen sera and serum spotted onto filter paper provided from 121 Chikungunya suspected cases collected at a biological laboratory on Saint-Martin Island. RESULTS This approach performed well in comparisons with standard methods, with a sensitivity of 100% and a specificity of 93.6% for the combined technical approaches (RT-PCR and serological results). Comparisons of serum samples spotted onto filter paper and frozen samples showed a concordance rate of 94.8% in molecular tests and 98.2% in serological tests. CONCLUSIONS This simple sampling technique could overcome the problems of the lack of efficient CHIKV diagnosis tools in remote regions, providing good results regardless of the molecular or serological approach used. This simple filter paper-based method can be used to diagnose both chikungunya and dengue infections, as previously demonstrated following transport at ambient temperature to specialized laboratories. Given the set-up costs and high performance of this method, it could be recommended for the monitoring and control of Chikungunya virus expansion in the Americas and in other affected regions.
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Guzman MG, Halstead SB, Artsob H, Buchy P, Farrar J, Gubler DJ, Hunsperger E, Kroeger A, Margolis HS, Martínez E, Nathan MB, Pelegrino JL, Simmons C, Yoksan S, Peeling RW. Dengue: a continuing global threat. Nat Rev Microbiol 2011; 8:S7-16. [PMID: 21079655 DOI: 10.1038/nrmicro2460] [Citation(s) in RCA: 1233] [Impact Index Per Article: 94.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Dengue fever and dengue haemorrhagic fever are important arthropod-borne viral diseases. Each year, there are ∼50 million dengue infections and ∼500,000 individuals are hospitalized with dengue haemorrhagic fever, mainly in Southeast Asia, the Pacific and the Americas. Illness is produced by any of the four dengue virus serotypes. A global strategy aimed at increasing the capacity for surveillance and outbreak response, changing behaviours and reducing the disease burden using integrated vector management in conjunction with early and accurate diagnosis has been advocated. Antiviral drugs and vaccines that are currently under development could also make an important contribution to dengue control in the future.
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Affiliation(s)
- Maria G Guzman
- Instituto de Medicina Tropical, 'Pedro Kouri', PO Box 601, Marianao 13, Ciucad de la Habana, Cuba
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Guzman MG, Jaenisch T, Gaczkowski R, Ty Hang VT, Sekaran SD, Kroeger A, Vazquez S, Ruiz D, Martinez E, Mercado JC, Balmaseda A, Harris E, Dimano E, Leano PSA, Yoksan S, Villegas E, Benduzu H, Villalobos I, Farrar J, Simmons CP. Multi-country evaluation of the sensitivity and specificity of two commercially-available NS1 ELISA assays for dengue diagnosis. PLoS Negl Trop Dis 2010; 4:e811. [PMID: 20824173 PMCID: PMC2930874 DOI: 10.1371/journal.pntd.0000811] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 08/04/2010] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Early diagnosis of dengue can assist patient triage and management and prevent unnecessary treatments and interventions. Commercially available assays that detect the dengue virus protein NS1 in the plasma/serum of patients offers the possibility of early and rapid diagnosis. METHODOLOGY/PRINCIPAL FINDINGS The sensitivity and specificity of the Pan-E Dengue Early ELISA and the Platelia Dengue NS1 Ag assays were compared against a reference diagnosis in 1385 patients in 6 countries in Asia and the Americas. Platelia was more sensitive (66%) than Pan-E (52%) in confirmed dengue cases. Sensitivity varied by geographic region, with both assays generally being more sensitive in patients from SE Asia than the Americas. Both kits were more sensitive for specimens collected within the first few days of illness onset relative to later time points. Pan-E and Platelia were both 100% specific in febrile patients without evidence of acute dengue. In patients with other confirmed diagnoses and healthy blood donors, Platelia was more specific (100%) than Pan-E (90%). For Platelia, when either the NS1 test or the IgM test on the acute sample was positive, the sensitivity versus the reference result was 82% in samples collected in the first four days of fever. NS1 sensitivity was not associated to disease severity (DF or DHF) in the Platelia test, whereas a trend for higher sensitivity in DHF cases was seen in the Pan-E test (however combined with lower overall sensitivity). CONCLUSIONS/SIGNIFICANCE Collectively, this multi-country study suggests that the best performing NS1 assay (Platelia) had moderate sensitivity (median 64%, range 34-76%) and high specificity (100%) for the diagnosis of dengue. The poor sensitivity of the evaluated assays in some geographical regions suggests further assessments are needed. The combination of NS1 and IgM detection in samples collected in the first few days of fever increased the overall dengue diagnostic sensitivity.
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Affiliation(s)
- Maria G. Guzman
- Virology Department, Pan American Health Organization/World Health Organization Collaborating Center for the Study of Dengue and Its Vector, Instituto de Medicina Tropical “Pedro Kouri”, Habana, Cuba
| | - Thomas Jaenisch
- Section Clinical Tropical Medicine, Department of Infectious Diseases, University Hospital of Heidelberg, Heidelberg, Germany
| | - Roger Gaczkowski
- Section Clinical Tropical Medicine, Department of Infectious Diseases, University Hospital of Heidelberg, Heidelberg, Germany
| | - Vo Thi Ty Hang
- Oxford University, Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Shamala Devi Sekaran
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Axel Kroeger
- TDR-World Health Organization, Geneva, Switzerland
| | - Susana Vazquez
- Virology Department, Pan American Health Organization/World Health Organization Collaborating Center for the Study of Dengue and Its Vector, Instituto de Medicina Tropical “Pedro Kouri”, Habana, Cuba
| | - Didye Ruiz
- Virology Department, Pan American Health Organization/World Health Organization Collaborating Center for the Study of Dengue and Its Vector, Instituto de Medicina Tropical “Pedro Kouri”, Habana, Cuba
| | - Eric Martinez
- Virology Department, Pan American Health Organization/World Health Organization Collaborating Center for the Study of Dengue and Its Vector, Instituto de Medicina Tropical “Pedro Kouri”, Habana, Cuba
| | | | | | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California, United States of America
| | | | | | | | - Elci Villegas
- Instituto Experimental “Jose W Torrealba” Núcleo Universitario “Rafael Rangel”, Universidad de los Andes Trujillo, Bogotá, Venezuela
| | - Herminia Benduzu
- Instituto Experimental “Jose W Torrealba” Núcleo Universitario “Rafael Rangel”, Universidad de los Andes Trujillo, Bogotá, Venezuela
| | | | - Jeremy Farrar
- Oxford University, Clinical Research Unit, Ho Chi Minh City, Vietnam
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Sierra B, Perez AB, Vogt K, Garcia G, Schmolke K, Aguirre E, Alvarez M, Kern F, Kourí G, Volk HD, Guzman MG. Secondary heterologous dengue infection risk: Disequilibrium between immune regulation and inflammation? Cell Immunol 2010; 262:134-40. [PMID: 20219186 DOI: 10.1016/j.cellimm.2010.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 11/23/2009] [Accepted: 02/04/2010] [Indexed: 11/18/2022]
Abstract
Increased serum levels of cytokines released by cells of the immune response have been detected in patients suffering from dengue disease. Likewise, secondary infections by a different dengue virus serotype result in a highest risk of development of the severe dengue disease. Both findings suggest that the memory immune response is one of the key players in the pathogenesis of this disease. Here we take advantage of the particular Cuban epidemiological situation in dengue to analyze a broad spectrum of cell-mediated immune response mediators at mRNA and protein level. Evidences for a regulatory immune pattern in homologous (TGF-beta, IL-10) vs. pro-inflammatory pattern (IFN-gamma, TNF-alpha) in heterologous dengue virus re-challenge were found, suggesting a possible association with the higher incidence of severe dengue cases in the latter case.
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Affiliation(s)
- Beatriz Sierra
- Cellular Immunology Lab, Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and its Vector, Institute of Tropical Medicine, Pedro Kouri Autopista Novia del Mediodia, La Lisa, Ciudad Habana, Cuba.
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Immunoglobulin G antibody response in children and adults with acute dengue 3 infection. J Virol Methods 2009; 159:6-9. [DOI: 10.1016/j.jviromet.2009.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Revised: 02/04/2009] [Accepted: 02/12/2009] [Indexed: 11/21/2022]
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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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Troyo A, Porcelain SL, Calderón-Arguedas O, Chadee DD, Beier JC. Dengue in Costa Rica: the gap in local scientific research. Rev Panam Salud Publica 2007; 20:350-60. [PMID: 17316494 PMCID: PMC2408883 DOI: 10.1590/s1020-49892006001000012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Adriana Troyo
- University of Miami, Department of Epidemiology and Public Health, Global Public Health Program, Miami, Florida, United States of America. Send correspondence to: Adriana Troyo, Global Public Health Program, University of Miami, 12500 SW 152nd Street, Building B, Miami, FL 33177, United States; e-mail:
- Universidad de Costa Rica, Centro de Investigación en Enfermeda-des Tropicales, Departamento de Parasitología, Facultad de Micro-biología, San José, Costa Rica
| | - Sherri L. Porcelain
- University of Miami, Department of Epidemiology and Public Health, Global Public Health Program, Miami, Florida, United States of America. Send correspondence to: Adriana Troyo, Global Public Health Program, University of Miami, 12500 SW 152nd Street, Building B, Miami, FL 33177, United States; e-mail:
- University of Miami, Department of International Studies, Miami, Florida, United States
| | - Olger Calderón-Arguedas
- Universidad de Costa Rica, Centro de Investigación en Enfermeda-des Tropicales, Departamento de Parasitología, Facultad de Micro-biología, San José, Costa Rica
| | - Dave D. Chadee
- University of the West Indies, Department of Life Sciences, St. Augustine, Trinidad and Tobago
| | - John C. Beier
- University of Miami, Department of Epidemiology and Public Health, Global Public Health Program, Miami, Florida, United States of America. Send correspondence to: Adriana Troyo, Global Public Health Program, University of Miami, 12500 SW 152nd Street, Building B, Miami, FL 33177, United States; e-mail:
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de la C Herrera R, Cabrera MV, García S, Gilart M. IgM antibodies to dengue virus in dried blood on filter paper. Clin Chim Acta 2006; 367:204-6. [PMID: 16500634 DOI: 10.1016/j.cca.2005.12.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2005] [Revised: 12/20/2005] [Accepted: 12/27/2005] [Indexed: 11/29/2022]
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Tran TNT, de Vries PJ, Hoang LP, Phan GT, Le HQ, Tran BQ, Vo CMT, Nguyen NV, Kager PA, Nagelkerke N, Groen J. Enzyme-linked immunoassay for dengue virus IgM and IgG antibodies in serum and filter paper blood. BMC Infect Dis 2006; 6:13. [PMID: 16436203 PMCID: PMC1403783 DOI: 10.1186/1471-2334-6-13] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2005] [Accepted: 01/25/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The reproducibilty of dengue IgM and IgG ELISA was studied in serum and filter paper blood spots from Vietnamese febrile patients. METHODS 781 pairs of acute (t0) and convalescent sera, obtained after three weeks (t3) and 161 corresponding pairs of filter paper blood spots were tested with ELISA for dengue IgG and IgM. 74 serum pairs were tested again in another laboratory with similar methods, after a mean of 252 days. RESULTS Cases were classified as no dengue (10 %), past dengue (55%) acute primary (7%) or secondary (28%) dengue. Significant differences between the two laboratories' results were found leading to different diagnostic classification (kappa 0.46, p < 0.001). Filter paper results correlated poorly to serum values, being more variable and lower with a mean (95% CI) difference of 0.82 (0.36 to 1.28) for IgMt3, 0.94 (0.51 to 1.37) for IgGt0 and 0.26 (-0.20 to 0.71) for IgGt3. This also led to differences in diagnostic classification (kappa value 0.44, p < 0.001) The duration of storage of frozen serum and dried filter papers, sealed in nylon bags in an air-conditioned room, had no significant effect on the ELISA results. CONCLUSION Dengue virus IgG antibodies in serum and filter papers was not affected by duration of storage, but was subject to inter-laboratory variability. Dengue virus IgM antibodies measured in serum reconstituted from blood spots on filter papers were lower than in serum, in particular in the acute phase of disease. Therefore this method limits its value for diagnostic confirmation of individual patients with dengue virus infections. However the detection of dengue virus IgG antibodies eluted from filter paper can be used for sero-prevalence cross sectional studies.
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Affiliation(s)
- Thanh Nga T Tran
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
- Department of Microbiology, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Peter J de Vries
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
| | - Lan Phuong Hoang
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
- Department of Tropical Diseases, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Giao T Phan
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
- Department of Tropical Diseases, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Hung Q Le
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
- Department of Tropical Diseases, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Binh Q Tran
- Department of Tropical Diseases, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Chi Mai T Vo
- Department of Microbiology, Cho Ray Hospital, 102 B Nguyen Chi Thanh, Ho Chi Minh City, Vietnam
| | - Nam V Nguyen
- Binh Thuan Malaria and Goiter Control Center, 133A Hai Thuong Lan Ong, Phan Thiet, Vietnam
| | - Piet A Kager
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands Amsterdam, the Netherlands
| | - Nico Nagelkerke
- Dept of Community Medicine, United Arab Emirates University, P.O. Box 17666 Al Ain, United Arab Emirates
| | - Jan Groen
- Department of Clinical Virology, Erasmus Medical Center Rotterdam, The Netherlands
- Department of Microbiology and Virology, Focus Diagnostics, Cypress CA, USA
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González D, Castro OE, Kourí G, Perez J, Martinez E, Vazquez S, Rosario D, Cancio R, Guzman MG. Classical dengue hemorrhagic fever resulting from two dengue infections spaced 20 years or more apart: Havana, Dengue 3 epidemic, 2001–2002. Int J Infect Dis 2005; 9:280-5. [PMID: 16023878 DOI: 10.1016/j.ijid.2004.07.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2003] [Revised: 07/16/2004] [Accepted: 07/20/2004] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To report the clinical, laboratory and sonographic findings in 76 adult cases of dengue hemorrhagic fever (DHF). PATIENTS AND METHODS A dengue 3 epidemic occurred in Havana City from June 2001 to March 2002. 12,889 cases were reported, with 81 DHF cases. From this, 76 serologically confirmed cases were studied descriptively. RESULTS Bronchial asthma and white race were important risk factors for the severe form of the disease. Fever (100%), headache (92.1%), myalgia (76.3%), arthralgia (73.7%) and retro-orbital pain (57.7%) were the most frequent general symptoms. Vomiting and abdominal pain were observed in 59.2% and 48.6% of cases, respectively. The most common bleeding site was the vagina (64%), followed by the skin (55.2%). Eighteen patients (23.6%) had shock syndrome. Laboratory findings included thrombocytopenia (100%), hemoconcentration (93.4%), an increase in liver enzymes (82.8%), and leukopenia (71%). Ultrasound detected thickening of the gallbladder wall in 35.1%, pleural effusion in 20.3%, and splenomegaly in 12.9% of cases. CONCLUSION These findings contribute to a better understanding of the clinical aspects of DHF in adult patients due to the dengue 3 virus.
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Affiliation(s)
- Daniel González
- Pedro Kouri Tropical Medicine Institute, Virology Department, Autopista Novia del Mediodía, La Lisa, Havana City, Cuba
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Prado I, Rosario D, Bernardo L, Alvarez M, Rodríguez R, Vázquez S, Guzmán MG. PCR detection of dengue virus using dried whole blood spotted on filter paper. J Virol Methods 2005; 125:75-81. [PMID: 15737419 DOI: 10.1016/j.jviromet.2005.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2004] [Revised: 12/20/2004] [Accepted: 01/11/2005] [Indexed: 10/25/2022]
Abstract
Whole blood dried onto filter paper constitutes a potentially useful material for molecular testing of viruses, including dengue. In order to assess the stability of viral RNA, we carried out dengue-RNA detection in whole blood infected with dengue virus that had been previously spotted onto filter paper. Filter papers were stored at room temperature, 4 and -70 degrees C and processed for PCR assay at intervals of 2, 4, 6 and 9 weeks. Our results demonstrated that dengue-RNA was stable in filter paper for 9 weeks at all tested temperatures. Furthermore, we evaluated these conditions using frozen sera and dried blood samples onto filter paper from 52 patients with confirmed clinical diagnosis of dengue infection. PCR results showed a 100% specificity and 93% sensitivity for dried blood samples. This storage method facilitates the transportation and analysis by nucleic acid amplification techniques even when freezing conditions are not available.
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Affiliation(s)
- Irina Prado
- Virology Department, PAHO/WHO Collaborating Center for Viral Diseases, Pedro Kourí Tropical Medicine Institute, Autopista Novia del Mediodía, Km 6 1/2, P.O. Box Marianao 13, Havana, Cuba
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Vázquez S, Pérez AB, Ruiz D, Rodríguez R, Pupo M, Calzada N, González L, González D, Castro O, Serrano T, Guzmán MG. Serological markers during dengue 3 primary and secondary infections. J Clin Virol 2004; 33:132-7. [PMID: 15911428 DOI: 10.1016/j.jcv.2004.10.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2004] [Revised: 08/20/2004] [Accepted: 10/14/2004] [Indexed: 11/29/2022]
Abstract
BACKGROUND The detection of the IgM antibody for the dengue virus in serum by ELISA has become one of the most important and useful methods for diagnosis of dengue using a single acute-phase serum sample. Currently, this system is an invaluable tool for the surveillance of dengue fever (DF) and dengue hemorrhagic fever (DHF). The usefulness of other serological markers such as IgA and IgE have been less studied. OBJECTIVE To study the IgM, IgA and IgE specific antibody response in dengue 3 infected patients with different clinical picture and type of infection. STUDY DESIGN One hundred and twenty-seven serum samples collected on days 5-7 at the onset of fever from clinically and serologically confirmed dengue cases were studied. Forty-two were classified as primary dengue fever cases, 48 as secondary dengue fever cases and 37 as secondary dengue hemorrhagic fever cases. All samples were tested by capture ELISA in order to detect dengue IgM, IgA and IgE antibodies. RESULTS AND CONCLUSIONS In this study, significant differences were observed in the IgM, IgA and IgE response between the study groups. High IgA and IgE OD ratios in secondary dengue cases were found. The usefulness of serotype specific IgM antibody detection is also analyzed and discussed. A priority for future dengue research in terms of protection, recovery of infection and immunopathogenesis is to elucidate the role of these immunoglobulins. The cross reactivity response to IgM between dengue virus serotypes in primary and secondary cases should also be more studied.
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Affiliation(s)
- S Vázquez
- Virology Department, PAHO/WHO Collaborating Center for Viral Diseases, Pedro Kourí Institute, Autopista Novia del Mediodía, Km 61/2, La Lisa, Ciudad de la Habana, P.O. Box: 601 Marianao 13, Havana City, Cuba (IPK).
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Peláez O, Guzmán MG, Kourí G, Pérez R, San Martín JL, Vázquez S, Rosario D, Mora R, Quintana I, Bisset J, Cancio R, Masa AM, Castro O, González D, Avila LC, Rodríguez R, Alvarez M, Pelegrino JL, Bernardo L, Prado I. Dengue 3 epidemic, Havana, 2001. Emerg Infect Dis 2004; 10:719-22. [PMID: 15200868 PMCID: PMC3323093 DOI: 10.3201/eid1004.030271] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In June 2001, dengue transmission was detected in Havana, Cuba; 12,889 cases were reported. Dengue 3, the etiologic agent of the epidemic, caused the dengue hemorrhagic fever only in adults, with 78 cases and 3 deaths. After intensive vector control efforts, no new cases have been detected.
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Affiliation(s)
- Otto Peláez
- Centro Provincial de Higiene y Epidemiología de Ciudad Habana, Habana, Cuba
| | | | | | - Raúl Pérez
- Viceministerio para la Higiene y la Epidemiología, Habana, Cuba
| | | | | | | | - Regla Mora
- Centro Provincial de Higiene y Epidemiología de Ciudad Habana, Habana, Cuba
| | | | | | | | - Ana M Masa
- Centro Provincial de Higiene y Epidemiología de Ciudad Habana, Habana, Cuba
| | | | | | - Luis C. Avila
- Centro Provincial de Higiene y Epidemiología de Ciudad Habana, Habana, Cuba
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Abstract
Dengue diagnosis was one of the topics discussed at the symposium 'The Global Threat of Dengue - Desperately Seeking Solutions' organized during the 10th International Congress of Infectious Diseases held in Singapore in 2002. In this paper, a review is presented focusing on the main advances, problems and challenges of dengue diagnosis.IgM capture ELISA, virus isolation in mosquito cell lines and live mosquitoes, dengue specific monoclonal antibodies and PCR have all represented major advances in dengue diagnosis. However, an appropriate rapid, early and accessible diagnostic method useful both for epidemiological surveillance and clinical diagnosis is still needed. Also, tools that suggest a prognosis allowing for better management are also needed. Finally, laboratory infrastructure, technical expertise and research capacity must be improved in endemic countries in order to positively influence dengue surveillance, clinical case management and the development of new approaches to dengue control.
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Affiliation(s)
- María G Guzmán
- Virology Department, PAHO/WHO Collaborating Center for Viral Diseases, 'Pedro Kouri;' Tropical Medicine Institute, Autopista Novia del Mediodi;a, Km 6, Ciudad Habana, Cuba.
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Affiliation(s)
- Goro Kuno
- Arbovirus Diseases Branch, Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado 80522, USA
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Vázquez S, Valdés O, Pupo M, Delgado I, Alvarez M, Pelegrino JL, Guzmán MG. MAC-ELISA and ELISA inhibition methods for detection of antibodies after yellow fever vaccination. J Virol Methods 2003; 110:179-84. [PMID: 12798246 DOI: 10.1016/s0166-0934(03)00128-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The IgM antibody capture ELISA (MAC-ELISA) and ELISA inhibition methods for the detection of antibodies against dengue virus were modified to detect antibodies against yellow fever virus. Tests were carried out in 21 persons vaccinated with 17D and compared with the Plaque reduction neutralizing test. Of 17 naive subjects vaccinated, 16 (94%) seroconverted using the MAC-ELISA test and 14 (82%) seroconverted (or >/=fourfold titer increase) in the ELISA inhibition method. Cross-reactivity was evaluated by both tests and resulted in a high specificity to IgM antibodies against yellow fever, when all the samples from vaccinated individuals were negative by MAC-ELISA using dengue antigen. However, 10.7% of the positive dengue sera from the Santiago de Cuba epidemic cross-reacted by MAC-ELISA using yellow fever antigen. ELISA inhibition method showed high cross-reactivity when the 21 sera pairs were worked with yellow fever and dengue antigens. The MAC-ELISA and ELISA inhibition methods have become indispensable tools in our laboratory in order to maintain a surveillance system for dengue and dengue hemorrhagic fever. They are relatively rapid, simple, and they do not require sophisticated equipment. Both MAC-ELISA and ELISA inhibition methods for yellow fever could be useful for diagnosis, surveillance and yellow fever vaccine evaluation.
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Affiliation(s)
- Susana Vázquez
- 'Pedro Kouri;' Institute (IPK), PAHO/WHO Collaborating Center for Viral Diseases, Havana, Cuba.
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Guzmán MG, Alvarez M, Rodríguez R, Rosario D, Vázquez S, Vald s L, Cabrera MV, Kourí G. Fatal dengue hemorrhagic fever in Cuba, 1997. Int J Infect Dis 1999; 3:130-5. [PMID: 10460923 DOI: 10.1016/s1201-9712(99)90033-4] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES After more than 15 years without dengue activity, a dengue II epidemic was reported in Cuba in 1997. Three thousand and twelve serologically confirmed cases were reported, with 205 dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) cases and 12 fatalities. This report presents the clinical, serologic, and virologic findings in the 12 fatal DHF/DSS cases. METHODS Serum and necropsy samples were studied by viral isolation in C636 cell line and polymerase chain reaction. Serum samples were tested by IgM capture enzyme-linked immunoassay (ELISA) and ELISA inhibition method (EIM). RESULTS All 12 cases were classified as DHF/DSS according to the Pan American Health Organization Guidelines for Control and Prevention of Dengue and Dengue Hemorrhagic Fever in the Americas. All patients were older than 15 years. Women were more frequently affected. The symptoms and signs presented by these patients were similar to those previously described in DHF/DSS cases. Clinical deterioration occurred on average at day 3.75. Abdominal pain and persistent vomiting were the earliest and most frequent warning signs. Dengue infection was confirmed in all cases. IgM antibodies were detected in 11 of 12 cases, all of them with a secondary infection. Dengue II virus was detected by viral isolation in 12 samples and by polymerase chain reaction in 17. Virus or RNA was detected in various tissues, including kidney, heart, lung, and brain. CONCLUSION The clinical, pathologic, and laboratory features of 12 cases of fatal dengue hemorrhagic fever were reviewed. The results obtained demonstrate that adults with a primary dengue infection are at risk of developing the severe disease (DHF) if they are infected with a different serotype.
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Affiliation(s)
- M G Guzmán
- Department of Virology, PAHO/WHO Collaborator Center for Viral Diseases, Tropical Medicine Institute of Havana, Havana, Cuba
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