Comparable diagnostic accuracy of SARS-CoV-2 Spike RBD and N-specific IgG tests to determine pre-vaccination nation-wide baseline seroprevalence in Mexico

A major challenge for developing countries during the COVID-19 pandemic is affordable and adequate monitoring of disease progression and population exposure as the primary source relevant epidemiological indicators. Serology testing enables assessing population exposure and to guide vaccination strategies but requires rigorous accuracy validation before population-wide implementation. We adapted a two-step ELISA protocol as a single-step protocol for detection of IgG against the Receptor Binding Domain (RBD) of SARS-CoV-2 spike protein and compared its diagnostic accuracy with a commercial immunoassay anti-nucleoprotein IgG. Both methods yielded adequate and comparable diagnostic accuracy after 3 weeks post-symptom onset and were implemented in a nation-wide population based serological survey during August-November 2020. Anti-RBD National seroprevalence was 23.6%, 1.3% lower, but not significantly, than for anti-N. Double positive seroprevalence was 19.7%. Anti-N single-positive seroprevalence was 3.72% and anti-RBD single-positive seroprevalence was 1.98%. Discrepancies in the positivity to either single marker may be due to different kinetics of each antibody marker as well as the heterogeneity of the sampling time in regards to local epidemic waves. Baseline single positivity prevalence will be useful to assess the serological impact of vaccination and natural infection in further serosurveillance efforts.

Primary dengue virus infections induce differential cytokine production in Mexican patients

Severe dengue pathogenesis is not fully understood, but high levels of proinflammatory cytokines have been associated with dengue disease severity. In this study, the cytokine levels in 171 sera from Mexican patients with primary dengue fever (DF) and dengue haemorrhagic fever (DHF) from dengue virus (DENV) 1 (n = 116) or 2 (n = 55) were compared. DF and DHF were defined according to the patient’s clinical condition, the primary infections as indicated by IgG enzymatic immunoassay negative results, and the infecting serotype as assessed by real-time reverse transcription-polymerase chain reaction. Samples were analysed for circulating levels of interleukin (IL)-12p70, interferon (IFN)-γ, tumour necrosis factor (TNF)-α, IL-6, and IL-8 using a commercial cytometric bead array. Significantly higher IFN-γ levels were found in patients with DHF than those with DF. However, significantly higher IL-12p70, TNF-α, and IL-6 levels were associated with DHF only in patients who were infected with DENV2 but not with DENV1. Moreover, patients with DF who were infected with DENV1 showed higher levels of IL-12p70, TNF-α, and IL-6 than patients with DHF early after-fever onset. The IL-8 levels were similar in all cases regardless of the clinical condition or infection serotype. These results suggest that the association between high proinflammatory cytokine levels and dengue disease severity does not always stand, and it once again highlights the complex nature of DHF pathogenesis.

Evaluation of a novel commercial rapid test for dengue diagnosis based on specific IgA detection

The performance of the novel commercial test ASSURE® Dengue IgA Rapid test (MP Diagnostics) was evaluated using a panel of 172 sera collected from dengue patients and 47 sera from healthy blood donors. The overall specificity and sensitivity were 61.0% and 85.1%, respectively. However, the positivity rate for IgA went from 33.3% for sera collected the same day of fever onset to 81.2% for sera collected 5 days after fever onset. Infections with serotype 2 viruses were detected more efficiently than those with serotype 1 viruses, and no sera from infections with serotypes 3 and 4 were available. In addition, the kit was twice more efficient at detecting secondary infections than at detecting primary infections. Finally, the ASSURE® test showed good repeatability and reproducibility. The results of this study suggest that the ASSURE® Dengue IgA Rapid test may become a useful and easy-to-use test for early dengue diagnosis.

[Causes of postpartum intrauterine device rejection]

The objective of this study was to determine the causes of rejection to intrauterine device postpartum (IDP) in puerperal patients before they left the hospital. Two hundred puerperal patients who accepted IDP and two hundred patients who rejected IDP were studied. They received a questionaire to know the motives to accept or not IDP and degree of knowledge about it. There was not statistical differences between groups in relation to age, scholarity, religion, marital status, occupation and degree of knowledge, 51% had prenatal control, 62% of puerperal patients who rejected IDP did not have information about this contraceptive method, in 17% husband did not accept it and 9.5% have been influenced by negative rumors about IDP. In conclusion puerperal patients reject IDP mainly for lack of knowledge in relation to IDP and because their husbands did not accept it.

Fate of phase I and phase II Coxiella burnetii in several macrophage-like tumor cell lines

Several macrophage-like tumor cell lines of murine origin were exposed to phase I and phase II Coxiella burnetii, and the subsequent fate of the parasites was determined by electron and bright-field microscopy. Phase I C. burnetii proliferated within and established a persistent infection of P388D1, J774, and PU-5-IR cell lines but not of WEHI-3 and WEHI-274 cell lines. Phase II C. burnetii, however, entered into and persistently infected all five cell lines. The parasites proliferated within vacuoles. Macrophage cell lines persistently infected with phase I and phase II C. burnetii were maintained for over 200 and 100 days, respectively. Within P388D1 cells, the phase I C. burnetii converted, in part, to phase II; phase II organisms remained in the phase II state. The differential fate of the two rickettsial phases after exposure to the WEHI-3 and WEHI-274 cells may be attributable to surface differences such as lipopolysaccharide content.