Koraka Penelopie, Zeller Herve, Niedrig Matthias, Osterhaus Albert D M E, Groen Jan
Laboratory for Exotic Viral Infections, Institute of Virology, Erasmus Medical Centre, Dr Molenwaterplein 40 3015GD, Rotterdam, The Netherlands.
Microbes Infect. 2002 Oct;4(12):1209-15. doi: 10.1016/s1286-4579(02)01647-7.
Flavivirus infections are a significant public health problem, since several members of the Flaviviridae family are highly pathogenic to humans. Accurate diagnosis and differentiation of the infecting virus is important, especially in areas where many flaviviruses are circulating. In this study we evaluated a newly developed commercially available immunofluorescence assay (IFA) (INDX, Baltimore, MD, USA) for the detection of IgM and IgG antibodies against dengue virus, yellow fever virus, Japanese encephalitis virus and West Nile virus. IFA was compared with standard diagnostic enzyme immunoassays (EIAs) specific for the detection of IgM and IgG antibodies against these viruses. Forty-seven serum samples from patients with a defined flavivirus infection were tested. As controls, serum samples from individuals with antibodies against tick-borne encephalitis virus and hepatitis C virus as well as healthy individuals were included. The results obtained from this study indicate that IFA showed a significantly better discrimination for flavivirus specific IgM antibodies than did the standard IgM specific EIAs (the overall cross-reactivity varied between 4 and 10% by IFA and 30-44% by EIA for the respective viruses). In contrast, the detection of flavivirus specific IgG antibodies showed high cross-reactions in both IFA and EIAs (overall cross-reactivity 16-71 and 62-84%, respectively). This study clearly stated the complexity of flavivirus diagnosis, showing that one cannot rely on one assay or search for one virus only. The flavivirus IFA is a useful tool for the identification of flavivirus infections during the acute stage of disease. In particular, IFA can be an important diagnostic tool for testing samples from travellers who have been accidentally exposed to these viruses.
黄病毒感染是一个重大的公共卫生问题，因为黄病毒科的几个成员对人类具有高度致病性。准确诊断和区分感染的病毒很重要，特别是在多种黄病毒传播的地区。在本研究中，我们评估了一种新开发的市售免疫荧光测定法（IFA）（INDX，美国马里兰州巴尔的摩），用于检测针对登革热病毒、黄热病毒、日本脑炎病毒和西尼罗河病毒的IgM和IgG抗体。将IFA与用于检测针对这些病毒的IgM和IgG抗体的标准诊断酶免疫测定法（EIA）进行比较。对47份确诊为黄病毒感染患者的血清样本进行了检测。作为对照，纳入了具有抗蜱传脑炎病毒和丙型肝炎病毒抗体的个体以及健康个体的血清样本。本研究获得的结果表明，与标准的IgM特异性EIA相比，IFA对黄病毒特异性IgM抗体的区分能力明显更好（对于各自的病毒，IFA的总体交叉反应率在4%至10%之间，EIA为30%至44%）。相比之下，在IFA和EIA中检测黄病毒特异性IgG抗体均显示出高交叉反应（总体交叉反应率分别为16%至71%和62%至84%）。这项研究清楚地表明了黄病毒诊断的复杂性，表明不能仅依赖一种检测方法或仅寻找一种病毒。黄病毒IFA是在疾病急性期识别黄病毒感染的有用工具。特别是，IFA可以成为检测意外接触这些病毒的旅行者样本的重要诊断工具。
