Center for Infectious Disease Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Center for Infectious Disease Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
J Clin Virol. 2019 Aug;117:5-10. doi: 10.1016/j.jcv.2019.05.008. Epub 2019 May 19.
Infections with parvovirus B19 (B19V) have been associated with a wide range of disease manifestations of which erythema infectiosum (fifth disease) in children is most common. Clinical signs following infection of children with B19V can be similar to measles and rubella. Laboratory detection of B19V infections is based on detection of B19V-specific IgM antibodies by enzyme immunoassay (IgM-EIA) and/or B19V DNA by quantitative PCR (qPCR) on blood samples. The need for invasive sampling can be a barrier for public health diagnostics.
To evaluate the use of a dual target B19V-qPCR directed against the NS1 and VP2 of B19V on oral fluid samples as a non-invasive alternative for laboratory diagnosis of B19V infections in children below 12 years of age with exanthema.
Oral fluid and serum samples were collected from 116 children with exanthema. All serum samples were tested by IgM-EIA/IgG-EIA, while all oral fluid and 56 serum samples were tested by B19V-qPCR.
B19V-specific IgM antibodies were detected in 25 of 116 children in the study. B19V DNA was detected in oral fluid in 17 of the 25 children who were IgM positive, as well as two children who were IgM-equivocal or negative. The child with the equivocal IgM had a high quantity of B19V DNA in oral fluid (7 log IU/ml), compatible with an acute B19V infection. The IgM-negative child was IgG-positive and 4 log IU/ml B19V DNA was detected in the oral fluid sample, suggesting an acute infection and a falsely negative IgM. Sample size calculations indicated that oral fluid samples for qPCR should be collected from 2 to 3 children during outbreaks of exanthema to achieve similar sensitivity as IgM-EIA for one child (≥0.9) to confirm or exclude B19V.
Results indicate that oral fluid samples are a suitable public health alternative for detection of B19V infections, potentially lowering the barriers for sampling.
细小病毒 B19（B19V）感染与多种疾病表现有关，其中儿童的传染性红斑（第五病）最为常见。儿童感染 B19V 后的临床症状可能与麻疹和风疹相似。B19V 感染的实验室检测基于血液样本中 B19V 特异性 IgM 抗体的酶免疫分析（IgM-EIA）和/或定量 PCR（qPCR）检测（B19V DNA）。对于公共卫生诊断而言，侵入性采样可能是一个障碍。
评估针对 B19V 的 NS1 和 VP2 的双靶标 B19V-qPCR 在口腔液样本中的应用，作为 12 岁以下出疹儿童 B19V 感染实验室诊断的非侵入性替代方法。
采集 116 例出疹儿童的口腔液和血清样本。所有血清样本均采用 IgM-EIA/IgG-EIA 检测，所有口腔液和 56 例血清样本均采用 B19V-qPCR 检测。
在研究的 116 例儿童中，有 25 例检测到 B19V 特异性 IgM 抗体。25 例 IgM 阳性儿童的口腔液中检测到 B19V DNA，2 例 IgM 不确定或阴性儿童的口腔液中也检测到 B19V DNA。IgM 不确定的儿童口腔液中 B19V DNA 含量较高（7 log IU/ml），与急性 B19V 感染相符。IgM 阴性的儿童 IgG 阳性，口腔液样本中检测到 4 log IU/ml 的 B19V DNA，提示急性感染和 IgM 假阴性。样本量计算表明，在出疹暴发期间，应从 2 至 3 例儿童采集口腔液样本进行 qPCR，以获得与 IgM-EIA 检测 1 例儿童（≥0.9）相当的敏感性，从而确认或排除 B19V。
结果表明，口腔液样本是检测 B19V 感染的一种合适的公共卫生替代方法，可能降低采样的障碍。
