These authors contributed equally to the work and share the first authorship.
Department of Virology, Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Euro Surveill. 2023 Oct;28(40). doi: 10.2807/1560-7917.ES.2023.28.40.2300054.
BackgroundRodent-borne viruses such as orthohantaviruses and arenaviruses cause considerable disease burden with regional and temporal differences in incidence and clinical awareness. Therefore, it is important to regularly evaluate laboratory diagnostic capabilities, e.g. by external quality assessments (EQA).AimWe wished to evaluate the performance and diagnostic capability of European expert laboratories to detect orthohantaviruses and lymphocytic choriomeningitis virus (LCMV) and human antibody response towards orthohantaviruses.MethodsWe conducted an EQA in 2021; molecular panels consisted of 12 samples, including different orthohantaviruses (Seoul, Dobrava-Belgrade (DOBV), Puumala (PUUV) and Hantaan orthohantavirus), LCMV and negative controls. Serological panels consisted of six human serum samples reactive to PUUV, DOBV or negative to orthohantaviruses. The EQA was sent to 25 laboratories in 20 countries.ResultsThe accuracy of molecular detection of orthohantaviruses varied (50‒67%, average 62%) among 16 participating laboratories, while LCMV samples were successfully detected in all 11 participating laboratories (91-100%, average 96%). The accuracy of serological diagnosis of acute and past orthohantavirus infections was on average 95% among 20 participating laboratories and 82% in 19 laboratories, respectively. A variety of methods was used, with predominance of in-house assays for molecular tests, and commercial assays for serological ones.ConclusionSerology, the most common tool to diagnose acute orthohantavirus infections, had a high accuracy in this EQA. The molecular detection of orthohantaviruses needs improvement while LCMV detection (performed in fewer laboratories) had 95% accuracy. Further EQAs are recommended to be performed periodically to monitor improvements and challenges in the diagnostics of rodent-borne diseases.
以正汉坦病毒和沙粒病毒为代表的啮齿动物源性病毒具有明显的地域和时间分布差异，其所致疾病负担较重。因此，定期评估实验室诊断能力（例如通过外部质量评估）非常重要。
我们旨在评估欧洲专家实验室检测正汉坦病毒和淋巴细胞性脉络丛脑膜炎病毒（LCMV）的性能和诊断能力，以及检测人体针对正汉坦病毒的抗体反应。
我们于 2021 年开展了一项外部质量评估，分子检测包由 12 个样本组成，包括不同的正汉坦病毒（汉城、多布拉伐-贝尔格莱德（DOBV）、普马拉（PUUV）和汉坦病毒）、LCMV 和阴性对照。血清学检测包包括 6 个人血清样本，这些样本对 PUUV、DOBV 有反应或对正汉坦病毒呈阴性。该外部质量评估发送给了 20 个国家的 25 个实验室。
16 个参与实验室对正汉坦病毒分子检测的准确率各不相同（50%至 67%，平均 62%），而 11 个参与实验室均成功检测到了 LCMV 样本（91%-100%，平均 96%）。20 个参与实验室对急性和既往正汉坦病毒感染的血清学诊断准确率平均为 95%，19 个实验室的准确率分别为 82%。该研究使用了多种方法，其中分子检测以内部检测为主，血清学检测则以商业检测为主。
血清学是诊断急性正汉坦病毒感染的最常用工具，在本次外部质量评估中具有较高的准确率。正汉坦病毒的分子检测需要改进，而 LCMV 检测（在较少的实验室中进行）的准确率为 95%。建议定期开展更多的外部质量评估，以监测啮齿动物源性疾病诊断方面的改进和挑战。
