Tarantola D J, Huq F, Nakano J H, Foster S O
J Clin Microbiol. 1981 Apr;13(4):723-5. doi: 10.1128/jcm.13.4.723-725.1981.
In September 1975 Bangladesh was the only country in the world with endemic variola major, and the eradication of the disease was imminent. A rapid and accurate laboratory diagnostic method was required to supplement immunodiffusion in agar gel and culture on chorioallantoic membrane of embryonated egg available at the Institute of Public Health in Dacca, Bangladesh. To determine its effectiveness, a new, improved immunofluorescence (IF) staining technique was introduced. Laboratory specimens (scabs or vesicular or pustular impressions) were collected from patients who had, or were suspected of having, smallpox. Seventy-eight of 144 specimens collected were found to be IF positive for smallpox. As the number of laboratory-positive cases far exceeded the number of clinically diagnosed smallpox cases, IF-positive cases were reinvestigated and subsamples of the IF-positive specimens were tested at a World Health Organization poxvirus reference laboratory at the Centers for Disease Control in Atlanta, Ga. The results indicated 100% sensitivity for the IF technique (no false-negative results) in diagnosing variola major but also showed a high rate of false-positive results. Consequently, IF could not be recommended as a routine screening test for smallpox.
1975年9月，孟加拉国是世界上唯一存在地方性重症天花的国家，该病的根除迫在眉睫。当时在孟加拉国达卡的公共卫生研究所，需要一种快速准确的实验室诊断方法来补充琼脂凝胶免疫扩散法以及鸡胚绒毛尿囊膜培养法。为了确定其有效性，引入了一种新的、改进的免疫荧光（IF）染色技术。从患有或疑似患有天花的患者身上采集实验室标本（痂皮或水疱或脓疱印记）。在采集的144份标本中，有78份被发现天花免疫荧光检测呈阳性。由于实验室确诊病例数远远超过临床诊断的天花病例数，因此对免疫荧光检测呈阳性的病例进行了重新调查，并将免疫荧光检测呈阳性标本的子样本送到位于佐治亚州亚特兰大疾病控制中心的世界卫生组织痘病毒参考实验室进行检测。结果表明，免疫荧光技术在诊断重症天花方面具有100%的灵敏度（无假阴性结果），但也显示出较高的假阳性率。因此，免疫荧光检测不能被推荐作为天花的常规筛查试验。
