| Autor: |
Lindsey NP; Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado., Messenger SL; Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California., Hacker JK; Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California., Salas ML; Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California., Scott-Waldron C; Louisiana Office of Public Health, Baton Rouge, Louisiana., Haydel D; Louisiana Office of Public Health, Baton Rouge, Louisiana., Rider E; Louisiana Office of Public Health, Baton Rouge, Louisiana., Simonson S; Louisiana Office of Public Health, Baton Rouge, Louisiana., Brown CM; Massachusetts Department of Public Health, Jamaica Plain, Massachusetts., Patel P; Massachusetts Department of Public Health, Jamaica Plain, Massachusetts., Smole SC; Massachusetts Department of Public Health, Jamaica Plain, Massachusetts., Neitzel DF; Minnesota Department of Health, Saint Paul, Minnesota., Schiffman EK; Minnesota Department of Health, Saint Paul, Minnesota., Palm J; Minnesota Department of Health, Saint Paul, Minnesota., Strain AK; Minnesota Department of Health, Saint Paul, Minnesota., Vetter SM; Minnesota Department of Health, Saint Paul, Minnesota., Nefzger B; Minnesota Department of Health, Saint Paul, Minnesota., Fischer M; Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado., Rabe IB; Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado. |
| Abstrakt: |
Most diagnostic testing for West Nile virus (WNV) disease is accomplished using serologic testing, which is subject to cross-reactivity, may require cumbersome confirmatory testing, and may fail to detect infection in specimens collected early in the course of illness. The objective of this project was to determine whether a combination of molecular and serologic testing would increase detection of WNV disease cases in acute serum samples. A total of 380 serum specimens collected ≤7 days after onset of symptoms and submitted to four state public health laboratories for WNV diagnostic testing in 2014 and 2015 were tested. WNV immunoglobulin M (IgM) antibody and RT-PCR tests were performed on specimens collected ≤3 days after symptom onset. WNV IgM antibody testing was performed on specimens collected 4-7 days after onset and RT-PCR was performed on IgM-positive specimens. A patient was considered to have laboratory evidence of WNV infection if they had detectable WNV IgM antibodies or WNV RNA in the submitted serum specimen. Of specimens collected ≤3 days after symptom onset, 19/158 (12%) had laboratory evidence of WNV infection, including 16 positive for only WNV IgM antibodies, 1 positive for only WNV RNA, and 2 positive for both. Of specimens collected 4-7 days after onset, 21/222 (9%) were positive for WNV IgM antibodies; none had detectable WNV RNA. These findings suggest that routinely performing WNV RT-PCR on acute serum specimens submitted for WNV diagnostic testing is unlikely to identify a substantial number of additional cases beyond IgM antibody testing alone. |
