A school outbreak of parvovirus B19 infection investigated using salivary antibody assays

Abstract

SUMMARYAn outbreak of parvovirus B19 infection at a primary school was investigated using saliva samples. Antibody capture immunoassays for salivary B19 IgG and IgM were developed using a recombinant B19 antigen and monoclonal antibody to B19 virus. Evaluation of the salivary IgG assay using paired serum and saliva samples from 43 staff at St Thomas' Hospital showed that it had a sensitivity of 100% and a specificity of 95%. Evaluation of the salivary B19 IgM assay using 87 paired blood and saliva samples from a study of general practitioner rubella notifications showed it had a sensitivity of 60% and a specificity of 98 %. Using the salivary assay the level of B19 IgG within 2 weeks of the start of the outbreak ranged from 5-33 % in children and 29% in staff. By detecting salivary B19 IgM and/or B19 IgG seroconversions, attack rates of 8-50% in children in different classes and 47% in staff were observed. Household transmission was also studied and an attack rate of 45 % was recorded in 11 susceptibles. After the outbreak, the level of B19 IgG in children with the highest attack rates was 60-70%, similar to that seen in adults in the UK. This study highlights the risk of B19 infection in an institutional setting and shows that saliva samples are a useful alternative to blood.

Evaluation of a commercial assay for the detection of mumps specific IgM antibodies in oral fluid and serum specimens

“…The many advantages of using oral fluid samples rather than blood in virus specific antibody tests have been well documented (Parry, 1993;Perry et al, 1993;Rice and Cohen, 1996). In addition, the number of commercially available oral fluid collection devices and their efficiency for antibody extraction and specific antibody measurement has previously been studied (Vyse et al, 2001).…”

The Diagnostic Applications of Saliva— A Review

“…Saliva was also found to be a reliable alternative to serum for identification of the antibody to parvovirus B 19. Sensitivity of 100% and specificity of 95% were observed for the detection of infected individuals at a primary school (Rice and Cohen, 1996).…”

Use of Saccharomyces cerevisiae -Expressed Recombinant Nucleocapsid Protein To Detect Hantaan Virus-Specific Immunoglobulin G (IgG) and IgM in Oral Fluid

“…Oral fluid can be used instead of serum because of the similar IgG and IgM profiles in oral fluid and serum, although the concentrations are much lower in oral fluid. This approach has successfully been used for the routine diagnosis and surveillance of viral infections, including measles, mumps, rubella, and diseases caused by other viruses (7,19,22,23,24,27,28,33). The sampling method is safe, noninvasive, and easier and cheaper than blood sampling, and the compliance rate is high (18).…”