Dried Blood Spots versus Sera for Detection of Rubella Virus-Specific Immunoglobulin M (IgM) and IgG in Samples Collected during a Rubella Outbreak in Peru

Helfand, Rita F.; Cabezas, César; Abernathy, Emily; Castillo‐Solórzano, Carlos; Ortiz, Ana Cecília Tomasini; Sun, Hong; Osores, Fernando; Oliveira, Lúcia Helena de; Whittembury, Álvaro; Charles, Myrna; Andrus, Jon Kim; Icenogle, Joe

doi:10.1128/cvi.00144-07

Cited by 31 publications

(31 citation statements)

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“…There were very few equivocal results for the large control population of blood donors enrolled (e.g., 3/99 [3%] by the DBE EIA) and a larger percentage of equivocal results among suspected rubella cases (e.g., 27/225 [12%] by the DBE EIA), supporting the inclusion of the samples with equivocal results with the samples with positive results, as has been done previously with dried blood spots and serum (10,11 The DBE EIA results, which gave the highest number of positive results for serum, are compared with the results of RNA detection in OF by RT-PCR in Table 2. Overall, 12% (27/225) of the suspected rubella cases were RT-PCR positive but IgM negative; the number of suspected rubella cases confirmed by RT-PCR but missed by antibody testing ranged from 31% (10/32) on day 1 to 3% (1/37) on day 4.…”

Section: Comparison Of Of Rt-pcr and Igm Serologymentioning

confidence: 70%

“…The specific methodology, including ethics approval, has been described previously (10). Briefly, health care workers in five zones in Perú enrolled persons Ն8 months of age who presented to local health care centers with suspected rubella (fever and rash) within 28 days of rash onset.…”

Section: Methodsmentioning

confidence: 99%

“…Blood and OF specimens were transported on wet ice to the Peruvian Ministry of Health's National Reference Laboratory for Measles/ Rubella, and blood samples were processed as described previously (10). OF specimens were stored unprocessed at Ϫ20°C for up to 4 months.…”

Section: Methodsmentioning

confidence: 99%

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Confirmation of Rubella within 4 Days of Rash Onset: Comparison of Rubella Virus RNA Detection in Oral Fluid with Immunoglobulin M Detection in Serum or Oral Fluid

et al. 2009

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Rubella virus infection is typically diagnosed by the identification of rubella virus-specific immunoglobulinSymptomatic rubella is characterized by a mild fever and a maculopapular rash of short duration. The clinical diagnosis of rubella is unreliable, and many rash illnesses, such as those caused by measles virus and parvovirus B19, mimic rubella (2). Therefore, laboratory confirmation is essential for the diagnosis of rubella and is typically done by testing serum samples for rubella virus (RV)-specific immunoglobulin M (IgM) antibodies. Serum IgM and IgG responses to RV develop rapidly in the first few days after the onset of rash. However, approximately 50% of samples collected on the day of rash onset test negative for RV-specific IgM antibodies (1, 9, 17). Often, only a single serum sample taken near the time of rash onset is available, resulting in the lack of serologic confirmation of many rubella cases. Thus, the development of a rapid laboratory diagnostic tool for the confirmation of rubella within the first few days of symptom onset would improve the ability to confirm rubella.The isolation of virus in cell culture or the detection of viral RNA by reverse transcription-PCR (RT-PCR) also provides reliable evidence of RV infection (26). Unfortunately, blood is not a good sample for use for the detection of RV, because the highest viral titers in blood typically occur before the onset of rash and virus is undetectable in blood by 2 days after rash onset (6). The virus titer in throat swabs, however, usually reaches a peak titer on the day of rash onset and the titers in throat swabs decline more slowly than those in blood, so that virus can be detected for up to 5 to 7 days after rash onset (6). Several RT-PCR assays for the detection of the RV genome in clinical samples have been described (3,7,15,16,20,25). Templates for the determination of viral sequences for molecular epidemiology can also be made by using RT-PCR.The use of alternative specimens could help reduce the obstacles to specimen collection, storage, and transport in the field (22). Oral fluid (OF), which is collected by rubbing an absorptive device between the gum and the cheek, can be obtained by a method that is relatively noninvasive, is easier to obtain than blood, and has the advantage that it can be used for both RVspecific antibody detection and RV genome detection (12,19,20). Currently, in the United Kingdom, OF samples from notified clinically diagnosed cases are collected between 1 and 6 weeks after the onset of symptoms and are transported by mail to the Central Public Health Laboratory, where they are tested for specific antibody and viral RNA by RT-PCR. By the use of this strategy, specimens from 54.6% of rubella notifications from 1995 through 2001 were obtained for laboratory testing and specimens from 12.7% of the rubella notifications were confirmed to represent rubella cases (20,21).

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Section: Comparison Of Of Rt-pcr and Igm Serologymentioning

confidence: 70%

Section: Methodsmentioning

confidence: 99%

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Confirmation of Rubella within 4 Days of Rash Onset: Comparison of Rubella Virus RNA Detection in Oral Fluid with Immunoglobulin M Detection in Serum or Oral Fluid

et al. 2009

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“…), where short-term storage or transportation of blood samples to a remote testing laboratory may be needed. This approach has been successfully utilized for serological surveillance of human viral infections in resource-limited countries (7,29). For elephant-testing applications, a more extensive DBS validation with greater numbers of well-characterized samples will be required.…”

Section: Discussionmentioning

confidence: 99%

Highly Accurate Antibody Assays for Early and Rapid Detection of Tuberculosis in African and Asian Elephants

Greenwald

Lyashchenko

Esfandiari

et al. 2009

Clin Vaccine Immunol

102

127

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Tuberculosis (TB) in elephants is a reemerging zoonotic disease caused primarily by Mycobacterium tuberculosis. Current methods for screening and diagnosis rely on trunk wash culture, which has serious limitations due to low test sensitivity, slow turnaround time, and variable sample quality. Innovative and more efficient diagnostic tools are urgently needed. We describe three novel serologic techniques, the ElephantTB Stat-Pak kit, multiantigen print immunoassay, and dual-path platform VetTB test, for rapid antibody detection in elephants. The study was performed with serum samples from 236 captive African and Asian elephants from 53 different locations in the United States and Europe. The elephants were divided into three groups based on disease status and history of exposure: (i) 26 animals with cultureconfirmed TB due to M. tuberculosis or Mycobacterium bovis, (ii) 63 exposed elephants from known-infected herds that had never produced a culture-positive result from trunk wash samples, and (iii) 147 elephants without clinical symptoms suggestive of TB, with consistently negative trunk wash culture results, and with no history of potential exposure to TB in the past 5 years. Elephants with culture-confirmed TB and a proportion of exposed but trunk wash culture-negative elephants produced robust antibody responses to multiple antigens of M. tuberculosis, with seroconversions detectable years before TB-positive cultures were obtained from trunk wash specimens. ESAT-6 and CFP10 proteins were immunodominant antigens recognized by elephant antibodies during disease. The serologic assays demonstrated 100% sensitivity and 95 to 100% specificity. Rapid and accurate antibody tests to identify infected elephants will likely allow earlier and more efficient treatment, thus limiting transmission of infection to other susceptible animals and to humans.

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“…Disadvantages include requirements for development and validation of assays as well as small volume of samples collected [Parker and Cubit, 1999]. Since its first implementation for the diagnosis of phenylketonuria in newborns in the 1960s [McDade et al, 2007], DBS has been used for the diagnosis of a number of metabolic disorders and for the analysis of a wide range of biomarkers [McDade et al, 2007], including antibodies raised against several viruses, such as the human immunodeficiency virus [Major et al, 1991; Castro et al, 2008], rubella virus [Punnarugsa and Mungmee, 1991; Neto et al, 1995; Helfand et al, 2001, 2007; Karapanagiotidis et al, 2005], measles virus [Helfand et al, 2001; Ridell et al, 2002], HTLV [Parker et al, 1995], Epstein‐Barr virus [Fachiroh et al, 2008], and hepatitis viruses [Villa et al, 1981; Gil et al, 1997; Tappin et al, 1998; De Almeida et al, 1999; McCarron et al, 1999; Desbois et al, 2009]. However, the use of DBS for the detection of antibodies to hepatitis A virus (anti‐HAV) has been limited [Gil et al, 1997; De Almeida et al, 1999; Desbois et al, 2009], and there are no studies which describe the use of DBS for assessing the humoral response after hepatitis A vaccination.…”

Section: Introductionmentioning

confidence: 99%

The use of dried blood spots for assessing antibody response to hepatitis A virus after natural infection and vaccination

Melgaço

Pinto

Rocha

et al. 2010

Journal of Medical Virology

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During recent years, vaccination against hepatitis A has been implemented in several countries. It is expected that the increase in mass vaccination against hepatitis A will eventually result in a decreased prevalence of anti-HAV antibodies in the general population. For this reason, a suitable clinical sample for diagnosis of hepatitis A must be sufficiently sensitive to enable detection of lower antibodies titers. In this study, the feasibility of using dried blood spots (DBS) was assessed for the detection of anti-HAV antibodies after a natural infection and vaccination. Seventy-four DBS and paired plasma samples were obtained from a group of college students for a cross-sectional hepatitis A seroepidemiological study. Forty-six students seronegative for anti-HAV were selected randomly and immunized with an inactivated hepatitis A vaccine using an 0-6 month schedule. Seroconversion was monitored in paired plasma and DBS samples 6 months after the first dose followed by a period of 8 and 24 months after the second dose. A strong correlation between OD/CO rates of paired plasma and DBS samples for the detection of anti-HAV was observed. The sensitivity and specificity of the DBS compared with plasma for the detection of anti-HAV antibodies after natural infection was 100%. The sensitivity of DBS in samples collected 24 months after the second dose of hepatitis A vaccine was 95.4%. The results showed that DBS samples can be used for the detection of anti-HAV antibodies both after natural infection or vaccination.

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Dried Blood Spots versus Sera for Detection of Rubella Virus-Specific Immunoglobulin M (IgM) and IgG in Samples Collected during a Rubella Outbreak in Peru

Cited by 31 publications

References 7 publications

Confirmation of Rubella within 4 Days of Rash Onset: Comparison of Rubella Virus RNA Detection in Oral Fluid with Immunoglobulin M Detection in Serum or Oral Fluid

Confirmation of Rubella within 4 Days of Rash Onset: Comparison of Rubella Virus RNA Detection in Oral Fluid with Immunoglobulin M Detection in Serum or Oral Fluid

Highly Accurate Antibody Assays for Early and Rapid Detection of Tuberculosis in African and Asian Elephants

The use of dried blood spots for assessing antibody response to hepatitis A virus after natural infection and vaccination

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