Evaluation of Chikungunya Diagnostic Assays: Differences in Sensitivity of Serology Assays in Two Independent Outbreaks

Yap, Grace; Pok, Kwoon-Yong; Lai, Yee-Ling; Hapuarachchi, Hapuarachchige Chanditha; Chow, Angela; Leo, Yee‐Sin; Tan, Li-Kiang; Ng, Lee Ching

doi:10.1371/journal.pntd.0000753

Cited by 100 publications

(76 citation statements)

References 22 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The two isolates D2/Singapore/0904aTw and D2/ Singapore/0904bTw, derived from case 1 and case 2, respectively, had 100% nucleotide identity in their envelope genes and belonged to the Cosmopolitan genotype. Our data are in agreement with recent reports that E1-226V mutant CHIKV strains grouped into the Central/East/South African genotype and DENV-2 strains grouped into the Cosmopolitan genotype were predominant epidemic strains circulating in Singapore in 2009 (7,19). As various genotypic strains may differ in epidemic potential and virulence, molecular epidemiological surveillance can provide valuable information in decision making regarding patient care, outbreak investigation, and control measures (2,4).…”

supporting

confidence: 92%

Concurrent Isolation of Chikungunya Virus and Dengue Virus from a Patient with Coinfection Resulting from a Trip to Singapore

Chang

Shu

et al. 2010

J Clin Microbiol

View full text Add to dashboard Cite

We report two cases of imported infection in patients who had returned to Taiwan from Singapore: one was coinfected with chikungunya virus and dengue virus type 2, and the other was infected with the same dengue virus. Both viruses were successfully isolated from the coinfected case by using antibody neutralization and a plaque purification technique.Dengue fever, caused by a flavivirus in the family Flaviviridae, is the most prevalent arboviral disease in tropical and subtropical regions of Asia, the Pacific and Caribbean islands, and Central and South America (9). Chikungunya, caused by an alphavirus in the family Togaviridae, is endemic to Africa and Asia (12). Both diseases are transmitted to humans by day-biting Aedes aegypti and Aedes albopictus mosquitoes, and both diseases have similar clinical symptoms, including fever, rash, and joint pains as well as headache, fatigue, nausea, vomiting, and muscle pain; a laboratory test is required to distinguish between the two diseases. Thus, many risk factors for chikungunya virus (CHIKV) and dengue virus (DENV) infections are the same or similar. The urban mosquito Aedes aegypti is the primary vector of both viruses throughout most of their geographic range, although Aedes albopictus was recently identified as the main vector of the recently emerged CHIKV E1-226V variant of the African genotype (17).The explosive epidemics of chikungunya in Indian Ocean islands and India since 2004 and the worldwide increase in travel have facilitated the expansion of different strains of CHIKV of the African genotype into overlap areas where DENV is endemic (13). As a result, cocirculation of CHIKV and DENV has been reported in various geographic areas, including India, Sri Lanka, Gabon, Cameroon, Madagascar, Malaysia, Indonesia, Singapore, and Thailand. Consequently, a few studies showing patients coinfected with CHIKV and DENV have been reported in India, Sri Lanka, Malaysia, and Gabon (1,5,8,11,14). Although molecular and serologic evidence demonstrated or suggested coinfections in the abovementioned reports, neither CHIKV nor DENV was isolated from these patients. Successful isolation of both viruses is needed to conduct basic and applied research on CHIKV and DENV biology, immunology, and pathogenesis, as well as the development of laboratory diagnosis, antiviral drugs, and vaccines.The first and only concurrent isolation of CHIKV and DENV-2, from a single blood specimen taken from a patient in the acute phase of a dengue-like illness in southern India in 1964, was reported by Myers and Carey (10). In their study, the dominance of CHIKV in the coinfected patient's serum, along with growth competition, prevented the initial isolation of DENV-2; isolation was finally accomplished through pretreatment of the acute-phase serum sample with a CHIKV-specific mouse antibody, followed by inoculation into infant mice for in vivo growth. Here we report only the second case confirmed by actual isolation of CHIKV and DENV-2, from a patient returned from Singapore, using an in vitro cell...

show abstract

supporting

confidence: 92%

Concurrent Isolation of Chikungunya Virus and Dengue Virus from a Patient with Coinfection Resulting from a Trip to Singapore

Chang

Shu

et al. 2010

J Clin Microbiol

View full text Add to dashboard Cite

show abstract

“…A laboratory-developed indirect immunofluorescence assay (IFA) based on the Titerplane system (Euroimmun US, Inc., Morris Plains, NJ) was used to measure CHIKV IgG (26,27). Sera diluted 1:10 in phosphate-buffered saline (PBS) were added to reaction fields of a reagent tray, and a slide containing mounted glass biochips coated with CHIKV (strain EU 14)-infected Vero cells or uninfected Vero cells was placed into the recesses of the reagent tray.…”

Section: Chikv Igg Ifamentioning

confidence: 99%

“…An approach similar to that described for CHIKV IgG detection was used to measure CHIKV IgM (26,27). Sera were diluted 1:10 in PBS containing goat anti-human IgG (Focus Diagnostics Products, Cypress, CA), and after 15 min at room temperature, diluted sera were transferred to reagent tray reaction fields.…”

Section: Chikv Igg Ifamentioning

confidence: 99%

Chikungunya Virus RNA and Antibody Testing at a National Reference Laboratory since the Emergence of Chikungunya Virus in the Americas

Prince¹,

Seaton²,

Matud³

et al. 2014

Clin. Vaccine Immunol.

View full text Add to dashboard Cite

Since first reported in the Americas in December 2013, chikungunya virus (CHIKV) infections have been documented in travelers returning from the Caribbean, with many cases identified by CHIKV antibody and/or RNA testing at our laboratory. We used our large data set to characterize the relationship between antibody titers and RNA detection and to estimate IgM persistence. CHIKV RNA was measured by nucleic acid amplification and CHIKV IgG/IgM by indirect immunofluorescence. Of the 1,306 samples submitted for RNA testing in January through September 2014, 393 (30%) were positive; for 166 RNA-positive samples, CHIKV antibody testing was also ordered, and 84% were antibody negative. Of the 6,971 sera submitted for antibody testing in January through September 2014, 1,811 (26%) were IgM positive; 1,461 IgM positives (81%) were also IgG positive. The relationship between the CHIKV antibody titers and RNA detection was evaluated using 376 IgM-positive samples (138 with RNA testing ordered and 238 deidentified and tested for RNA). RNA detection showed no significant association with the IgM titer but was inversely related to the IgG titer; 63% of the IgG negative sera were RNA positive, compared to 36% of sera with low IgG titers (1:10 to 1:80) and 16% with IgG titers of >1:160. Using second-sample results from 62 seroconverters, we estimated that CHIKV IgM persists for 110 days (95% confidence interval, 78 to 150 days) after the initial antibody-negative sample. These findings indicate that (i) RNA detection is more sensitive than antibody detection early in CHIKV infection, (ii) in the absence of RNA results, the IgG titer of the IgM-positive samples may be a useful surrogate for viremia, and (iii) CHIKV IgM persists for approximately 4 months after symptom onset. C hikungunya virus (CHIKV) is an alphavirus transmitted from one person to another via mosquitos of the genus Aedes (1-3). Nearly all individuals infected with CHIKV become symptomatic, typically exhibiting fever, rash, and debilitating arthralgia (1-3). Most infected individuals show complete recovery within a few weeks; however, 15 to 60% of patients develop chronic arthralgia, which in turn can lead to arthritic joint damage (2, 4-7). Intrapartum mother-to-child transmission has been documented, with serious neurologic and hemorrhagic complications observed in affected infants (8).Since CHIKV was first identified in 1953 (9), there have been multiple epidemics of CHIKV infections throughout Africa and Asia (2). A particularly large CHIKV outbreak began in eastern Africa in late 2004 and then spread to Indian Ocean islands, India, and southeast Asia over the next 2 years. Estimates suggest that nearly 2 million people became infected during this outbreak (2, 10-15).Because the mosquito vectors for CHIKV transmission are present in tropical and temperate regions worldwide and recently infected travelers moving between areas where CHIKV is endemic and not endemic exhibit high levels of viremia (16), epidemiologists have warned that CHIKV could move into new g...

show abstract

“…In the acute phase of illness, detection of viral nucleic acid in serum by RT-PCR is possible [6]. After this period, diagnosis relies on detection of specific antibodies against CHIKV [7][8]. Laboratory confirmation of CHIKV infection is usually achieved by detection of viral genome or demonstration of seroconversion in paired serum samples [9].…”

Section: Diagnosismentioning

confidence: 99%

Cases of chikungunya virus infection in travellers returning to Spain from Haiti or Dominican Republic, April-June 2014

et al. 2014

View full text Add to dashboard Cite

Ten cases of chikungunya were diagnosed in Spanish travellers returning from Haiti (n=2), the Dominican Republic (n=7) or from both countries (n=1) between April and June 2014. These cases remind clinicians to consider chikungunya in European travellers presenting with febrile illness and arthralgia, who are returning from the Caribbean region and Central America, particularly from Haiti and the Dominican Republic. The presence of Aedes albopictus together with viraemic patients could potentially lead to autochthonous transmission of chikungunya virus in southern Europe.

show abstract

Evaluation of Chikungunya Diagnostic Assays: Differences in Sensitivity of Serology Assays in Two Independent Outbreaks

Cited by 100 publications

References 22 publications

Concurrent Isolation of Chikungunya Virus and Dengue Virus from a Patient with Coinfection Resulting from a Trip to Singapore

Concurrent Isolation of Chikungunya Virus and Dengue Virus from a Patient with Coinfection Resulting from a Trip to Singapore

Chikungunya Virus RNA and Antibody Testing at a National Reference Laboratory since the Emergence of Chikungunya Virus in the Americas

Cases of chikungunya virus infection in travellers returning to Spain from Haiti or Dominican Republic, April-June 2014

Contact Info

Product

Resources

About