Serological response of patients suffering from primary and recrudescent typhus: comparison of complement fixation reaction, Weil-Felix test, microimmunofluorescence, and immunoblotting

Abstract

Microimmunofluorescence and Western immunoblotting were compared with the classical complement fixation reaction and the Weil-Felix test to study the serological responses of patients to Rickettsia prowazekii and both Proteus vulgaris OX19 and OX2 during primary and recrudescent typhus infections. The serological response to R. prowazekii was found to be similar during primary and recrudescent typhus, and all sera examined contained antibodies to the same R. prowazekii cell structures. Immunoglobulin G (IgG) and IgM were found to be the dominant anti-R. prowazekii immunoglobulins in all sera tested and were found to be directed against the 100-kDa protein and the lipopolysaccharide. IgA antibodies, when present, were mainly against the 100-kDa protein. For P. vulgaris, IgG antibodies recognized the proteins and lipopolysaccharides of both OX19 and OX2 serotypes; IgM antibodies were directed against the P. vulgaris OX2 lipopolysaccharide. In addition, donor blood sera, which were negative by microimmunofluorescence, were found to contain IgG immunoglobulins reacting with R. prowazekii protein antigens of 135, 60, and 47 kDa by western immunoblotting.

Rickettsioses as paradigms of new or emerging infectious diseases

“…This is critical when sporadic cases are observed, since the epidemic potentials of the two rickettsiae differ greatly. In our experience, indirect immunofluorescence and immunoblot tests cannot differentiate between Brill-Zinsser disease (recrudescent typhus) and primary epidemic typhus (82). Epidemic typhus remains a very serious threat for humans.…”

Laboratory diagnosis of rickettsioses: current approaches to diagnosis of old and new rickettsial diseases

“…Patients with Brill-Zinsser disease or infected with R. akari usually have no agglutinating antibodies detectable by the Weil-Felix test. Among the former case group of patients, patients occasionally have rising IgM antibody titers (53), therefore explaining a possible positive Weil-Felix test result (98). However, the Weil-Felix test may be positive without rising IgM antibody titers (102).…”

Case Report: Polymerase Chain Reaction Testing of Tick Bite Site Samples for the Diagnosis of Human Granulocytic Anaplasmosis

“…A serological test (IgG and IgM) for the detection of A. phagocytophilum was performed using an indirect immunofluorescent antibody assay (IFA) from a commercial kit (Fuller Laboratories, Fullerton, CA) according to the manufacturer's protocol. 10 The serological positive cutoff value of the kit is 1:80 for the IgG titer and 1:16 for the IgM titer.…”