Zika Virus IgM 25 Months after Symptom Onset, Miami-Dade County, Florida, USA

Griffin, Isabel; Martin, Stacey W.; Fischer, Marc; Chambers, Trudy V.; Kosoy, Olga; Goldberg, Cynthia C.; Falise, Alyssa; Villamil, Vanessa; Пономарева, О. А.; Gillis, Leah D; Blackmore, Carina; Jean, Reynald

doi:10.3201/eid2512.191022

Cited by 17 publications

(13 citation statements)

References 9 publications

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“…For this reason, we analyzed the antibody responses to the nonstructural protein (NS1) of ZIKV. Since ZIKV IgM can persist several months after infection [ 13 , 14 ], testing for ZIKV IgM at the beginning of the third trimester of pregnancy would allow for the retrospective identification of acute maternal infection during the first or second trimester. Stored plasma samples collected during the last trimester of pregnancy were analyzed for IgM and IgG antibodies against NS1 of ZIKV using commercial kits reported to have a very high specificity (100% overall specificity of ZIKV IgG ELISA, 95% confidence interval: 95.9–100.0) (Anti-Zika virus Elisa, Euroimmun, Germany) [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Lack of Association between Adverse Pregnancy Outcomes and Zika Antibodies among Pregnant Women in Thailand between 1997 and 2015

Ngo‐Giang‐Huong

Leroi²,

Fusco

et al. 2021

Viruses

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Data about Zika virus infection and adverse pregnancy outcomes in Southeast Asia are scarce. We conducted an unmatched case-control study of Zika virus (ZIKV) serology in pregnant women enrolled in human immunodeficiency virus (HIV) or hepatitis B virus (HBV) perinatal prevention trials between 1997 and 2015 in Thailand. Case and control groups included women with and without adverse pregnancy outcomes. Plasma samples collected during the last trimester of pregnancy were tested for ZIKV IgG/IgM and Dengue IgG/IgM (Euroimmun, AG, Germany). Case newborn plasma samples were tested for ZIKV IgM and ZIKV RNA (Viasure, Spain). The case group included women with stillbirth (n = 22) or whose infants had microcephaly (n = 4), a head circumference below the first percentile (n = 14), neurological disorders (n = 36), or had died within 10 days after birth (n = 11). No women in the case group were positive for ZIKV IgM, and none of their live-born neonates were positive for ZIKV IgM or ZIKV RNA. The overall ZIKV IgG prevalence was 29%, 24% in the case and 34% in the control groups (Fisher’s exact test; p = 0.13), while the dengue IgG seroprevalence was 90%. Neither neonatal ZIKV infections nor ZIKV-related adverse pregnancy outcomes were observed in these women with HIV and/or HBV during the 18-year study period.

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Section: Methodsmentioning

confidence: 99%

Lack of Association between Adverse Pregnancy Outcomes and Zika Antibodies among Pregnant Women in Thailand between 1997 and 2015

Ngo‐Giang‐Huong

Leroi²,

Fusco

et al. 2021

Viruses

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“…Conversely, anti-NS1 antibody detection methods are thought to be more specific while compromising sensitivity [24]. Kinetic studies of antibody production in patients infected with ZIKV have shown that IgM antibodies begin to appear as early as two days of illness onset and may persist for up to 25 months after exposure, followed by the production of long-lasting IgG antibodies a few days later [38][39][40][41][42][43][44]. Interestingly, however, a recent study by Henderson et al [45] reported decreasing levels of antibody prevalence to ZIKV in residents of Fiji and French Polynesia two years after the ZIKV outbreak in those locations.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of anti-Zika virus IgM, IgAM and IgG ELISAs during co-circulation of Zika, dengue, and chikungunya viruses in Brazil and Venezuela

et al. 2021

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Background Serological diagnosis of Zika virus (ZIKV) infection is challenging because of the antibody cross-reactivity among flaviviruses. At the same time, the role of Nucleic Acid Testing (NAT) is limited by the low proportion of symptomatic infections and the low average viral load. Here, we compared the diagnostic performance of commercially available IgM, IgAM, and IgG ELISAs in sequential samples during the ZIKV and chikungunya (CHIKV) epidemics and co-circulation of dengue virus (DENV) in Brazil and Venezuela. Methodology/Principal findings Acute (day of illness 1–5) and follow-up (day of illness ≥ 6) blood samples were collected from nine hundred and seven symptomatic patients enrolled in a prospective multicenter study of symptomatic patients recruited between June 2012 and August 2016. Acute samples were tested by RT-PCR for ZIKV, DENV, and CHIKV. Acute and follow-up samples were tested for IgM, IgAM, and IgG antibodies to ZIKV using commercially available ELISAs. Among follow-up samples with a RT-PCR confirmed ZIKV infection, anti-ZIKV IgAM sensitivity was 93.5% (43/48), while IgM and IgG exhibited sensitivities of 30.3% (10/35) and 72% (18/25), respectively. An additional 24% (26/109) of ZIKV infections were detected via IgAM seroconversion in ZIKV/DENV/CHIKV RT-PCR negative patients. The specificity of anti-ZIKV IgM was estimated at 93% and that of IgAM at 85%. Conclusions/Significance Our findings exemplify the challenges of the assessment of test performance for ZIKV serological tests in the real-world setting, during co-circulation of DENV, ZIKV, and CHIKV. However, we can also demonstrate that the IgAM immunoassay exhibits superior sensitivity to detect ZIKV RT-PCR confirmed infections compared to IgG and IgM immunoassays. The IgAM assay also proves to be promising for detection of anti-ZIKV seroconversions in sequential samples, both in ZIKV PCR-positive as well as PCR-negative patients, making this a candidate assay for serological monitoring of pregnant women in future ZIKV outbreaks.

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“…The IgM antibody response in ZIKV infection is longstanding; a recent study detected Zika IgM 25 weeks post infection [ 33 ]. This is compounded by cross reactivity across the Flaviviridae family [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Experience with a triplex arbovirus nucleic acid test (NAT) at a Canadian Public Health Laboratory

et al. 2021

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Background Dengue, chikungunya and zika infections occur in tropical and subtropical regions of the world. We describe the utilization of an in-house nucleic acid test (NAT) targeting all three viruses for febrile returning travelers in Alberta, Canada. Methods NAT was performed until 40 days from symptom onset or exposure due to the prolonged duration of zika virus RNA detection. From Sept 1, 2017 to August 31, 2019, 2552 specimens from 1932 patients were tested. Results Approximately 2% of patients tested were NAT positive for dengue virus (n = 42), chikungunya virus (n = 4), and zika virus (n = 1). The majority presented with fever, myalgia and rash. Regions with the most frequent travel included SouthEast Asia (68.5%), South America (25%) and the Caribbean (6.5%). Ct values were stronger (~ 1.5 logs) for patients within 1–3 days following onset of clinical symptoms than those presenting later. Nineteen patients had urine and plasma submitted; 5 were positive for both specimens and 2 were positive only for dengue virus in the urine. Also, Ct values were lower for plasma when compared to the corresponding urine. RNA was detected until 10 days and 5 days post-exposure in plasma and urine respectively for dengue virus. Conclusions Owing to dengue viremia detected beyond the conventional 7 days and low levels of circulating zika virus globally, a cutoff of 14 days from symptom onset to NAT is sufficient to diagnose acute cases. Inclusion of a zoonotic history form that collects appropriate clinical history results in improved test utilization.

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Zika Virus IgM 25 Months after Symptom Onset, Miami-Dade County, Florida, USA

Cited by 17 publications

References 9 publications

Lack of Association between Adverse Pregnancy Outcomes and Zika Antibodies among Pregnant Women in Thailand between 1997 and 2015

Lack of Association between Adverse Pregnancy Outcomes and Zika Antibodies among Pregnant Women in Thailand between 1997 and 2015

Diagnostic performance of anti-Zika virus IgM, IgAM and IgG ELISAs during co-circulation of Zika, dengue, and chikungunya viruses in Brazil and Venezuela

Experience with a triplex arbovirus nucleic acid test (NAT) at a Canadian Public Health Laboratory

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