Abstract
Serological diagnosis of Zika virus (ZIKV) infection is challenging because of antigenic cross-reactivity with dengue virus (DENV). This study evaluated the accuracy of the Zika IgM antibody capture enzyme-linked immunosorbent assay (CDC Zika IgM MAC-ELISA) in differentiating between ZIKV and DENV infections. To determine sensitivity, we used acute- and convalescent-phase sera from 21 patients with RT-PCR-confirmed ZIKV infection. To determine specificity, we used acute- and convalescent-phase sera from 60 RT-PCR-confirmed dengue cases and sera from 23 blood donors. During the acute-phase of the illness, the assay presented a sensitivity of 12.5% (2/16) for samples collected 0–4 days post symptoms onset (DPSO), and of 75.0% (3/4) for samples collected 5–9 DPSO. During the convalescent-phase of the illness, the test sensitivity was 90.9% (10/11), 100% (2/2), and 0% (0/2) for samples obtained 12–102, 258–260, and 722–727 DPSO, respectively. Specificity for acute- and convalescent-phase samples from RT-PCR-confirmed dengue cases was 100% and 93.2%, respectively. Specificity for blood donor samples was 100%. The assay is an accurate method for Zika serological diagnosis and proved to be reliable for use during surveillance and outbreak investigations in settings where ZIKV and DENV cocirculate.
Highlights
Zika virus (ZIKV) is a mosquito-borne flavivirus that belongs to the Flaviviridae Family. the majority of infections are asymptomatic or produce mild and self-limited clinical manifestations, such as rash, low-grade fever, and arthralgia, it can lead to severe neurological complications, exemplified by the Guillain-Barré syndrome and the congenital Zika syndrome [1,2,3].Diagnostics 2020, 10, 835; doi:10.3390/diagnostics10100835 www.mdpi.com/journal/diagnosticsDiagnosis of Zika virus (ZIKV) infection is based on clinical, epidemiological, and laboratorial data
We evaluated the CDC Zika MAC-ELISA specificity in a group of 60 dengue cases selected among the RT-PCR-confirmed dengue cases detected during the acute febrile illness (AFI) enhanced surveillance study previously described
It is noteworthy that our findings on the kinetics of ZIKV IgM antibody response, as revealed by the serial sampling of RT-PCR-confirmed Zika patients at different time points, are in agreement with those of other studies that showed that ZIKV IgM antibodies starts to be detected four or five days post infection and maintain detectable levels for at least twelve weeks [5,20]
Summary
Zika virus (ZIKV) is a mosquito-borne flavivirus that belongs to the Flaviviridae Family. Diagnosis of Zika virus (ZIKV) infection is based on clinical, epidemiological, and laboratorial data. Viral RNA can be detected in the first 5–7 days following the onset of symptoms, and, after this period, IgM antibodies may be detected by serological assays [4,5]. ZIKV has antigenic similarities with other flaviviruses, especially dengue virus (DENV), which can result in antibody cross-reactivity between the two [6]. As ZIKV and DENV share similar transmission determinants [7,8], serological diagnosis of ZIKV infection is challenging in areas where DENV is endemic
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