Detection of viral antigen, IgM and IgG antibodies in cerebrospinal fluid of Chikungunya patients with neurological complications

Rajpal S Kashyap,Hemant J Purohit,Shweta H Morey,Nitin H Chandak,Girdhar M Taori,Hatim F Daginawala

doi:10.1186/1743-8454-7-12

Abstract

BackgroundDuring Chikungunya virus (CHIKV) epidemic in Nagpur, India, we identified some suspected Chikungunya patients with neurological complications. Early and cost-effective diagnosis of these patients remains problematic despite many new advanced diagnostic methods. A reliable diagnostic test, which could be performed in any standard pathology laboratory, would help to obtain definitive early diagnosis of CHIKV patients with neurological complications. In our laboratory, in-house ELISA protocol for viral antigen, immunoglobulin M (IgM) and IgG detection has been developed and assessed for the diagnosis of CHIKV patients with neurological complications.MethodCerebrospinal fluid samples of forty-six patients who developed neurological symptoms within two months of CHIKV infections along with control subjects were included in the study and were analyzed for the presence of antigens and of IgM and IgG using an ELISA protocol.ResultsThe ELISA method for antigen detection yielded 80% sensitivity and 87% specificity for the diagnosis of CHIKV patients with neurological complications. The sensitivity for detection of IgM 48% or IgG 63% was significantly lower than the antigen assay (80%).ConclusionThe detection of viral antigen in CSF of CHIKV patients with neurological complications by ELISA method gave a more reliable diagnosis than antibodies detection that can be used to develop an immunodiagnostic assay with increased sensitivity and specificity.

Highlights

During Chikungunya virus (CHIKV) epidemic in Nagpur, India, we identified some suspected Chikungunya patients with neurological complications
In our institute we have identified several suspected CHIKV patients associated with neurological complications [5]
We have developed an ELISA based viral antigen detection assay for the diagnosis of CHIKV infection

Summary

Introduction

During Chikungunya virus (CHIKV) epidemic in Nagpur, India, we identified some suspected Chikungunya patients with neurological complications. A reliable diagnostic test, which could be performed in any standard pathology laboratory, would help to obtain definitive early diagnosis of CHIKV patients with neurological complications. In-house ELISA protocol for viral antigen, immunoglobulin M (IgM) and IgG detection has been developed and assessed for the diagnosis of CHIKV patients with neurological complications. There have been recent outbreaks of CHIKV associated with severe morbidity. Over 2000 cases of Chikungunya fever have been reported from Malegaon town in Nasik district, Maharashtra state, India between February-March 2006 [3]. In May 2006, a big outbreak in Nagpur district of Maharashtra was reported. In Nagpur city alone, as per communication of District Health Officer, in Government dispensaries 50 to 100 cases of Chikungunya were seen everyday. The major causes of morbidity included severe dehydration, electrolyte imbalance, and loss of glycemic control

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