Abstract
Commercial chikungunya virus (CHIKV)–specific IgM detection kits were evaluated at the Centers for Disease Control and Prevention (CDC), the Public Health Agency of Canada National Microbiology Laboratory, and the Caribbean Public Health Agency (CARPHA). The Euroimmun Anti-CHIKV IgM ELISA kit had ≥ 95% concordance with all three reference laboratory results. The limit of detection for low CHIK IgM+ samples, as measured by serial dilution of seven sera up to 1:12,800 ranged from 1:800 to 1:3,200. The Euroimmun IIFT kit evaluated at CDC and CARPHA performed well, but required more retesting of equivocal results. The InBios CHIKjj Detect MAC-ELISA had 100% and 98% concordance with CDC and CARPHA results, respectively, and had equal sensitivity to the CDC MAC-ELISA to 1:12,800 dilution in serially diluted samples. The Abcam Anti-CHIKV IgM ELISA had high performance at CARPHA, but at CDC, performance was inconsistent between lots. After replacement of the biotinylated IgM antibody controls with serum containing CHIKV-specific IgM and additional quality assurance/control measures, the Abcam kit was rereleased and reevaluated at CDC. The reformatted Abcam kit had 97% concordance with CDC results and limit of detection of 1:800 to 1:3,200. Two rapid tests and three other CHIKV MAC-ELISAs evaluated at CDC had low sensitivity, as the CDC CHIKV IgM in-house positive controls were below the level of detection. In conclusion, laboratories have options for CHIKV serological diagnosis using validated commercial kits.
Highlights
Chikungunya virus (CHIKV) is an arthropod-borne alphavirus that causes acute epidemic polyarthralgia and febrile illness.[1,2,3,4] Since 2004, CHIKV has reemerged in Africa, Asia, and Oceania, resulting in millions of human infections.[1,5,6,7] In the fall of 2013, local transmission of CHIKV was reported on Saint Martin Island in the Caribbean.[8,9] Since the virus has disseminated rapidly throughout the Americas.[10]
The Euroimmun ELISA was evaluated at Centers for Disease Control and Prevention (CDC), NML, and Caribbean Public Health Agency (CARPHA); the Abcam and InBios ELISA kits and the Euroimmun indirect immunofluorescent test (IIFT) were evaluated at CDC and CARPHA; and the CTK, Genway, and SD Diagnostics ELISA kits and the CTK and SD BIOLINE CHIKV IgM rapid tests were evaluated only at CDC
Nine CHIKV IgM detection assays were assessed at CDC with a panel of serum specimens that had previously been submitted to and tested at the CDC arbovirus diagnostic laboratory (Table 1)
Summary
Chikungunya virus (CHIKV) is an arthropod-borne alphavirus that causes acute epidemic polyarthralgia and febrile illness.[1,2,3,4] Since 2004, CHIKV has reemerged in Africa, Asia, and Oceania, resulting in millions of human infections.[1,5,6,7] In the fall of 2013, local transmission of CHIKV was reported on Saint Martin Island in the Caribbean.[8,9] Since the virus has disseminated rapidly throughout the Americas.[10] In the United States, dengue (DEN) and CHIK became reportable diseases in January 2010 and January 2015, respectively. Dengue viruses (DENVs) co-circulate in many of the regions where CHIKV has emerged, and clinical symptoms between the two diseases are similar.[11,12] Laboratorybased diagnosis is essential to differentiate CHIKV from DENV infections, as the clinical care of the patients may be different.[13]
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