Abstract
Zika virus (ZIKV) emerged and spread rapidly in South American countries during 2015. Efforts to diagnose ZIKV infection using serological tools were challenging in dengue-endemic areas because of antigenic similarities between both viruses. Here, we assessed the performance of an in-house developed IgM antibody capture enzyme-linked immunosorbent assay (MAC-ELISA) and the plaque reduction neutralization test (PRNT) to diagnose ZIKV infection. Acute and convalescent paired serum samples from 51 patients who presented with clinical symptoms suggestive of an arbovirus illness in dengue-endemic areas of Honduras, Venezuela, Colombia and Peru were used in the assessment. Samples were tested for ZIKV, dengue and chikungunya virus using a variety of laboratory techniques. The results for the ZIKV-RNA screening and seroconversion detected by the microneutralization test were used to construct a composite reference standard. The overall sensitivity and specificity for the MAC-ELISA were 93.5% and 100.0%, respectively. Contrastingly, the overall sensitivity and specificity for the PRNT were 96.8% and 95.0%, respectively. Restricting the analysis according to IgM or neutralizing antibodies against dengue, the performances of both serological assays were adequate. The findings of this study reveal that the MAC-ELISA and PRNT would provide initial reliable laboratory diagnostic assays for ZIKV infection in dengue-endemic areas.
Highlights
In 2015, an outbreak of Zika virus (ZIKV) was reported in northeast Brazil, where other arboviruses, including dengue (DENV) and chikungunya (CHIKV) viruses, were co-circulating
The aim of the study was to assess the diagnostic performance of MAC-ELISA and plaque reduction neutralization test (PRNT), which were developed in-house for the diagnosis of ZIKV infection using clinical samples collected from patients who lived in flavivirus-endemic areas
4 Participants were classified as ZIKV-positive cases by the composite reference if ZIKV-RNA was detected in the acute sample, displayed seroconversion in paired serum samples by ZIKV microneutralization test (MNT), or both
Summary
In 2015, an outbreak of Zika virus (ZIKV) was reported in northeast Brazil, where other arboviruses, including dengue (DENV) and chikungunya (CHIKV) viruses, were co-circulating. Cases caused by ZIKV were confirmed using molecular techniques [1,2]. After the emergence of ZIKV in Brazil and its laboratory confirmation, the virus spread rapidly throughout the Americas, including Colombia, Peru, Honduras, Venezuela and other countries [3,4,5]. The clinical manifestations of ZIKV infections vary from asymptomatic to severe neurologic and ocular disorders [8,9]. The majority of ZIKV infections are asymptomatic or cause mild to moderate illness [5,10]. Due to the high risk of developing severity among immunosuppressed, pregnant women and people with underlying medical conditions, there is a necessity for reliable and highly specific tools to diagnosed ZIKV diseases
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