Intérêt des IgM antiamariles dans le diagnostic et la surveillance épidémiologique de la fièvre jaune

Abstract

Summary The authors followed the kinetics of specific IgM production in 27 patients from whom virus was isolated during a yellow fever outbreak in 1982. The ELISA technique was carried out in polystyrene microtitre plates. The IgM to be titrated were immunoabsorbed by capture on solid phase by coating the wells with human anti-μ chain antibody. The antigen was prepared by purification of infected suckling mouse brain by gel filtration according to the Chrom-ELISA technique. The steps which followed included the addition of anti-yellow fever ascitic fluid and peroxidase-labelled mouse anti-IgG. Ortho-tolidine was used as the chromogene substrate to reveal the reaction. This enabled a first reading with the naked eye. Early sera from 90% of patients from whom yellow fever virus was isolated had no detectable IgM. These appeared during the first week after onset. Evidence of IgM in a single serum after viraemia allows a good presumptive diagnostic, thus facilitating epidemiological investigations particularly in the detection of the first cases. In addition, the extension of the infective focus can be more easily monitored. Further to this outbreak, the advantages of the rapid detection of anti-yellow fever IgM have been shown in the detection of several sporadic cases.