Abstract
A peptide-based enzyme-linked immunosorbent assay (ELISA) can be used for retrospective serosurveillance of severe acute respiratory syndrome (SARS) by helping identify undetected chains of disease transmission. The assay was developed by epitope mapping, using synthetic peptides from the spike, membrane, and nucleocapsid protein sequences of SARS-associated coronavirus. The new peptide ELISA consistently detected seroconversion by week 2 of onset of fever, and seropositivity remained through day 100. Specificity was 100% on normal blood donor samples, on serum samples associated with infection by other pathogens, and on an interference panel. The peptide-based test has advantages of safety, standardization, and automation over previous immunoassays for SARS. The assay was used for a retrospective survey of healthy healthcare workers in Taiwan who treated SARS patients. Asymptomatic seroconversions were detected in two hospitals that had nosocomial disease.
Highlights
A peptide-based enzyme-linked immunosorbent assay (ELISA) can be used for retrospective serosurveillance of severe acute respiratory syndrome (SARS) by helping identify undetected chains of disease transmission
In patient 2, from whom blood was drawn on days 0, 6, 16, 27, and 116, seroconversion was apparent on day 16 after the onset of fever
A convenient ELISA to detect IgG to SARS-CoV, based on site-specific synthetic antigens taken from the S, M, and N proteins of the virus, has high specificity
Summary
A peptide-based enzyme-linked immunosorbent assay (ELISA) can be used for retrospective serosurveillance of severe acute respiratory syndrome (SARS) by helping identify undetected chains of disease transmission. Retrospective surveillance for infection is an important means to screen for and interrupt undetected chains of disease transmission. Such surveillance may be key to tracking the severe acute respiratory syndrome–associated coronavirus (SARS-CoV) because mild and asymptomatic cases of SARS-CoV infection that do not meet the World Health Organization’s case definition [1] have been identified by immunoassays [2,3,4], and SARS-CoV–like viruses have been isolated from wild mammals [5]. The results from a retrospective serologic survey by the peptide ELISA of healthcare workers from facilities affected by nosocomial outbreaks are presented as a working example
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