Abstract
We conducted a cross-sectional seroepidemiological study in 2012-2013 to determine the seroprevalence of varicella-zoster virus (VZV) in adolescents and adults living in Korea, where varicella vaccination has been recommended universally at age 12-15 months since 2005. Residual serum samples were collected from 1196 healthy adults and adolescents aged ⩾10 years between November 2012 and March 2013. The fluorescent antibody to membrane antigen (FAMA) test and enzyme-linked immunosorbent assay (ELISA) were performed to determine the seroprevalence of VZV. The seroprevalences of VZV were compared between six age groups: 10-19, 20-29, 30-39, 40-49, 50-59, and ⩾60 years. The seroprevalence of VZV in the entire study cohort was 99·1% according to the FAMA test and 93·1% as determined by ELISA. The seroprevalences of the six age groups were as follows: 96·0%, 99·5%, 99·5%, 99·5%, 100%, and 100%, respectively, by the FAMA test, and 83·3%, 93·0%, 93·0%, 97·5%, 94·5%, and 97·5%, respectively, by ELISA. Seroprevalence increased significantly with age (P < 0·001); moreover, the seroprevalence in subjects aged 10-19 years was significantly lower than in other age groups (P < 0·001), as measured by both the FAMA test and ELISA. Thus, strategies to increase protective immunity against VZV in teenagers are necessary.
Highlights
Because the fluorescent antibody to membrane antigen (FAMA) test is such a labour- and time-intensive test to perform routinely in clinical practice, we evaluated the usefulness of enzyme-linked immunosorbent assay (ELISA) again
Most previous reports using the FAMA test employed cells infected either with the Oka strain of varicella-zoster virus (VZV), or with clinical strains obtained from patients with chickenpox or herpes zoster, as antigens [21, 27, 29, 33,34,35]; this study is the first to use cells infected with the MAV/06 strain of VZV as an antigen
The VZV MAV/06 strain is an attenuated VZV strain used in the production of varicella vaccines; the original clinical strain was obtained from a child with chickenpox in 1989 in Seoul, Korea [36]
Summary
Between November 2012 and March 2013, residual serum samples were collected from healthy adults and adolescents aged 510 years who visited the Health Promotion Centres of three hospitals in Korea. VZV-infected cells were provided from the Mogam Biotechnology Institute (Yongin, Korea). After washing with phosphate-buffered saline (PBS), the slide was air-dried at room temperature. Fixed cells were stored at −70 °C until the FAMA test was performed. Serum dilutions (20 μl) were aliquoted into each well of the acetone-fixed slide and incubated for 30 min at 37 °C. After three washes with PBS, slides were air-dried at room temperature. Cells were washed three times with PBS and were air-dried at room temperature, mounted with ClearMountTM Mounting Solution (Invitrogen, USA), and covered with a coverslip. Using a fluorescent microscope (100× magnification), the incubated cells were examined for complete ringlike fluorescence around their surfaces; this process was performed by two independent investigators
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