Establishment of a comprehensive and high throughput serological algorithm for Zika virus diagnostic testing

Diagn Microbiol Infect Dis. 2019 Jun;94(2):140-146. doi: 10.1016/j.diagmicrobio.2019.01.004. Epub 2019 Jan 14.

Abstract

The previous serological algorithm for Zika virus (ZIKV) comprised screening by anti-ZIKV IgM capture ELISA (MAC-ELISA) for samples collected within 3 months postexposure or onset (MPEO). Samples positive by MAC-ELISA and samples collected beyond 3 MPEO were tested by the confirmatory plaque reduction neutralization test (PRNT), which proved laborious and time-consuming during the 2015 outbreak. Thus, we evaluated several ZIKV ELISAs to establish an anti-IgM and anti-IgG combination for use as a screening tool for all samples prior to PRNT confirmation. The MAC-ELISA or InBios-M in combination with the Euroimmun-G demonstrated sensitivities of 99.1% and 97.2%, respectively, and nonflavivirus specificity of 96.0%. Their cross-reactivities were 71.4% and 50.0%, respectively, for sera positive for Dengue virus antibodies. Due to near-perfect interrater agreement with PRNT and excellent detection of samples collected beyond 3 MPEO, these combinations were recommended as a screening protocol in a new high-throughput algorithm with special considerations for ZIKV diagnostics.

Keywords: Diagnostic testing; Serology; Zika virus.

Publication types

  • Evaluation Study

MeSH terms

  • Algorithms*
  • Antibodies, Viral / blood*
  • Cross Reactions
  • Dengue Virus / immunology
  • Enzyme-Linked Immunosorbent Assay / methods
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Mass Screening / methods*
  • Sensitivity and Specificity
  • Serologic Tests / methods*
  • Zika Virus / immunology*
  • Zika Virus Infection / diagnosis*

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • Immunoglobulin M