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. 2000 Jun;38(6):2232-9.
doi: 10.1128/JCM.38.6.2232-2239.2000.

Evaluation of immunoglobulin M (IgM) and IgG enzyme immunoassays in serologic diagnosis of West Nile Virus infection

G Tardei  1 , S Ruta, V Chitu, C Rossi, T F Tsai, C Cernescu
Affiliations

Evaluation of immunoglobulin M (IgM) and IgG enzyme immunoassays in serologic diagnosis of West Nile Virus infection

G Tardei et al. J Clin Microbiol. 2000 Jun.

Abstract

A unique urban encephalitis epidemic in Romania signaled the emergence of neurological infection due to West Nile (WN) virus as a novel public health threat in Eastern Europe and provided an opportunity to evaluate patterns of immunoglobulin G (IgG) and IgM reactivity in IgM capture and IgG enzyme-linked immunosorbent assays (ELISAs). WN virus infection was diagnosed serologically in 236 of 290 patients from whom acute serum or cerebrospinal fluid (CSF) samples were available. In 37% of serum samples and in 25% of CSF samples collected in the first week of illness, anti-WN virus IgM antibody was detected in the absence of virus-specific IgG. The switch to an IgG antibody response occurred after 4 to 5 days of illness and earlier in CSF than in serum. A specific humoral immune response was detected in the CSF before the serum in some patients for whom paired CSF and serum samples from the same day were available. IgM antibody in convalescent serum samples persisted beyond 2 months after the onset of illness in more than 50% of patients. ELISA optical density values and antibody concentrations were well correlated for both IgM and IgG immunoassays. Anti-WN virus IgM antibody in acute-phase samples did not cross-react significantly with flaviviruses in other antigenic groups.

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Figures

FIG. 1
FIG. 1
Cumulative percent positivity of anti-WN virus IgM and IgG ELISA antibodies in sera (A) and CSF (B) of patients with confirmed and presumptive recent WN virus infection by day after onset of illness.
FIG. 2
FIG. 2
Patterns of WN virus-specific IgM and IgG antibody reactivity in CSF and serum by interval after onset of illness.
FIG. 3
FIG. 3
Correlation between OD values and IgM (A) and IgG (B) antibody concentrations in serum. Sera with high IgM and IgG WN virus-specific antibody titers were tested in twofold dilutions; the bars represent the mean OD value for each given serum dilution, and error bars were set at ±1 standard deviation of the mean. The trend line equation and R2 values are shown.
FIG. 4
FIG. 4
Correlation plots between OD values and day of disease for IgM (A) an IgG (B).
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