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Journal of Clinical Microbiology, September 2005, p. 4691-4695, Vol. 43, No. 9
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.9.4691-4695.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Clinical Utility of Commercial Enzyme Immunoassays during the Inaugural Season of West Nile Virus Activity, Alberta, Canada

Peter A. G. Tilley,1* Roberta Walle,1 Anthony Chow,2 Gayatri C. Jayaraman,3 Kevin Fonseca,1 Michael A. Drebot,4 Jutta Preiksaitis,2 and Julie Fox1

Provincial Laboratory for Public Health (Microbiology), Calgary site, Calgary, Alberta, Canada,1 Provincial Laboratory for Public Health (Microbiology), Edmonton site, Edmonton, Alberta, Canada,2 Centre for Infectious Disease Prevention and Control, Health Canada, Ottawa, Canada,3 National Microbiology Laboratory, Winnipeg, Manitoba, Canada4

Received 21 October 2004/ Returned for modification 26 March 2005/ Accepted 20 June 2005

West Nile virus (WNV) has spread rapidly across North America, creating a need for rapid and accurate laboratory diagnosis on a large scale. Immunoglobulin M (IgM) capture enzyme immunoassays (EIA) became commercially available in the summer of 2003, but limited data are available on their clinical performance. Consolidated human WNV diagnostic testing for the province of Alberta, Canada, at the public health laboratory permitted a large-scale evaluation of the assays, covering a wide clinical spectrum. Two thousand nine hundred sixty-nine sera were tested, from 2,553 Alberta residents, and 266 cases were identified. Sensitivities of the Focus assay and first-generation Panbio IgM capture EIA were 79 and 80%, respectively. During the first week of illness only 53 to 58% of cases were positive, but sensitivity was 96 to 97% after day 8. Sensitivity for neurological cases was 92% overall. Specificity was high for the Focus kit at 98.9%, but only 82.9% for the first Panbio kit. A positive Focus WNV IgG result with a twofold rise in IgG index was a reliable indicator of acute flavivirus infection (67/67 WNV). Agreement between the IgG test and hemagglutinin inhibition titers in paired sera was at least 82%. Commercial IgM and IgG EIA proved useful for WNV diagnosis, provided follow-up sera were collected after 8 days of illness.

* Corresponding author. Mailing address: Provincial Laboratory for Public Health (Microbiology), 3030 Hospital Drive, Calgary, Alberta, Canada T2N 4W4. Phone: (403) 944-1203. Fax: (403) 283-0142. E-mail: p.tilley{at}provlab.ab.ca.

Journal of Clinical Microbiology, September 2005, p. 4691-4695, Vol. 43, No. 9
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.9.4691-4695.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Rawlins, M. L., Swenson, E. M., Hill, H. R., Litwin, C. M. (2007). Evaluation of an Enzyme Immunoassay for Detection of Immunoglobulin M Antibodies to West Nile Virus and the Importance of Background Subtraction in Detecting Nonspecific Reactivity. CVI 14: 665-668 [Abstract] [Full Text]  
  • Tilley, P. A G, Fox, J. D, Jayaraman, G. C, Preiksaitis, J. K (2007). Maculopapular rash and tremor are associated with West Nile fever and neurological syndromes. J. Neurol. Neurosurg. Psychiatry 78: 529-531 [Abstract] [Full Text]  
  • Sambol, A. R., Hinrichs, S. H., Hogrefe, W. R., Schweitzer, B. K. (2007). Performance of a Commercial Immunoglobulin M Antibody Capture Assay Using Analyte-Specific Reagents To Screen for Interfering Factors during a West Nile Virus Epidemic Season in Nebraska. CVI 14: 87-89 [Abstract] [Full Text]  


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