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Journal of Clinical Microbiology, June 2000, p. 2232-2239, Vol. 38, No. 6
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Evaluation of Immunoglobulin M (IgM) and IgG Enzyme Immunoassays in Serologic Diagnosis of West Nile Virus Infection

G. Tardei,1 S. Ruta,2 V. Chitu,1 C. Rossi,3 T. F. Tsai,4,* and C. Cernescu2

Institute of Virology1 and Carol Davila University of Medicine and Pharmacy,2 Bucharest, Romania; U.S. Army Medical Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21702-50113; and Division of Vector Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado 805224

Received 1 February 2000/Accepted 22 March 2000

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.

* Corresponding author. Present address: Wyeth Lederle Vaccines, 401 N. Middletown Rd., Pearl River, NY 10965. Phone: (914) 732-4053. E-mail: tsait{at}war.wveth.com.

Journal of Clinical Microbiology, June 2000, p. 2232-2239, Vol. 38, No. 6
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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