Expanded Molecular Testing on Patients with Suspected West Nile Virus Disease

Details

• Alternative Title:
  Vector Borne Zoonotic Dis
• Personal Author:
  Lindsey, Nicole P. ; Messenger, Sharon L. ; Hacker, Jill K. ; Salas, Maria L. ; Scott-Waldron, Christine ; Haydel, Danielle ; Rider, Errin ; Simonson, Sean ; Brown, Catherine M. ; Patel, Pinal ; Smole, Sandra C. ; Neitzel, David F. ; Schiffman, Elizabeth K. ; Palm, Jennifer ; Strain, Anna K. ; Vetter, Sara M. ; Nefzger, Brian ; Fischer, Marc ; Rabe, lngrid B.
• Description:
  Most diagnostic testing for West Nile virus (WNV) disease is accomplished using serologic testing, which is subject to cross-reactivity, may require cumbersome confirmatory testing, and may fail to detect infection in specimens collected early in the course of illness. The objective of this project was to determine whether a combination of molecular and serologic testing would increase detection of WNV disease cases in acute serum samples. A total of 380 serum specimens collected ≤7 days after onset of symptoms and submitted to four state public health laboratories for WNV diagnostic testing in 2014 and 2015 were tested. WNV immunoglobulin M (IgM) antibody and RT-PCR tests were performed on specimens collected ≤3 days after symptom onset. WNV IgM antibody testing was performed on specimens collected 4-7 days after onset and RT-PCR was performed on IgM-positive specimens. A patient was considered to have laboratory evidence of WNV infection if they had detectable WNV IgM antibodies or WNV RNA in the submitted serum specimen. Of specimens collected ≤3 days after symptom onset, 19/158 (12%) had laboratory evidence of WNV infection, including 16 positive for only WNV IgM antibodies, 1 positive for only WNV RNA, and 2 positive for both. Of specimens collected 4-7 days after onset, 21/222 (9%) were positive for WNV IgM antibodies; none had detectable WNV RNA. These findings suggest that routinely performing WNV RT-PCR on acute serum specimens submitted for WNV diagnostic testing is unlikely to identify a substantial number of additional cases beyond IgM antibody testing alone.
• Subjects:
  Article PCR Surveillance West Nile
• Source:
  Vector Borne Zoonotic Dis. 19(9):690-693
• Pubmed ID:
  31081745
• Pubmed Central ID:
  PMC7135921
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States
• Volume:
  19
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:4a9093ffade0447783e668e5df9a44eeb5d461c9a972878d4c2c4148fea7be05
• Download URL:
  https://stacks.cdc.gov/view/cdc/86599/cdc_86599_DS1.pdf
• File Type:
  [PDF - 53.16 KB ]