title: Evaluation of serological methods for diagnosis of Puumala hantavirus infection (nephropathia epidemica).
abstract: Nephropathia epidemica (NE), Puumala (PUU) virus infection, is a febrile disease which is commonly associated with acute renal impairment. To differentiate NE from other acute febrile illnesses, a rapid and reliable serological diagnosis is important, and a number of different protocols have recently been introduced. In the present report we describe a comparative evaluation of six PUU virus immunoglobulin M (IgM) and seven IgG enzyme-linked immunosorbent assay (ELISA) protocols based on native, Escherichia coli-expressed, or baculovirus-expressed nucleocapsid protein (N). Neutralization and immunofluorescence assays were included for comparison. Equally high sensitivities and specificities were obtained with three mu-capture-based IgM ELISAs using native, baculovirus-expressed, and E. coli-expressed N antigens, respectively, and by an ELISA based on purified E. coli-expressed full-length N adsorbed to solid phase. The assays based on truncated amino-terminal N proteins, including a commercially available PUU virus IgM ELISA, all showed lower sensitivities. For detection of PUU virus-specific IgG, ELISAs based on monoclonal antibody-captured native or baculovirus-expressed N antigens showed optimal sensitivities and specificities, while the assays based on E. coli-expressed N did not detect all PUU virus IgG-positive serum samples. A commercially available PUU virus IgG ELISA based on E. coli-expressed amino-terminal N showed a significantly lower sensitivity than those of all other IgG assays.
authors.affiliation: Swedish Institute for Infectious Disease Control, Stockholm.
authors.forename: K B
authors.initials: KB
authors.lastname: Sjölander
authors.forename: F
authors.initials: F
authors.lastname: Elgh
authors.forename: H
authors.initials: H
authors.lastname: Kallio-Kokko
authors.forename: O
authors.initials: O
authors.lastname: Vapalahti
authors.forename: M
authors.initials: M
authors.lastname: Hägglund
authors.forename: V
authors.initials: V
authors.lastname: Palmcrantz
authors.forename: P
authors.initials: P
authors.lastname: Juto
authors.forename: A
authors.initials: A
authors.lastname: Vaheri
authors.forename: B
authors.initials: B
authors.lastname: Niklasson
authors.forename: A
authors.initials: A
authors.lastname: Lundkvist
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D000918:Antibody Specificity; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods* / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D005455:Fluorescent Antibody Technique / Q000706:statistics & numerical data; D006476:Orthohantavirus / Q000276:immunology; D018778:Hantavirus Infections / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D009500:Neutralization Tests / Q000706:statistics & numerical data; D019251:Nucleocapsid / Q000276:immunology; D019590:Nucleocapsid Proteins; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods* / Q000706:statistics & numerical data; D014773:Virology / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D019590:Nucleocapsid Proteins; C100886:nucleocapsid protein, Puumala virus