title: Diagnostic rapid tests for acute hantavirus infections: specific tests for Hantaan, Dobrava and Puumala viruses versus a hantavirus combination test.
abstract: Hantaviruses infecting humans in Eurasia include Hantaan, Seoul, Puumala and the closely related Dobrava and Saaremaa viruses. These viruses are causative agents of hemorrhagic fever with renal syndrome (HFRS), which is recognized as a severe health care problem in several countries. Diagnostics of hantavirus infections relies on serology, performed principally with enzyme immunoassay (EIA) or immunofluorescence assay (IFA). We developed four 5-min immunochromatographic IgM-antibody tests for diagnostics of acute Puumala, Dobrava and Hantaan virus infections and a similar combination test to detect all Eurasian pathogenic hantavirus infections. We evaluated the assays using 100 fingertip blood samples collected randomly from Finnish volunteers, 28 confirmed hantavirus IgM-negative sera, and 77 sera from patients with acute infections of various hantaviruses. The specificities and sensitivities of the Puumala-, Dobrava- and Hantaan virus -specific tests varied from 96 to 100%, whereas, the combination test showed 96% specificity and 80 to 93% sensitivity. Cross-reactions were observed commonly between the Dobrava and the Hantaan virus tests, but only rarely between the Puumala and the Hantaan virus, or the Puumala and the Dobrava virus, tests. Altogether, the rapid tests showed less cross-reactivity than the respective EIA tests. According to the results, the performance of these tests meets well the requirements for diagnostic use. Nevertheless, the specific one-antigen tests were markedly more sensitive than the combination test. However, if optimized, a combination test would be suitable for regions where several hantaviruses circulate.
authors.affiliation: Department of Chemistry, University of Kuopio, PO Box 1627, FIN-70211, Kuopio, Finland. helena.hujakka@uku.fi
authors.forename: Helena
authors.initials: H
authors.lastname: Hujakka
authors.forename: Vesa
authors.initials: V
authors.lastname: Koistinen
authors.forename: Ilpo
authors.initials: I
authors.lastname: Kuronen
authors.forename: Pekka
authors.initials: P
authors.lastname: Eerikäinen
authors.forename: Markku
authors.initials: M
authors.lastname: Parviainen
authors.forename: Ake
authors.initials: A
authors.lastname: Lundkvist
authors.forename: Antti
authors.initials: A
authors.lastname: Vaheri
authors.forename: Olli
authors.initials: O
authors.lastname: Vapalahti
authors.forename: Ale
authors.initials: A
authors.lastname: Närvänen
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D016022:Case-Control Studies; D003429:Cross Reactions; D005260:Female; D018063:Hantaan virus / Q000276:immunology / Q000302:isolation & purification*; D006476:Orthohantavirus / Q000276:immunology / Q000302:isolation & purification*; D018778:Hantavirus Infections / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D006480:Hemorrhagic Fever with Renal Syndrome / Q000175:diagnosis / Q000276:immunology / Q000821:virology; D006801:Humans; D005779:Immunodiffusion / Q000379:methods; D008297:Male; D008875:Middle Aged; D029262:Puumala virus / Q000276:immunology / Q000302:isolation & purification*; D014773:Virology / Q000379:methods*
chemical_list: D000914:Antibodies, Viral