Enzyme-linked immunosorbent assays in seroprevalence studies of Q fever: the need for cut-off adaptation and the consequences for prevalence data.
Large outbreaks of Q fever have recently increased the awareness of this disease as a public health issue. Knowledge of the general impact of Q fever relies mainly on seroprevalence studies and it is fundamental that seroprevalence is assessed accurately. Therefore we evaluated the few enzyme-linked immunosorbent assays (ELISAs) commercially available for this purpose. An outbreak in 2005 in Jena, a city of 100,000 inhabitants, gave us the opportunity for the evaluation. However, we found disappointingly low sensitivities for two (42% and 51%) of three commercial ELISAs for detecting past infection. Nevertheless, all assays had good classification potential but cut-off adaptation is needed. Based on the unequal worldwide distribution of the differently performing tests in studies, Q fever seroprevalence is likely to be underestimated in studies from Europe whereas the data from North America and Australia are likely to be more reliable.
Centre for Infectious Diseases and Infection Control,University Hospital Jena,Germany.
J
J
Frosinski
Institute of Medical Microbiology,University Hospital Jena,Germany.
B
B
Hermann
Institute of Transfusion Medicine,University Hospital Jena,Germany.
K
K
Maier
Institute of Laboratory Medicine,University Hospital Jena,Germany.
K
K
Boden
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D001315:Australia / Q000453:epidemiology; D002908:Chronic Disease; D016997:Coxiella burnetii / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D004812:Epidemiologic Methods; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D015995:Prevalence; D011778:Q Fever / Q000097:blood* / Q000453:epidemiology*; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies; D055815:Young Adult
D000907:Antibodies, Bacterial
Coxiella; Q fever; estimating disease prevalence; infectious disease epidemiology; zoonoses