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Evaluation of a rapid test for the detection of Tick Borne Encephalitis (TBE) IgM in serum and CSF
Department of Laboratory Medicine, Faculty of Medicine and Health, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
Department of Laboratory Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
Department of Clinical Microbiology Kronoberg County, Karlskrona, Sweden.
Department of Clinical Microbiology Kronoberg County, Karlskrona, Sweden.
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2016 (English)In: Journal of Clinical Virology, ISSN 1386-6532, E-ISSN 1873-5967, Vol. 82, p. S29-S30Article in journal (Refereed) Published
Abstract [en]

Introduction: The incidence of Tick-borne encephalitis (TBE) is increasing with 150–300 cases reported in Sweden annually. The clinical picture can be hard to differentiate from other causes of encephalitis and a rapid reliable diagnosis is therefore important. The laboratory diagnosis of TBE relies on ELISA-based testing to determine specific anti-TBE IgM and IgG in serum and in CSF. The aim of this study was to evaluate the ReaScan TBE IgM rapid test (Reagena, Toivala, Finland), a qualitative immune-chromatographic lateral flow assay for the rapid detection of TBE IgM in serum and CSF.

Materials and methods: The material consisted of two blinded panels of serum and CSF. (1) 16 serum samples previously analyzed for TBE IgM and IgG using ELISA (Euroimmun) at the department of Clinical Microbiology Kronoberg County. Six of these were positive for TBE IgM, three of which had a matching CSF sample. (2) Seven (7) serum samples (6 with matching CSF samples) from patients diagnosed with TBE in Örebro County during 2015 based on IgM positivity (Immunozym) performed at the Dept of Clinical Virology, Karolinska University Hospital. All samples were analyzed using the ReaScan TBE IgM rapid test according to the manufacturer’s instructions.

Results: The results obtained using ReaScan were in full concordance with the Euroimmun IgM assay for all 16 serum-samples from Kronoberg County. Of the 7 serum samples from Örebro 5 were positive for IgM with both ReaScan and Euroimmun with the remaining 2 samples being classified as Equivocal with Reascan and negative with Euroimmun. Of the 9 CSF samples tested, 2 were positive, 2 equivocal and 5 negative. The two CSF-samples with equivocal result and three of the negative CSF samples had corresponding serum samples that were positive for TBE IgM using Reascan.

Conclusions: According to this small evaluation the ReaScan IgM rapid test seems to have a comparable performance to two commercially available ELISA assays (Euroimmun and Immunozym) for the detection of TBE IgM in serum. The two samples with equivocal Reascan-result originated from one patient on immunosuppression and one who acquired TBE despite vaccination. As others have shown the additive value of testing for IgM in CSF might be limited as only two out of nine samples here tested were positive. The Reascan TBE IgM assay seems as a valid diagnostic option for a rapid diagnosis of TBE. Additional ELISA with analysis of both IgM and IgG as well as molecular detection of TBE might be performed as confirmatory tests.

Place, publisher, year, edition, pages
Elsevier, 2016. Vol. 82, p. S29-S30
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Medical Biotechnology
Identifiers
URN: urn:nbn:se:oru:diva-54938DOI: 10.1016/j.jcv.2016.08.057ISI: 000390584800057OAI: oai:DiVA.org:oru-54938DiVA, id: diva2:1068336
Available from: 2017-01-25 Created: 2017-01-25 Last updated: 2018-07-23Bibliographically approved

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