RESUMEN
Dengue virus (DENV) is the most prevalent arbovirus in the world, found mainly in tropical regions. As clinical manifestations present frequently as nonspecific febrile illness, laboratory diagnosis is essential to confirm DENV infections and for epidemiological studies. Recombinant envelope (E) antigens of four serotypes of DENV were used to develop an immunoglobulin G enzyme-linked immunosorbent assay (IgG-ELISA). To evaluate the IgG-ELISA, a panel of serum samples that had been tested previously by a plaque reduction neutralization test (PRNT) was investigated for the presence of anti-E antibodies against the four DENV serotypes. IgG-ELISA was found to have a sensitivity (91%) and specificity (98%) at a receiver-operating characteristic (ROC) optimized cutoff and demonstrated high performance as well as good indexes. A concordance of 97% was achieved between both assays, and only 21/704 (3%) samples were not concordant. The results of the present study demonstrate a moderate correlation between neutralizing antibody titers and IgG-ELISA values. These findings indicate that the recombinant protein-based IgG-ELISA is a suitable method for routine serodiagnosis, monitoring and seroepidemiological studies of DENV infections.
Asunto(s)
Anticuerpos Antivirales/sangre , Virus del Dengue/inmunología , Dengue/diagnóstico , Ensayo de Inmunoadsorción Enzimática , Proteínas del Envoltorio Viral/inmunología , Anticuerpos Neutralizantes/sangre , Anticuerpos Antivirales/inmunología , Antígenos Virales/inmunología , Dengue/inmunología , Dengue/virología , Virus del Dengue/clasificación , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Pruebas de Neutralización , Proteínas Recombinantes/inmunología , Sensibilidad y Especificidad , Estudios Seroepidemiológicos , Pruebas SerológicasRESUMEN
BACKGROUND: Bovine vaccinia is an exanthematic disease caused by Vaccinia virus (VACV). This zoonosis has been associated with several cases of bovine infection, particularly in milk herds. Farmers, milkers and their close contacts developed lesions on the hands, forearms, legs and face accompanied by fever, headache, malaise, myalgia and axillary, inguinal and cervical lymphadenopathy. VACV infections have a significant public health impact due to their occupational character, high frequency of transmission and the improper medical treatment often applied. OBJECTIVES: To study natural human infection by VACV and to analyze clinical and epidemiological aspects, emphasizing the patients' immunological status. STUDY DESIGN: Ninety-eight individuals from rural properties with bovine vaccinia (BV) outbreaks who were at risk due to contact were submitted to epidemiological and clinical studies. From these individuals, 54 sera were analyzed by serological and molecular procedures. This study was conducted in Rio de Janeiro State from September 2002 to October 2006. RESULTS: The clinical frequency of infection was 52.0%, with 57.4% ELISA and 43.0% PRNT-positive reactions. DNAemia was detected in 18.5% of the analyzed sera, and 50% of smallpox-vaccinated individuals developed symptoms. CONCLUSIONS: This study confirms the high clinical frequency of human VACV infection, even among vaccinated individuals. The infection was related to detection of IgG- or IgM-specific antibodies that correlates in most of the cases with positive PRNT. The DNAemia suggests viremia during VACV natural infections. Our data indicate that patients vaccinated against smallpox may no longer be protected.