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Am. J. Trop. Med. Hyg., 80(5), 2009, pp. 837-840
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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Comparison of Indirect Immunofluorescence Assays for Diagnosis of Scrub Typhus and Murine Typhus Using Venous Blood and Finger Prick Filter Paper Blood Spots

Rattanaphone Phetsouvanh, Stuart D. Blacksell, Kemajittra Jenjaroen, Nicholas P. J. Day, AND Paul N. Newton*
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic; Centre for Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

We performed indirect immunofluorescence assays (IFAs) to compare levels of IgM and IgG antibodies to Orientia tsutsugamushi and Rickettsia typhi in admission-phase serum samples and filter paper blood spots (assayed immediately and stored at 5.4°C and 29°C for 30 days) collected on the same day from 53 adults with suspected scrub typhus and murine typhus admitted to Mahosot Hospital Vientiane, Lao People’s Democratic Republic. The sensitivities and specificities of admission-phase filter paper blood spots in comparison to paired sera were between 91% and 95% and 87% and 100%, respectively, for the diagnosis of scrub typhus and murine typhus. The classification of patients as having or not having typhus did not significantly differ after storage of the blood spots for 30 days (P > 0.4) at 5.4°C and 29°C. Because filter paper blood samples do not require sophisticated and expensive storage and transport, they may be an appropriate specimen collection technique for the diagnosis of rickettsial disease in the rural tropics.

Received November 15, 2008. Accepted for publication February 17, 2009.

Acknowledgments: We thank the patients who participated in this study; and the doctors and nursing staff of Infectious Disease Adults ward; the staff of the Microbiology Laboratory Mahosot Hospital; the Director of Mahosot Hospital; Nicholas J White; the Australian Rickettsial Reference Laboratory; and Didier Raoult, Florence Fenollar, and Jean-Marc Rolain (University of Marseille, Marseille, France) for advice and assistance.

Financial support: This study was supported by the Wellcome Trust of Great Britain as part of the Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration.

* Address correspondence to Paul N. Newton, Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic. E-mail: paul{at}tropmedres.ac

Authors’ addresses: Rattanaphone Phetsouvanh and Paul N. Newton, Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic and Centre for Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, OX3 7LJ, United Kingdom. Stuart D. Blacksell and Nicholas P. J. Day, Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic, Centre for Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, OX3 7LJ, United Kingdom, and Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok 10400, Thailand. Kemajittra Jenjaroen, Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic and Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok 10400, Thailand.






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Copyright © 2009 by the American Society of Tropical Medicine and Hygiene.