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Evaluation of IgM Antibody Capture Enzyme-Linked Immunosorbent Assay Kits for Detection of IgM against Japanese Encephalitis Virus in Cerebrospinal Fluid Samples

Infection with Japanese encephalitis virus (JEV) is a major public health problem in Asia. Detection of JEV-specific IgM in serum and cerebrospinal fluid (CSF) by the IgM antibody capture enzyme-linked immunosorbent assay (MAC-ELISA) is currently the most widely used diagnostic method to detect JEV infection. Because of the possible presence of IgM cross-reactivity with other flaviviruses in serum and the high ratio of inapparent-to-apparent JEV infections, a positive result in serum only suggests a recent infection and not necessarily an encephalitic illness caused by JEV. Consequently, detection of JEV-specific IgM in CSF assumes great diagnostic relevance. We evaluated two commercial JEV MAC-ELISA kits using 60 CSF samples obtained from patients with acute encephalitis syndrome. The Panbio and XCyton kits had sensitivities of 65–80% and 95% and specificities of 90% and 97.5%, respectively. Performance information on these commercial JEV MAC-ELISA kits for CSF should assist in laboratory-based JE surveillance programs.

Received March 17, 2009. Accepted for publication July 30, 2009.

Acknowledgments: We thank the manufacturers of the Panbio and XCyton diagnostic kits for submitting their assays for evaluation; Kamala J. Sondekoppa (technician, Department of Neurovirology, NIMHANS) for initial characterization of samples; the director of NIMHANS, for support; and Amanda Panella, Janeen Laven, and Olga Kosoy (Arboviral Diseases Diagnostic Laboratory, Division of Vector-Borne Infectious Diseases [DVBID], CDC) for assistance.

Financial support: Testing of samples at DVBID/CDC was provided by the Acute Meningitis-Encephalitis Syndrome Surveillance project of the CDC Global Disease Detection and Response Initiative.

^* Address correspondence to Barbara W. Johnson, Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, 3150 Rampart Road, Fort Collins, CO 80521. E-mail: bfj9{at}cdc.gov

Authors’ addresses: Vasanthapuram Raviand Anita Desai, Department of Neurovirology, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, India. Jaimie S. Robinson, Brandy J. Russell, and Barbara W. Johnson, Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, 3150 Rampart Road, Fort Collins, CO 80521. Nalini Ramamurty, Immunization and Vaccine Development, World Health Organization South East Asia Regional Office, New Delhi, India. David Featherstone, Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland.