Volume 94, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Japanese encephalitis virus (JEV) is the leading cause of pediatric viral neurological disease in Asia. The JEV-specific IgM antibody-capture enzyme-linked immunosorbent assay (MAC-ELISA) in cerebrospinal fluid (CSF) and serum is the recommended method of laboratory diagnosis, but specificity of JEV MAC-ELISA can be low due to cross-reactivity. To increase the specificity of the commercially available JE MAC-ELISA (JE ), a differential testing algorithm was developed in which samples tested by JE with positive results were subsequently tested by the DEN MAC-ELISA (DEN ) kit, and results of both tests were used to make the final interpretation. The testing algorithm was evaluated with a reference panel of serum and CSF samples submitted for confirmatory testing. In serum, the false Japanese encephalitis (JE) positive rate was reduced, but sequential testing in CSF resulted in reduced JE specificity, as true JEV+ CSF samples had positive results by both JE and DEN and were classified as JE− (dengue virus [DENV]+). Differential diagnosis of JE by sequential testing with JE and DEN increased specificity for JE in serum, but more data with CSF is needed to make a final determination on the usefulness of this testing algorithm for CSF.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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  • Received : 27 Aug 2015
  • Accepted : 15 Dec 2015
  • Published online : 06 Apr 2016

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