Volume 86, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Rabies diagnosis uses a direct fluorescent antibody test (FAT) that is difficult, costly, and time-consuming, and requires trained personnel. We developed a rapid immunochromatographic test (RICT) for the diagnosis of rabies. The efficacy of the RICT was compared with that of the FAT. Brain samples were collected from humans, dogs, cats, and other animals in Sri Lanka (n = 248), Bhutan (n = 27), and Thailand (n = 228). The sensitivity (0.74–0.95), specificity (0.98–1.0), positive predictive value (0.98–1.0), negative predictive value (0.75–0.97), accuracy (0.91–0.98), and kappa measure of agreement (0.79–0.93) were all satisfactory for animal samples and samples preserved in 50% glycerol saline solution. Because the RICT showed high sensitivity but low specificity with human brain samples, it is unsuitable for confirming rabies in humans. No amino acid substitutions were found in the antibody attachment sites of the nucleoprotein gene with FAT-positive, RICT-negative samples. The RICT is reliable, user friendly, rapid, robust, and can be used in laboratories with a modest infrastructure.


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  1. Wunner WH, Briggs DJ, , 2010. Rabies in the 21 century. PLoS Negl Trop Dis 4: e591.[Crossref]
  2. Knobel DL, Cleaveland S, Coleman PG, Fevre EM, Meltzer MI, Miranda ME, Shaw A, Zinsstag J, Meslin FX, , 2005. Re-evaluating the burden of rabies in Africa and Asia. Bull World Health Organ 83: 360368.
  3. Whitby JE, Johnstone P, Sillero-Zubiri C, , 1997. Rabies virus in the decomposed brain of an Ethiopian wolf detected by nested reverse transcription-polymerase chain reaction. J Wildl Dis 33: 912915.[Crossref]
  4. Crepin P, Audry L, Rotivel Y, Gacoin A, Caroff C, Bourhy H, , 1998. Intravitam diagnosis of human rabies by PCR using saliva and cerebrospinal fluid. J Clin Microbiol 36: 11171121.
  5. Wacharapluesadee S, Hemachudha T, , 2001. Nucleic-acid sequence based amplification in the rapid diagnosis of rabies. Lancet 358: 892893.[Crossref]
  6. Dacheux L, Wacharapluesadee S, Hemachudha T, Meslin FX, Buchy P, Reynes JM, Bourhy H, , 2010. More accurate insight into the incidence of human rabies in developing countries through validated laboratory techniques. PLoS Negl Trop Dis 4: e765.[Crossref]
  7. Fooks AR, Johnson N, Freuling CM, Wakeley PR, Banyard AC, McElhinney LM, Marston DA, Dastjerdi A, Wright E, Weiss RA, Muller T, , 2009. Emerging technologies for the detection of rabies virus: challenges and hopes in the 21st century. PLoS Negl Trop Dis 3: e530.[Crossref]
  8. Lembo T, Niezgoda M, Velasco-Villa A, Cleaveland S, Ernest E, Rupprecht CE, , 2006. Evaluation of a direct, rapid immunohistochemical test for rabies diagnosis. Emerg Infect Dis 12: 310313.[Crossref]
  9. Durr S, Naissengar S, Mindekem R, Diguimbye C, Niezgoda M, Kuzmin I, Rupprecht CE, Zinsstag J, , 2008. Rabies diagnosis for developing countries. PLoS Negl Trop Dis 2: e206.
  10. Kang B, Oh J, Lee C, Park BK, Park Y, Hong K, Lee K, Cho B, Song D, , 2007. Evaluation of a rapid immunodiagnostic test kit for rabies virus. J Virol Methods 145: 3036.[Crossref]
  11. Irwig L, Bossuyt P, Glasziou P, Gatsonis C, Lijmer J, , 2002. Designing studies to ensure that estimates of test accuracy are transferable. BMJ 324: 669671.[Crossref]
  12. Nishizono A, Khawplod P, Ahmed K, Goto K, Shiota S, Mifune K, Yasui T, Takayama K, Kobayashi Y, Mannen K, Tepsumethanon V, Mitmoonpitak C, Inoue S, Morimoto K, , 2008. A simple and rapid immunochromatographic test kit for rabies diagnosis. Microbiol Immunol 52: 243249.[Crossref]
  13. Wunner WH, Larson JK, Dietzschold B, Smith CL, , 1988. The molecular biology of rabies viruses. Rev Infect Dis 10 (Suppl 4): S771S784.[Crossref]
  14. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Moher D, Rennie D, de Vet HC, Lijmer JG, , 2003. The STARD statement for reporting studies of diagnostic accuracy: explanation and elaboration. Clin Chem 49: 718.[Crossref]
  15. Tierkel ES, Atanasiu P, Meslin FX, Kaplan MM, Koprowski H, , 1996. Rapid microscopic examination for Negri bodies and preparation of specimens for biological tests., eds. Laboratory Techniques in Rabies. Geneva: World Health Organization, 5565.
  16. Koprowski H, Meslin FX, Kaplan MM, Koprowski H, , 1996. The mouse inoculation test., eds. Laboratory Techniques in Rabies. Geneva: World Health Organization, 8087.
  17. Matsumoto T, Ahmed K, Wimalaratne O, Yamada K, Nanayakkara S, Perera D, Karunanayake D, Nishizono A, , 2010. Whole-genome analysis of a human rabies virus from Sri Lanka. Arch Virol 156: 659669.[Crossref]
  18. Altman DG, , 1991. Practical Statistics for Medical Research. London: Chapman and Hall.
  19. Iwasaki T, Inoue S, Tanaka K, Sato Y, Morikawa S, Hayasaka D, Moriyama M, Ono T, Kanai S, Yamada A, Kurata T, , 2004. Characterization of Oita virus 296/1972 of Rhabdoviridae isolated from a horseshoe bat bearing characteristics of both lyssavirus and vesiculovirus. Arch Virol 149: 11391154.[Crossref]
  20. Bourhy H, Dautry-Varsat A, Hotez PJ, Salomon J, , 2010. Rabies, still neglected after 125 years of vaccination. PLoS Negl Trop Dis 4: e839.[Crossref]
  21. Xu G, Weber P, Hu Q, Xue H, Audry L, Li C, Wu J, Bourhy H, , 2007. A simple sandwich ELISA (WELYSSA) for the detection of lyssavirus nucleocapsid in rabies suspected specimens using mouse monoclonal antibodies. Biologicals 35: 297302.[Crossref]
  22. Kasempimolporn S, Saengseesom W, Lumlertdacha B, Sitprija V, , 2000. Detection of rabies virus antigen in dog saliva using a latex agglutination test. J Clin Microbiol 38: 30983099.
  23. Peeling RW, Smith PG, Bossuyt PM, , 2006. A guide for diagnostic evaluations. Nat Rev Microbiol 4: S2S6.[Crossref]
  24. Tepsumethanon V, Lumlertdacha B, Mitmoonpitak C, Fagen R, Wilde H, , 1997. Fluorescent antibody test for rabies: prospective study of 8,987 brains. Clin Infect Dis 25: 14591461.[Crossref]
  25. Tucker JD, Bu J, Brown LB, Yin YP, Chen XS, Cohen MS, , 2010. Accelerating worldwide syphilis screening through rapid testing: a systematic review. Lancet Infect Dis 10: 381386.[Crossref]

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  • Received : 24 May 2011
  • Accepted : 26 Nov 2011

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