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Serological Differences after Acute Zika Virus Infections between Children and Adults: Implication for Use of a Serological Test

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  • 1 Bamrasnaradura Infectious Diseases Institute, Department of Diseases Control, Ministry of Public Health, Nonthaburi, Thailand;
  • | 2 National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand

ABSTRACT.

Information is limited regarding differential serological responses after acute Zika virus (ZIKV) infections and prevalence of cross-reactivity with anti-dengue virus (DENV) assays comparing children and adults. Early convalescent sera from a cohort of suspected mild DENV cases between December 2016 and September 2018 at Bamrasnaradura Infectious Diseases Institute in Thailand were tested for nonstructural protein 1 (NS1)–based anti-ZIKV IgM and IgG ELISAs (Euroimmun), and in-house anti-DENV IgM- and IgG-capture ELISAs. ZIKV cases were identified by positive real-time reverse transcriptase-polymerase chain reaction on urine. Sera from 26 (10 children and 16 adults) ZIKV and 227 (153 children and 74 adults) non-ZIKA cases collected at the median duration of 18 days (interquartile range [IQR] 18,19) post-onset of symptoms were tested. Comparing pediatric ZIKV to adult ZIKV cases, the mean anti-ZIKV IgM ratio was higher (2.12 versus 1.27 units, respectively; P = 0.07), whereas mean anti-ZIKV IgG ratio was lower (3.13 versus 4.24 units, respectively; P = 0.03). Sensitivity of anti-ZIKV IgM and specificity of anti-ZIKV IgG in pediatric ZIKV were higher than in adult ZIKV cases (80.0% versus 43.7% and 79.1% versus 43.2%, respectively). No cross-reactivity with anti-DENV IgM- and IgG-capture ELISA were reported in pediatric ZIKV cases in our study, whereas 25% and 12.5% were found in adult ZIKV cases, respectively. Age-related ZIKV serological differences have been observed. Positive NS1-based anti-ZIKV IgM and IgG ELISA at the early convalescent phase could be useful for ZIKV diagnosis in children, even in a dengue endemic setting.

Author Notes

Address correspondence to Jurai Wongsawat, Bamrasnaradura Infectious Diseases Institute, 38, Soi Tiwanon 14, Taladkwan, Muang, Nonthaburi 11000, Thailand. E-mail: juraiw@hotmail.com

Financial support: This work was supported by the Health Systems Research Institute, Thailand, grant number 59-077.

Disclosure: This study was approved by the Institutional Review Board of Bamrasnaradura Infectious Diseases Institute, Department of Disease Control, Ministry of Public Health, Thailand.

Authors’ addresses: Jurai Wongsawat, Patama Suttha, Somkid Srisopha, Nichapa Yonchoho, and Putiporn Limpanadusadee, Bamrasnaradura Infectious Diseases Institute, Department of Diseases Control, Ministry of Public Health, Nonthaburi, Thailand, E-mails: juraiw@hotmail.com, mueyeing64@gmail.com, s.srisopha@gmail.com, thongdee1010@gmail.com, and limgimoong@gmail.com. Sumalee Chanama, National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand, E-mail: sumalee.c@dmsc.mail.go.th.

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