Comparative Evaluation of the Indirect Immunoperoxidase Test for the Serodiagnosis of Rickettsial Disease

Daryl J. KellyU.S. Army Medical Research Unit, Institute for Medical Research, 50588 Kuala Lumpur, Malaysia

Search for other papers by Daryl J. Kelly in
Current site
Google Scholar
PubMed
Close
,
P. W. WongU.S. Army Medical Research Unit, Institute for Medical Research, 50588 Kuala Lumpur, Malaysia

Search for other papers by P. W. Wong in
Current site
Google Scholar
PubMed
Close
,
Elsie GanU.S. Army Medical Research Unit, Institute for Medical Research, 50588 Kuala Lumpur, Malaysia

Search for other papers by Elsie Gan in
Current site
Google Scholar
PubMed
Close
, and
George E. Lewis Jr.U.S. Army Medical Research Unit, Institute for Medical Research, 50588 Kuala Lumpur, Malaysia

Search for other papers by George E. Lewis Jr. in
Current site
Google Scholar
PubMed
Close
Restricted access

An indirect immunoperoxidase test was compared with an indirect fluorescent antibody test and the Weil-Felix OXK test for serodiagnosis of scrub typhus by measuring the rickettsial antigen specific activity of IgG, IgM, and whole globulin. Acute and convalescent sera from 50 Rickettsia tsutsugamushi isolate-positive scrub typhus patients and from 45 febrile patients diagnosed as having diseases other than scrub typhus were tested. The receiver operating characteristic for each test showed that the indirect immunoperoxidase and indirect fluorescent antibody tests were more sensitive and specific than the Weil-Felix test using convalescent and acute as well as paired sera. The indirect immunoperoxidase test showed no cross-reactivity when R. tstusugamushi antigen was tested against sera collected from patients living outside the scrub typhus-endemic area with diseases other than scrub typhus. The indirect immunoperoxidase and indirect fluorescent antibody tests were comparable in measured response to R. tsutsugamushi, R. typhi, and TT-118 (spotted fever group) antigen. Thus the indirect immunoperoxidase test represents a sensitive, specific, reproducible, and practical semiquantitative test for rickettsial disease diagnosis.

Save