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. 2017 Jun;55(6):1894-1901.
doi: 10.1128/JCM.00346-17. Epub 2017 Apr 5.

Sensitivity and Kinetics of an NS1-Based Zika Virus Enzyme-Linked Immunosorbent Assay in Zika Virus-Infected Travelers from Israel, the Czech Republic, Italy, Belgium, Germany, and Chile

Affiliations

Sensitivity and Kinetics of an NS1-Based Zika Virus Enzyme-Linked Immunosorbent Assay in Zika Virus-Infected Travelers from Israel, the Czech Republic, Italy, Belgium, Germany, and Chile

Yaniv Lustig et al. J Clin Microbiol. 2017 Jun.

Abstract

Serological diagnosis of Zika virus is challenging due to high cross-reactivity of Zika virus with other flavivirus antibodies. Recently, a Zika NS1-based enzyme-linked immunosorbent assay (ELISA) was developed and shown to be highly specific for Zika antibody detection; however, sensitivity was evaluated for only a small number of confirmed Zika-infected patients. In this study, we measured the sensitivity and kinetics of Zika IgM and IgG antibodies using the Zika NS1-based ELISA in 105 samples from 63 returning travelers infected with Zika virus (proven by PCR or neutralization assay) from Israel, Czech Republic, Italy, Belgium, Germany, and Chile. Zika virus IgM was detected from 2 to 42 days post-symptom onset (PSO) with an overall sensitivity of 79% in the first month and 68% until 2 months PSO, while IgG antibodies were detected from 5 days to 3 years PSO with 79% sensitivity. Interestingly, significant differences in IgM sensitivity and IgM detection period were observed between Israeli and European/Chilean Zika-infected travelers, adding to the complexity of Zika infection diagnosis and suggesting that other diagnostic methods should be complemented to reduce false-negative results.

Keywords: ELISA; NS1; Zika; sensitivity; travelers.

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Figures

FIG 1
FIG 1
Overall performance of Zika NS1-based ELISA. A total of 105 samples from ZIKV-infected travelers returning from areas where ZIKV is endemic were tested with IgM and IgG Zika NS1-based ELISA. Number of samples for each day post-symptom onset (A) and percentage of samples obtained 1 to 7, 8 to 26, 27 to 61, and>61 days post-symptom onset (B) are presented. Negative (Neg), positive (Pos), and equivocal IgM and IgG antibodies are indicated.
FIG 2
FIG 2
Differential sensitivity of IgM antibodies in Zika NS1-based ELISA. Samples obtained from travelers from Israel and European/Chilean countries with neutralization or RT-PCR-positive ZIKV infection were subjected to IgM and IgG Zika NS1-based ELISA. (A) Percent of negative (Neg), positive (Pos), and equivocal IgM and IgG antibody results from samples obtained 1 to 7, 8 to 26, 27 to 61, and>61 days post-symptom onset are presented. Number of samples in each time frame is indicated. (B) IgM detection rate of samples obtained from Zika-Infected patients; 1 to 26 and 1 to 61 days post-symptom onset in European/Chilean and Israeli travelers are presented. **, P value of <0.05.

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