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Challenges in diagnosing Zika-experiences from a reference laboratory n a non-endemic setting

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dc.contributor.author Van den Bossche, D. en_US
dc.contributor.author Michiels, J. en_US
dc.contributor.author Cnops, L. en_US
dc.contributor.author Foque, N. en_US
dc.contributor.author Meersman, K. en_US
dc.contributor.author Huits, R. en_US
dc.contributor.author Ariën, K. K. en_US
dc.contributor.author Van Esbroeck, M. en_US
dc.date.accessioned 2019-06-04T12:20:50Z
dc.date.available 2019-06-04T12:20:50Z
dc.date.issued 2019 en_US
dc.identifier.issn 0934-9723 en_US
dc.identifier.doi http://dx.doi.org/10.1007/s10096-019-03472-8 en_US
dc.identifier.other http://lib.itg.be/pdf/itg/2019/2019ejcm0001.pdf en_US
dc.identifier.other 36 en_US
dc.identifier.other ITG-C1A; ITG-B2A; ITG-C3A; ITG-C6A; ITG-B7A; ITG-CLA; MULTI; DCS; U-CLCB; U-TROPIC; U-HIVNTD; DBM; U-VIROL; JIF; DOI; PDF; Abstract; ITMPUB; DSPACE66 en_US
dc.identifier.uri http://hdl.handle.net/10390/10646
dc.description.abstract Diagnosing a patient with Zika infection is not always straightforward. Here, we aim to describe our data collected from December 2015 to December 2017 and discuss the implemented algorithm and diagnostic challenges we encountered. At the National Reference Center for Arboviruses at the Institute of Tropical Medicine, Antwerp, Belgium (ITM), a commercial Zika virus (ZIKV) enzyme-linked immunosorbent assay (ELISA) detecting immunoglobulin (Ig) M and IgG, a commercial ZIKV immunofluorescence assay (IFA) detecting IgM, and an in-house Zika virus neutralization test (VNT) were implemented. For molecular detection of ZIKV, an in-house and a commercial real-time RT-PCR were applied. An algorithm, adapted from the European Centre for Disease Control and Prevention (ECDC), was implemented. Between December 2015 and December 2017, we tested 6417 patients for ZIKV. Of those, according to ECDC criteria, 127 (2.0%) were classified as a confirmed Zika infection of which 39 by RT-PCR (0.6%), 15 (0.2%) as a probable Zika infection, 73 (1.1%) as undefined, and 65 (1.0%) as false positive reactions. Main challenges were the brief window for detection of IgM, cross-reactivity of antibodies with other flaviviruses and malaria, and low VNT titers in the acute phase. In RT-PCR negative samples, classification of ZIKV infection as recent or past proved difficult, when IgM was negative. The majority of patients could be classified according to ECDC criteria, though 1.1% of patients remained "undefined" and 1.0% were ELISA false positive reactions. Complementary IFA IgM was of added value to increase IgM detection rates. Improved serological assays and more longitudinal data on antibody kinetics are needed. en_US
dc.language English en_US
dc.relation.uri http://www.ncbi.nlm.nih.gov/pubmed/30680570 en_US
dc.subject Zika virus disease en_US
dc.subject Viral diseases en_US
dc.subject Diagnosis en_US
dc.title Challenges in diagnosing Zika-experiences from a reference laboratory n a non-endemic setting en_US
dc.type Article en_US
dc.citation.issue 4 en_US
dc.citation.jtitle European Journal of Clinical Microbiology and Infectious Diseases en_US
dc.citation.volume 38 en_US
dc.citation.pages 771-778 en_US
dc.citation.abbreviation Eur J Clin Microbiol Infect Dis en_US


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