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Comparison of mumps-IgM ELISAs in acute infection
Claudia H Krause1, Pamela J Molyneaux, Darrel O Ho-Yen
1Specialist Virology Centre, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, United Kingdom. Claudia.Krause@luht.scot.nhs.uk
Background:
In Scotland there has been an outbreak of mumps with over 4000 confirmed cases in the last 2 years. As laboratory diagnosis is usually requested on patients with symptoms, a prompt diagnosis early in the illness is required.
Objectives:
To assess the performance of the five different commercial IgM-ELISAs used in Scottish Virus laboratories.
Study Design:
The Specialist Virology Laboratory (SVC) Edinburgh distributed a serum panel to all Scottish laboratories that diagnose mumps by IgM-ELISA. The panel consisted of 45 sera from patients with confirmed mumps (date of onset known for 44/45) and 11 sera from patients with alternative diagnoses. Each laboratory performed their own commercial IgM-ELISAs blindly and reported results to the SVC Edinburgh.
Results:
Sensitivity ranged from 24% to 51%. Assays performed better on samples taken later than 10 days after onset of symptoms. Specificity was about 82% for most assays.
Conclusion:
The sensitivity of commercial mumps IgM-ELISAs varied greatly. The Microimmune mumps-IgM ELISA had the best overall sensitivity in acute serum specimens. Diagnostic laboratories should be developing the means to perform direct detection of mumps virus for acute presentation and requesting convalescent bloods, if acute blood samples have no detectable IgM.
Insights
Commercial mumps IgM-ELISA tests show variable sensitivity, with one assay performing best in early illness. Prompt diagnosis requires improved laboratory methods for mumps virus detection.
Area of Science:
- Virology
- Immunology
- Diagnostic Assay Development
Background:
- Scotland experienced a significant mumps outbreak with over 4000 cases in two years.
- Prompt laboratory diagnosis of mumps is crucial for effective patient management during outbreaks.
Purpose of the Study:
- To evaluate the diagnostic performance of five commercial IgM-ELISAs for mumps detection.
- To compare the sensitivity and specificity of different IgM-ELISA kits used in Scottish laboratories.
Main Methods:
- A standardized serum panel with confirmed mumps and alternative diagnoses was distributed to laboratories.
- Laboratories performed blinded testing using their routine commercial IgM-ELISAs.
- Results were reported to a central laboratory for analysis.
Main Results:
- Mumps IgM-ELISA sensitivity varied widely, ranging from 24% to 51%.
- Assay performance improved with samples collected more than 10 days post-symptom onset.
- Specificity was generally high, around 82% for most tested assays.
Conclusions:
- There is significant variability in the sensitivity of commercial mumps IgM-ELISAs.
- The Microimmune mumps-IgM ELISA demonstrated the best sensitivity for acute serum samples.
- Laboratories should consider direct mumps virus detection methods and the use of convalescent samples for improved diagnosis.
