Accuracy of rotavirus diagnosis: modified genome electrophoresis versus electron microscopy

530 human faecal samples were examined for the presence of rotavirus by electron microscopy (EM) and by a modified electrophoretic analysis of viral genome (PAGE). 516 stools gave identical results by both methods (97.4% agreement). The proportion of EM+, PAGE- samples (1/530) was significantly lower than the proportion of EM-, PAGE + samples (13/530) (P less than 0.01 with McNemar test). Relative sensitivity was 99.6% for PAGE and 95% for EM. False positive results could be excluded for each method because of the characteristic morphology of rotavirus particles (EM) and specificity of rotavirus electrophoretypes (PAGE). Discrepant cases were reexamined whenever possible and the causes of misdiagnosis are discussed.