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Evaluation of measles IgM antibody detection assays during the 2018-2019 outbreak in New York State
Kyle J Carson1, Heidi R Tucker1, Kelly Howard1
1The Wadsworth Center, New York State Department of Health, Albany, NY, USA.
Abstract:
Although measles was eliminated in the United States in 2000, a severe outbreak occurred between October 2018 and September 2019. New York was especially hard hit. Serology played an integral role in determining immune status (IgG) and identifying, along with molecular analyses, acute measles infections (IgM). Although an indirect immunofluorescence assay (IFA) was historically used by the New York State Department of Health for measles IgM detection, a higher throughput assay was needed to address the increased specimen numbers. Four commercial enzyme-linked immunosorbent assays (ELISAs) were evaluated for sensitivity and specificity in detecting measles IgM. Two ELISA formats were compared, indirect ELISA and IgM antibody capture. Both formats had comparable specificity as determined by cross-reactivity to non-measles specimens. Overall, the sensitivity of the capture ELISAs was greater than the indirect ELISAs and comparable to the indirect immunofluorescence assay with benefits regarding capacity, cost, and turnaround time.
Insights
During a measles outbreak, new enzyme-linked immunosorbent assays (ELISAs) were evaluated. IgM antibody capture ELISAs showed high sensitivity and specificity for measles detection, improving on older methods.
Area of Science:
- Immunology
- Virology
- Public Health
Background:
- Measles was eliminated in the US in 2000 but re-emerged in a significant outbreak from 2018-2019, particularly in New York.
- Serological assays are crucial for determining immune status (IgG) and diagnosing acute infections (IgM).
- The New York State Department of Health required a higher throughput assay for measles IgM detection beyond the traditional indirect immunofluorescence assay (IFA).
Purpose of the Study:
- To evaluate the sensitivity and specificity of four commercial enzyme-linked immunosorbent assays (ELISAs) for detecting measles IgM.
- To compare indirect ELISA and IgM antibody capture formats for measles IgM detection.
- To identify a suitable replacement for the IFA with improved capacity, cost-effectiveness, and turnaround time.
Main Methods:
- Four commercial ELISA kits for measles IgM detection were assessed.
- Two ELISA formats, indirect ELISA and IgM antibody capture, were compared.
- Assay specificity was determined using cross-reactivity tests with non-measles specimens.
- Assay sensitivity was compared to the established indirect immunofluorescence assay (IFA).
Main Results:
- Both indirect and capture ELISA formats demonstrated comparable specificity against non-measles specimens.
- The sensitivity of IgM antibody capture ELISAs was superior to indirect ELISAs.
- The sensitivity of capture ELISAs was comparable to the traditional IFA method.
- ELISAs offered significant advantages in terms of specimen throughput, cost, and turnaround time.
Conclusions:
- Commercial IgM antibody capture ELISAs are effective and sensitive diagnostic tools for measles during outbreaks.
- These ELISAs provide a viable, high-throughput alternative to IFA for measles IgM detection.
- The adoption of capture ELISAs can enhance public health response capabilities during infectious disease outbreaks.
