Usefulness of RT-PCR for the diagnosis of Japanese encephalitis in clinical samples

Scand J Infect Dis. 2008;40(10):815-20. doi: 10.1080/00365540802227102.

Abstract

The present study was carried out between July 2003 and December 2005 in PGIMER, Chandigarh, India and aimed to compare IgM capture ELISA and nested RT-PCR for the diagnosis of Japanese encephalitis (JE). The samples collected were cerebrospinal fluid and blood from 40 febrile patients with encephalitis (n=40, group I) and blood samples from febrile patients without encephalitis residing in JE endemic areas (n=45, group II). Overall, in CSF samples JE specific RNA was detected in 9/40 (22.5%), while 7/28 (25%) patients showed the presence of specific IgM antibodies. Only 28 CSF samples could be subjected to both RT-PCR and IgM and, among these, 13 cases were found to be confirmed JE based on IgM and/or RT-PCR positivity. Among the confirmed cases, 6 (6/13, 46.5%) could be detected by RT-PCR alone, 4 (4/13, 30.7%) by IgM capture ELISA and 3 (3/13, 23.1%) patients were positive by both the methods. All the RT-PCR positive cases had presented within 5 d of onset of illness. The serum samples of only 16 patients in group I could be tested for IgM antibodies and 5 (31.25%) were found to be positive, while in group II, 11.1% (5/45) positivity was observed. JE specific RNA could not be detected in serum samples of either group of patients. This study highlights the need for carrying out RT-PCR in CSF samples, compared to IgM antibody detection, for the early detection of JEV.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral / blood
  • Antibodies, Viral / cerebrospinal fluid
  • Chi-Square Distribution
  • Child, Preschool
  • Encephalitis Virus, Japanese / genetics
  • Encephalitis Virus, Japanese / immunology
  • Encephalitis Virus, Japanese / isolation & purification*
  • Encephalitis, Japanese / diagnosis*
  • Encephalitis, Japanese / immunology
  • Encephalitis, Japanese / virology
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Immunoglobulin M / blood
  • Immunoglobulin M / cerebrospinal fluid
  • India
  • Infant
  • Male
  • RNA, Viral / cerebrospinal fluid*
  • Reverse Transcriptase Polymerase Chain Reaction / methods*

Substances

  • Antibodies, Viral
  • Immunoglobulin M
  • RNA, Viral