Abstract

Background
Three commercial EIA tests for the detection of anti-B19V IgM were compared in samples from patients suspected of having measles to identify the best test to perform a differential diagnosis of rash diseases.
Material and Method
A total of 208 serum samples which fulfilled WHO recommendations for clinically suspected measles (fever and maculopapular rash) were investigated according to the WHO program of measles/rubella elimination for the presence of anti-measles virus (MeV) and anti-rubella virus (RUBV) IgM and then were tested by three commercially available EIA kits for anti-B19V IgM (Mikrogen, Biotrin, and DRG).
Results
Of the 208 samples, 21.6% and 28.4% were positive for anti-MeV and anti-RUBV IgM, respectively. Different numbers of positive samples for anti-B19V IgM were observed with the Mikrogen (14.4%), Biotrin (5.8%), and DRG (5.3%) tests. One hundred seventy-eight of the 208 samples had concordant results using all three tests: 6 concordant positive and 172 concordant negative. Samples with discrepant results were tested by PCR. Based on PCR and IgM detection, consensus values were generated and the numbers of true positive (21) and true negative (187) results were assumed. Comparison of the consensus values and the results obtained from the Mikrogen, Biotrin, and DRG tests revealed test sensitivities of 76.2%, 52.4%, and 52.4% and specificities of 92.5%, 99.5%, and 100%, respectively.
Conclusions
Although the three EIA tests for anti-B19 IgM detection showed good parameters for the differential diagnosis of measles/rubella, tests with a high specificity should be used.

Keywords: Polymerase Chain Reaction, Parvovirus B19, Human - immunology, Measles - immunology, Immunoenzyme Techniques - methods, Diagnosis, Differential, Cross Reactions, Sensitivity and Specificity