Volume 23, Number 4—April 2017
Biologic Evidence Required for Zika Disease Enhancement by Dengue Antibodies
||Zika virus PCR positive or serologically positive symptomatic persons (i.e., with febrile illness, Guillain-Barré syndrome or congenital Zika syndrome) of any age who have convalescent-phase serum samples available to test for DENV IgG by ELISA.
||Serum samples from age-, sex-, residence-, and ethnicity-matched controls with blood drawn at about the same time as each index case-patient. Ratio: 4 controls to 1 index case-patient.
||1. Convalescent-phase serum samples from case-patients are tested by indirect pan-DENV IgG ELISA. (A positive result indicates that the Zika virus infection occurred in a DENV-immune person.)|
|2. Control serum samples are tested for Zika virus neutralizing antibodies.|
|3. Control serum samples are tested for past DENV infections by using indirect pan-DENV IgG ELISA.|
|4. DENV IgG ELISA–positive serum samples from case-patients and controls are tested for DENV serotypes 1–4 neutralizing antibodies.|
|5. Frequency of prior DENV infections in symptomatic Zika virus case-patients is compared with frequency of DENV antibodies in Zika virus–immune controls. A statistically significant increase in past DENV infection indicates enhancement; a statistically significant reduction indicates protection.|
|6. All comparisons should be made separately and combined for persons of white and black† race.|
*DENV, dengue virus.
†The powerful DENV disease resistance gene(s) in black sub-Saharan Africans might also protect against Zika virus diseases.
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Page created: March 17, 2017
Page updated: March 17, 2017
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