Use of Urea Wash ELISA to Distinguish Zika and Dengue Virus Infections
Wen-Yang Tsai, Han Ha Youn, Jasmine Tyson, Carlos Brites, Jih-Jin Tsai, Celia Pedroso, Jan Felix Drexler, Angel Balmaseda, Eva Harris, and Wei-Kung Wang
Author affiliations: University of Hawaii at Manoa, Honolulu, Hawaii, USA (W.-Y. Tsai, H.H. Youn, J. Tyson, W.-K. Wang); Federal University of Bahia, Salvador, Brazil (C. Brites, C. Pedroso); Kaohsiung Medical University, Kaohsiung, Taiwan (J.-J. Tsai); University of Bonn Medical Centre, Bonn, Germany (J.F. Drexler); National Center for Diagnosis and Reference, Ministry of Health, Managua, Nicaragua (A. Balmaseda); University of California at Berkeley, Berkeley, California, USA (E. Harris)
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Figure 1
Figure 1. NS1 IgM and IgG ELISAs and urea wash in ZIKV–NS1 IgG ELISA. A) Positivity rates for each panel. Only samples collected <3 months after symptom onset were tested for IgM. B) sDENV infection and probable DENV-ZIKV panels were tested with different concentrations (4, 6, and 8 mol/L) of urea wash. C, D) sDENV and DENV-ZIKV panels were tested with 6 mol/L urea wash: C) all samples; D) samples positive for both DENV-1–NS1 and ZIKV-NS1 IgG ELISAs. Sensitivity and specificity are based on relative optical density cutoff at 0.28 (dashed line). Receiver-operating characteristics are shown in the graph on the right. Data are the mean of 2 experiments (each in duplicate). The 2-tailed Mann-Whitney test was used. DENV, dengue virus; DENV-ZIKV, confirmed Zika virus infection with previous exposure to DENV; NS1, nonstructural protein 1; pDENV1, primary DENV-1 infection; pZIKV, primary ZIKV infection; rOD, relative optical density; sDENV, secondary DENV infection; ZIKV, Zika virus.
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