Abstract
The value of immunoglobulin M (IgM) detection in the early diagnosis of influenza A was examined in a prospective study during an outbreak of influenza A/Philippines/2/82 (H3N2) virus infection in February and March 1986. The IgM response was investigated in sera from 64 adults with influenzalike symptoms; we found a fourfold rise in titer or high titers (greater than or equal to 80) of influenza A virus antibodies by the complement fixation test. The IgM response, analyzed by the hemadsorption immunosorbent technique, was compared with the IgG and IgA responses analyzed by an indirect enzyme-linked immunosorbent assay and the hemadsorption immunosorbent technique, respectively. Antigen detection in nasopharyngeal secretions by immunofluorescence was performed for all patients on admission to hospital. Specific IgM was detected in 86% (55 of 64) of the patients with influenza A. In sera from 36% (18 of 64) of the patients it was detected already on admission. Influenza A virus antigen was detected in nasopharyngeal cells by immunofluorescence on admission in 53% (34 of 64) of the patients. A combination of immunofluorescence and IgM results gave a significantly higher diagnostic rate, 69% (P less than 0.01), on admission than did each of the two tests separately. An IgA serum antibody response was seen in 76% (48 of 64) of the cases but did not contribute to any increase in the diagnostic rate. IgM detection by the hemadsorption immunosorbent technique was found to be a valuable supplement for the diagnosis of influenza A in an early phase of the disease.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Beyer W. E., Van der Logt J. T., van Beek R., Masurel N. Immunoglobulin G, A and M response to influenza vaccination in different age groups: effects of priming and boosting. J Hyg (Lond) 1986 Jun;96(3):513–522. doi: 10.1017/s0022172400066316. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Buchner Y. I., Heath R. B., Collins J. V., Pattison J. R. Detection of antibodies of the IgM class in sera of patients recently infected with influenza viruses. J Clin Pathol. 1976 May;29(5):423–427. doi: 10.1136/jcp.29.5.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Buchner Y. I., Heath R. B., Collins J. V., Pattison J. R. Serum IgM antibody and influenza A infection. J Clin Pathol. 1977 Aug;30(8):723–727. doi: 10.1136/jcp.30.8.723. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burlington D. B., Clements M. L., Meiklejohn G., Phelan M., Murphy B. R. Hemagglutinin-specific antibody responses in immunoglobulin G, A, and M isotypes as measured by enzyme-linked immunosorbent assay after primary or secondary infection of humans with influenza A virus. Infect Immun. 1983 Aug;41(2):540–545. doi: 10.1128/iai.41.2.540-545.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Duermeyer W., Wielaard F., van der Veen J. A new principle for the detection of specific IgM antibodies applied in an ELISA for hepatitis A. J Med Virol. 1979;4(1):25–32. doi: 10.1002/jmv.1890040104. [DOI] [PubMed] [Google Scholar]
- Döller G., Döller P. C., Gerth H. J. Diagnostic significance of influenza subtype-specific IgG, IgA, and IgM antibodies. J Biol Stand. 1986 Jul;14(3):163–175. doi: 10.1016/0092-1157(86)90001-6. [DOI] [PubMed] [Google Scholar]
- El-Hagrassy M. M., Banatvala J. E., Coltart D. J. Coxsackie-B-virus-specific IgM responses in patients with cardiac and other diseases. Lancet. 1980 Nov 29;2(8205):1160–1162. doi: 10.1016/s0140-6736(80)92595-7. [DOI] [PubMed] [Google Scholar]
- Gardner P. S., Grandien M., McQuillin J. Comparison of immunofluorescence and immunoperoxidase methods for viral diagnosis at a distance: a WHO collaborative study. Bull World Health Organ. 1978;56(1):105–110. [PMC free article] [PubMed] [Google Scholar]
- Grandien M., Pettersson C. A., Gardner P. S., Linde A., Stanton A. Rapid viral diagnosis of acute respiratory infections: comparison of enzyme-linked immunosorbent assay and the immunofluorescence technique for detection of viral antigens in nasopharyngeal secretions. J Clin Microbiol. 1985 Nov;22(5):757–760. doi: 10.1128/jcm.22.5.757-760.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hall C. B., McBride J. T., Walsh E. E., Bell D. M., Gala C. L., Hildreth S., Ten Eyck L. G., Hall W. J. Aerosolized ribavirin treatment of infants with respiratory syncytial viral infection. A randomized double-blind study. N Engl J Med. 1983 Jun 16;308(24):1443–1447. doi: 10.1056/NEJM198306163082403. [DOI] [PubMed] [Google Scholar]
- Hammond G. W., Smith S. J., Noble G. R. Sensitivity and specificity of enzyme immunoassay for serodiagnosis of influenza A virus infections. J Infect Dis. 1980 May;141(5):644–651. doi: 10.1093/infdis/141.5.644. [DOI] [PubMed] [Google Scholar]
- Hoffman P. C., Dixon R. E. Control of influenza in the hospital. Ann Intern Med. 1977 Dec;87(6):725–728. doi: 10.7326/0003-4819-87-6-725. [DOI] [PubMed] [Google Scholar]
- Julkunen I., Kleemola M., Hovi T. Serological diagnosis of influenza A and B infections by enzyme immunoassay. Comparison with the complement fixation test. J Virol Methods. 1984 Aug;9(1):7–14. doi: 10.1016/0166-0934(84)90078-8. [DOI] [PubMed] [Google Scholar]
- Julkunen I., Pyhälä R., Hovi T. Enzyme immunoassay, complement fixation and hemagglutination inhibition tests in the diagnosis of influenza A and B virus infections. Purified hemagglutinin in subtype-specific diagnosis. J Virol Methods. 1985 Jan;10(1):75–84. doi: 10.1016/0166-0934(85)90091-6. [DOI] [PubMed] [Google Scholar]
- Krech U., Wilhelm J. A. A solid-phase immunosorbent technique for the rapid detection of rubella IgM by haemagglutination inhibition. J Gen Virol. 1979 Aug;44(2):281–286. doi: 10.1099/0022-1317-44-2-281. [DOI] [PubMed] [Google Scholar]
- Madore H. P., Reichman R. C., Dolin R. Serum antibody responses in naturally occurring influenza A virus infection determined by enzyme-linked immunosorbent assay, hemagglutination inhibition, and complement fixation. J Clin Microbiol. 1983 Dec;18(6):1345–1350. doi: 10.1128/jcm.18.6.1345-1350.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McQuillin J., Madeley C. R., Kendal A. P. Monoclonal antibodies for the rapid diagnosis of influenza A and B virus infections by immunofluorescence. Lancet. 1985 Oct 26;2(8461):911–914. doi: 10.1016/s0140-6736(85)90849-9. [DOI] [PubMed] [Google Scholar]
- Murphy B. R., Phelan M. A., Nelson D. L., Yarchoan R., Tierney E. L., Alling D. W., Chanock R. M. Hemagglutinin-specific enzyme-linked immunosorbent assay for antibodies to influenza A and B viruses. J Clin Microbiol. 1981 Mar;13(3):554–560. doi: 10.1128/jcm.13.3.554-560.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ray C. G., Minnich L. L. Efficiency of immunofluorescence for rapid detection of common respiratory viruses. J Clin Microbiol. 1987 Feb;25(2):355–357. doi: 10.1128/jcm.25.2.355-357.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
- SEVER J. L. Application of a microtechnique to viral serological investigations. J Immunol. 1962 Mar;88:320–329. [PubMed] [Google Scholar]
- Schmitz H., von Deimling U., Flehmig B. Detection of IgM antibodies to cytomegalovirus (CMV) using an enzyme-labelled antigen (ELA). J Gen Virol. 1980 Sep;50(1):59–68. doi: 10.1099/0022-1317-50-1-59. [DOI] [PubMed] [Google Scholar]
- Shalit I., McKee P. A., Beauchamp H., Waner J. L. Comparison of polyclonal antiserum versus monoclonal antibodies for the rapid diagnosis of influenza A virus infections by immunofluorescence in clinical specimens. J Clin Microbiol. 1985 Nov;22(5):877–879. doi: 10.1128/jcm.22.5.877-879.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tuokko H. Comparison of nonspecific reactivity in indirect and reverse immunoassays for measles and mumps immunoglobulin M antibodies. J Clin Microbiol. 1984 Nov;20(5):972–976. doi: 10.1128/jcm.20.5.972-976.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Urquhart G. E. Serum IgM and IgA responses in influenza A infections. J Clin Pathol. 1974 Mar;27(3):198–201. doi: 10.1136/jcp.27.3.198. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Van Voris L. P., Betts R. F., Menegus M. A., Murphy B. R., Roth F. K., Douglas R. G., Jr Serological diagnosis of influenza A/USSR/77 H1N1 infection: value of ELISA compared to other antibody techniques. J Med Virol. 1985 Aug;16(4):315–320. doi: 10.1002/jmv.1890160403. [DOI] [PubMed] [Google Scholar]
- Vikerfors T., Grandien M., Johansson M., Pettersson C. A. Detection of an immunoglobulin M response in the elderly for early diagnosis of respiratory syncytial virus infection. J Clin Microbiol. 1988 May;26(5):808–811. doi: 10.1128/jcm.26.5.808-811.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wiley D. C., Wilson I. A., Skehel J. J. Structural identification of the antibody-binding sites of Hong Kong influenza haemagglutinin and their involvement in antigenic variation. Nature. 1981 Jan 29;289(5796):373–378. doi: 10.1038/289373a0. [DOI] [PubMed] [Google Scholar]
- van der Logt J. T., van Loon A. M., Heessen F. W., van der Veen J. Diagnosis of parainfluenza virus infection in children and older patients by detection of specific IgM antibody. J Med Virol. 1985 Jun;16(2):191–199. doi: 10.1002/jmv.1890160212. [DOI] [PubMed] [Google Scholar]
- van der Logt J. T., van Loon A. M., van der Veen J. Hemadsorption immunosorbent technique for determination of rubella immunoglobulin M antibody. J Clin Microbiol. 1981 Mar;13(3):410–415. doi: 10.1128/jcm.13.3.410-415.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
