Table 4.

Comparison of human sera seoreactivity using orthohantavirus-specific IFA and ICG strips.

	Sample	Age	Sex	IFA	ELISA	ICG STRIPS						Clinical Symptoms
						Group A			Group B	Group C
						Murinae			Arvicolinae	Sigmodontinae
						DOBV	SEOV	HTNV	PUUV	SNV	ANDV
Human	H38	88	M	neg	pos	+	–	+	+++	–	–	Jaundice, anorexia, hematuria and muscle pain.
	H67	15	F	pos	pos	+++	–	+++	+++	–	–	Fever, rash, joint pain and heartburn but was not hospitalized and the patient was a resident Barbadian.
	H29	65	M	neg	pos	++	+	+++	+++	+	+	Fever, rash, joint pain and respiratory symptoms, was admitted to the high dependency unit at the QEH hospital and later died.
	H22	24	M	neg	pos	–	–	–	+++	++	–	Respiratory symptoms and petechiae; admitted to the medical intensive care unit (MICU) at the QEH hospital. Bricklayer by profession, UK by origin but resident in Barbados.
	H37	8 months	M	neg	pos	+++	–	+++	+++	–	–	Fever, respiratory symptoms, difficulty breathing with rapid, weak pulse, and was admitted to the pediatric intensive care unit at the QEH hospital

Group A orthohantavirus antigens include Seoul virus (SEOV), Hantaan virus (HTNV) and Dobrava virus (DOBV), group B orthohantavirus antigens Puumala (PUUV) and Prospect Hill virus (PHV) and group C orthohantavirus antigens Sin Nombre virus (SNV) and Andes (ANDV). Laboratory testing included enzyme linked immunosorbent assay (ELISA), reverse transcriptase polymerase chain reaction (RT-PCR), immunofluorescent assay (IFA), immunochromatographic test (ICG) strips and pseudotype focus reduction neutralization assay (pFRNT). Acute sera are indicated by the ‘H’ and convalescent sera by ‘C’. ‘Neg’ is for negative and “Pos” is for positive. Samples with the designation ‘H” are acute human sera with ELISA-positive results. Key: no band/fluorescence or negative result (–); very weak fluorescence, borderline (+); medium to strong fluorescence, positive result (+, ++); very strong fluorescence comparable to control, strong positive (+++).