Acute West Nile virus neuroinvasive infections: Cross‐reactivity with dengue virus and tick‐borne encephalitis virus

Abstract

Cross-reactions in serology are common among flaviviruses. During the outbreak of West Nile virus (WNV) infections in Greece in 2010, WNV IgM-positive serum and cerebrospinal fluid samples were tested for the presence of IgM and IgG antibodies against Dengue virus (DENV) and tick-borne encephalitis virus. Higher cross-reactivity was observed in IgM antibodies between WNV and DENV; however, the index of the WNV antibodies was in all cases higher than that of the DENV antibodies. There is a need for caution when evaluating serologic results of flaviviral infections, while efforts have to be focused on the development of diagnostic assays with increased specificity.

Quantitative determination of IgM antibodies reduces the pitfalls in the serodiagnosis of tick-borne encephalitis

“…Although 10% of acute dengue post-infection sera analyzed in our study were TBE IgM-positive, they were all in the lower range between 140 AU and 420 AU. In agreement with recent reports from a WN outbreak in Greece, 29 none of acute WNV post-infection sera exceeded the cut-off of the TBE IgM ELISA, indicating differences in IgM antibody titers induced by different flavivirus infections and/or their degree of cross-reactivity with TBEV. Consistent with the published literature, [30][31][32][33][34][35] IgG antibodies are less specific and slightly more than 40% of all acute DEN and WN sera were positive in the TBE IgG ELISA.…”

Retrospective identification of human cases of West Nile virus infection in Austria (2009 to 2010) by serological differentiation from Usutu and other flavivirus infections

“…Since TBEV and WNV infections both display very similar clinical pictures, distinguishing between WNV and TBEV antibodies will be frequently required in routine diagnostic practice. The present and previous studies of our group [23] as well as others [24], however, indicate that the extent of cross-reactivity between the two viruses -especially in IgM assaysis so low that distinguishing between recent infections is usually unproblematic.…”

First Outbreak of West Nile Virus Neuroinvasive Disease in Humans, Croatia, 2012

“…In the majority of patients, WNV IgG antibodies were broadly reactive with DENV and TBEV, with higher cross-reactivity between WNV and DENV. Similar results were observed during the Greek outbreak of 2010 (Papa et al 2011).…”