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Journal of Clinical Microbiology, May 2008, p. 1659-1662, Vol. 46, No. 5
0095-1137/08/$08.00+0     doi:10.1128/JCM.02190-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Identifying Infections with Respiratory Syncytial Virus by Using Specific Immunoglobulin G (IgG) and IgA Enzyme-Linked Immunosorbent Assays with Oral-Fluid Samples

Centre for Geographic Medicine Research—Coast, Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya,¹ Centre for Infections, Health Protection Agency, London,² Department of Biological Sciences, University of Warwick, Coventry, United Kingdom³

Received 13 November 2007/ Returned for modification 9 January 2008/ Accepted 19 February 2008

Currently, respiratory syncytial virus (RSV) infection is identified in epidemiological studies by virus antigen or nucleic acid detection in combination with serology. Oral-fluid specimens may provide a noninvasive alternative to blood, and oral fluid is more suitable for sampling outside of the clinic setting. We evaluated an indirect enzyme-linked immunosorbent assay for the detection of RSV-specific immunoglobulin G (IgG) and IgA by using oral-fluid samples collected from individuals with RSV infections confirmed by an immunofluorescent antibody test. For five children sampled repeatedly from birth, antibody profiles in oral fluid quite consistently tracked those in paired sera, and RSV infections were detected by rising titers of antibodies of at least one Ig class. Specific IgG responses were generally more reliable than IgA responses, except in early infancy, where the reverse was sometimes true. For a further five young children from whom oral fluid was collected weekly following RSV infection, boosted antibody responses, frequently of a transient nature, lasting a few weeks, were observed; specific IgG responses were of longer duration and more pronounced than specific IgA responses. Our data show significant promise for the use of oral fluid alone in RSV infection surveillance. The observed rapid dynamics of the antibody responses are informative in defining study sampling intervals.

Published ahead of print on 27 February 2008.