Salivary diagnosis of rubella : a study of notified cases in the United Kingdom, 1991-4.
Rubella infections, notified by general practitioners on the basis of a clinical diagnosis, were investigated by testing blood and saliva samples for specific IgM.
Overall 52 (29%) of 178 cases with appropriately timed blood specimens were confirmed as recent rubella by IgM serology.
Only 2 (3%) of 74 cases in children under 5 years were confirmed compared to 50 (48%) of 104 cases in older children and adults.
The confirmation rate was lower (6%) in those with documented vaccination history than in those without (42%). The specificity of saliva rubella IgM testing compared to testing corresponding blood samples was 99%. The overall sensitivity of saliva rubella IgM testing was 81%. This rose to 90% if results from inappropriately timed specimens and specimens taking more than 1 week to reach the laboratory were excluded.
A corresponding saliva rubella IgG test was 98% sensitive and 100% specific.
Of 126 rubella IgM negative cases, 25 (20%) were positive for parvovirus B19 IgM.
This study confirmed that rubella surveillance based on clinical reports is not specific.
It also demonstrated that saliva samples, if taken 7-42 days after onset of illness and transported rapidly to the laboratory, are a feasible alternative to blood samples for rubella surveillance.
Mots-clés Pascal : Virus rubéole, Rubivirus, Togaviridae, Virus, Rubéole, Virose, Infection, Enfant, Homme, Diagnostic, Méthode, Détection, Anticorps, IgM, Immunité locale, Salive, Cavité buccale, Surveillance sanitaire, Royaume Uni, Europe
Mots-clés Pascal anglais : Rubella virus, Rubivirus, Togaviridae, Virus, Rubella, Viral disease, Infection, Child, Human, Diagnosis, Method, Detection, Antibody, IgM, Local immunity, Saliva, Oral cavity, Sanitary surveillance, United Kingdom, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0376744
Code Inist : 002B05C02B. Création : 25/01/1999.