Flavivirus Diagnostics
Elizabeth Hunsperger
from: Molecular Virology and Control of Flaviviruses (Edited by: Pei-Yong Shi). Caister Academic Press, U.K. (2012)
Abstract
Within the family of Flaviviridae there are many medically important viruses that cause human disease worldwide. These viruses were originally categorized based on phenotype due to their antigenic relatedness and placed within groups, subgroups and types and later confirmed with nucleic acid sequence analysis. Diagnosis of disease caused by flaviviruses has been primarily based on serological identification of anti-viral antibodies and virus isolation. Some of the classic serological techniques of hemagglutination inhibition assay and complement fixation were replaced with the enzyme linked immunosorbent assay (ELISA) for the detection of IgM, IgG and IgA antibodies primarily due to ease-of-use. The plaque reduction neutralization test (PRNT) provided the specificity needed for virus identification following a positive serological test by ELISA. The development of polymerase chain reaction (PCR) assays improved the ability to detect virus nucleic acid sequence when viral isolates were not obtained. Because reverse transcriptase PCR (RT-PCR) assays are easy to perform, have increased sensitivity and provide virus identification in a short period of time, RT-PCR has essentially replaced isolation techniques for rapid diagnosis. However, virus isolation is still essential for genetic analysis. The future of flaviviral disease diagnosis is new platforms for antibody and nucleic acid detection as well as the development of point-of-care diagnostics for clinical management
