A poliovirus type-specific IgM antibody-capture enzyme-linked immunosorbent assay for the rapid diagnosis of poliomyelitis.
To develop and evaluate an IgM antibody-capture ELISA for the rapid detection of poliovirus type-specific IgM antibodies in serum and CSF of patients suspected of poliomyelitis. The assay uses monoclonal antibody to human IgM as catching antibody, monovalent IPV as antigen and type-specific monoclonal antibodies labeled with horseradish peroxidase as detecting antibody. Sera from 21 of 24 patients, contacts of these patients or recently vaccinated children were positive in the IgM assay. Sera from 100 healthy individuals were negative in all three poliovirus type-specific ELISAs. Sera from 5 of 81 patients with non-polio viral infections showed (weak) reactivity in one or more of the IgM assays. In a prospective study, sera and/or CSFs from 72 patients with a recent clinical diagnosis of poliomyelitis were tested. A homotypic IgM antibody response was found in 51 of the 55 patients which shedded wild poliovirus in stool or throat. Poliovirus type-specific IgM antibodies were also detected in serum from 13 of the 17 patients, from whom no poliovirus was isolated. Poliovirus type-specific IgM-antibodies could be detected from the second day up till at least 28 days after onset of paralysis. Poliovirus infections still create measurable morbidity and mortality in the world. Rapid diagnosis methods are needed to detect infection. The use of the poliovirus type-specific IgM antibody-capture ELISA allows rapid diagnosis of poliomyelitis within 24 h after obtaining serum or a CSF specimen.