The application of measles specific IgM and IgG antibody detection in classification measles vaccine failure, Tianjin
10.3760/cma.j.issn.0253-9624.2019.05.014
- VernacularTitle: 应用麻疹IgM和IgG抗体判定疫苗免疫失败效果的研究
- Author:
Yaxing DING
1
;
Naiying MAO
2
;
Ying ZHANG
1
;
Zhigang GAO
1
;
Wenbo XU
2
Author Information
1. Institute for Infectious Diseases Control and Prevention of Tianjin Center for Diseases Control and Prevention, Tianjin 300011, China
2. National Institute for Viral Disease Control and Prevention of Chinese Center for Diseases Control and Prevention, Beijing 102206, China
- Publication Type:Journal Article
- Keywords:
Measles;
Immunoglobulin M;
Immunoglobulin G;
Primary vaccination failure;
Secondary vaccination failure
- From:
Chinese Journal of Preventive Medicine
2019;53(5):508-512
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the application of measles specific IgM and IgG antibody detection in classification of primary vaccination failure (PVF) and secondary vaccination failure (SVF).
Methods:Measles surveillance information system was used to collect measles confirmed cases in Tianjin, 2013-2015, and their blood specimens were collected, totally 284 cases were enrolled. Measles IgM and IgG were detected with enzyme-linked immunosorbent assay (ELISA), and the relative avidity index (RAI) was used to express the result of measles avidity. Measles IgM, IgG and IgM/IgG was analyzed with receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC) as evaluation indicators. In addition, compared with a measles outbreak (26 cases) of a middle school in Tianjin in 2016, for making further verification on the diagnostic value of vaccination failure with IgM, IgG and IgM/IgG.
Results:The age of cases ranged was 0-58 years old, the interval median (P25, P75) of serum collection after rash onset was 2 (1, 4) days. The positive rate of measles IgM and IgG in acute phase specimens were 76.06% (216 cases) and 88.38% (251 cases). According to the ROC curve analysis, the area under the ROC curve (AUC) of IgM, IgG and IgM/IgG were 0.753, 0.891 and 0.952, indicating that IgM/IgG was the best index to distinguish PVF and SVF. The best cut off value for IgM/IgG was 0.06, the sensibility and specificity were 88.75% and 86.63%. When IgM/IgG >1, 96.30% cases were low-avidity (RAI <40%), only 1 case was equivocal response (RAI: 40%-60%). 97.14% cases were high-avidity (RAI >60%) when IgM/IgG <0.01, only 3 cases were equivocal response (RAI 40%-60%). The threshold of IgM/IgG was used to verify the measles outbreak of a middle school in Tianjin, 2016. In the acute phase specimens, 100% (26 cases) of IgM/IgG were <0.06, 84.62% (22 cases) of IgM/IgG were <0.01.
Conclusion:The detection of measles IgM and IgG with ELISA, and IgM/IgG is a valuable diagnostic tool to distinguish PVF and SVF.
