Table 1.
Serum panels, clinical characteristics and serological assays.
Figure 1.
Immunofluorescence microscope slides for the multiparametric detection of hantavirus-specific antibodies.
A microscope slide has ten reaction fields, each of which contains a biochip mosaic, allowing ten samples or sample dilutions to be incubated simultaneously with the same range of substrates. Due to identical incubation protocols, IgG and IgM testing can be performed on different reactions fields of the same slide using the respective secondary antibody conjugate. Hantavirus Mosaic 1 comprises mosaics of six biochips coated with Hantaan virus (HTNV)-, Puumala virus (PUUV)-, Seoul virus (SEOV)-, Sin Nombre virus (SNV)-, Dobrava virus (DOBV)- and Saaremaa virus (SAAV)-infected cells (-IC). Hantavirus Mosaic 3 consists of mosaics of two biochips coated with Sin Nombre virus (SNV)- and Andes virus (ANDV)-IC.
Table 2.
Diagnostic performance of the multiparametric anti-hantavirus immunofluorescence assay (IFA).
Table 3.
Serum samples with discordant results between the reference tests and the multiparametric immunofluorescence assay (IFA).
Figure 2.
Multiparametric IFA-based reactivity patterns of hantavirus-specific serum antibodies.
Bars indicate reactivity rates or reciprocal geometric mean titers (rGMT) for IFA IgG positive sera (A and B; serum panel: I, n = 97; II, n = 5; III, n = 7; IV, n = 22; V, n = 52) and IFA IgM-positive sera (C and D; serum panel: I, n = 54; II, n = 5; III, n = 5; IV, n = 19; V, n = 48) for each substrate (cells infected with HTNV, PUUV, SEOV, SAAV, DOBV, SNV and ANDV). Dashed horizontal lines (right panels) indicate the reciprocal cut-off titer; black triangles indicate reactivity rates of 0% (left panels) or rGMTs of <10 (lower right panel). Results for panel IV with ANDV-infected cells were not available.
Figure 3.
Hantavirus serotype determination by multiparametric indirect immunofluorescence analysis.
For sera which were IFA positive for both anti-hantavirus IgG and IgM (serum panel: I, n = 54; II, n = 5; III, n = 5; IV, n = 19; V, n = 48), percentages of hantavirus serotypes with the highest reciprocal IgG endpoint titers were calculated (left bars). Right bars represent results of serotyping by IgG in conjunction with IgM detection. For serum panels I and V, only those serotypes which accounted for more than 2% of the total number of sera are indicated. Results for panel IV with ANDV-infected cells were not available.