Diagnosis of California (La Crosse) encephalitis by precipitin techniques: a prospective study

Counterelectrophoresis (CEP) and immunodiffusion (ID) were evaluated prospectively as methods for the early and rapid laboratory diagnosis of California encephalitis (CE). CEP and ID studies were done on paired sera from 127 patients with acute central nervous system infections. After the precipitin tests were completed, conventional hemagglutination inhibition, neutralizing, and complement fixing antibody titers were measured. The CEP system detected antibodies in 7 (41%) of 17 CE patients during their acute illness and in all 17 patients during convalescence. The ID method was less sensitive; 3 of 17 acute sera and 16 of 17 convalescent sera were ID positive. Comparative precipitin studies indicated that La Crosse virus was the infecting California group subtype in all 17 CE patients. Because CEP can be performed in 1.5 hr, is at least as sensitive as hemagglutination inhibition, neutralizing, and complement fixing tests, and can detect prospectively 41% of CE patients during their acute illness, it is recommended as a rapid diagnostic test for CE.