Diagnostic performance of commercial IgM and IgG enzyme-linked immunoassays (ELISAs) for diagnosis of Zika virus infection

Mariana Kikuti, Laura B. Tauro, Patrícia S.S. Moreira, Gúbio S. Campos, Igor A.D. Paploski, Scott C. Weaver, Mitermayer G. Reis, Uriel Kitron, Guilherme S. Ribeiro

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32 Scopus citations


Background: Serologic detection of Zika virus (ZIKV) infections is challenging because of antigenic similarities among flaviviruses. Objective: To evaluate the sensitivity and specificity of commercial ZIKV IgM and IgG enzyme-linked immunoassay (ELISA) kits. Methods: We used sera from febrile patients with RT-PCR-confirmed ZIKV infection to determine sensitivity and sera from RT-PCR-confirmed dengue cases and blood donors, both of which were collected before ZIKV epidemics in Brazil (2009-2011 and 2013, respectively) to determine specificity. Results: The ZIKV IgM-ELISA positivity among RT-PCR ZIKV confirmed cases was 0.0% (0/14) and 12.5% (1/8) for acute- and convalescent-phase sera, respectively, while its specificity was 100.0% (58/58) and 98.3% (58/59) for acute- and convalescent-phase sera of dengue patients, and 100.0% (23/23) for blood donors. The ZIKV IgG-ELISA sensitivity was 100.0% (6/6) on convalescent-phase sera from RT-PCR confirmed ZIKV patients, while its specificity was 27.3% (15/55) on convalescent-phase sera from dengue patients and 45.0% (9/20) on blood donors' sera. The ZIKV IgG-ELISA specificity among dengue confirmed cases was much greater among patients with primary dengue (92.3%; 12/13), compared to secondary dengue (7.1%; 3/42). Conclusions: In a setting of endemic dengue transmission, the ZIKV IgM-ELISA had high specificity, but poor sensitivity. In contrast, the ZIKV IgG-ELISA showed low specificity, particularly for patients previously exposed to dengue infections. This suggests that this ZIKV IgM-ELISA is not useful in confirming a diagnosis of ZIKV infection in suspected patients, whereas the IgG-ELISA is more suitable for ZIKV diagnosis among travelers, who reside in areas free of flavivirus transmission, rather than for serosurveys in dengue-endemic areas.

Original languageEnglish (US)
Article number108
JournalVirology journal
Issue number1
StatePublished - Jul 13 2018

Bibliographical note

Funding Information:
This study was supported by the Brazilian National Council for Scientific and Technological Development (grant 550160/2010–8 to MGR, grants 400830/ 2013–2 and 440891/2016–7 to GSR; and scholarships to IADP, UK, MGR, and GSR); the Bahia Foundation for Research Support (grant PNX0010/2011 to MGR, grants PPP0055/2011, JCB0020/2013, PET0026/2013, APP0044/2016, and PET0022/2016 to GSR); and the Coordination for the Improvement of Higher Education Personnel, Brazilian Ministry of Education (grant 440891/2016–7 to GSR and scholarship to MK). The funding sources had no role in study design; in the collection, analysis and interpretation of data; in the writing of the paper; and in the decision to submit the article for publication.

Publisher Copyright:
© 2018 The Author(s).


  • Enzyme-linked immunosorbent assay
  • Immunoglobulin G
  • Immunoglobulin M
  • Sensitivity and specificity
  • Zika virus


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