Serological Studies in Infectious Mononucleosis

Serological investigations performed on 27 patients with illnesses resembling infectious mononucleosis showed a significant increase in high antibody titres (more than 1:40) to EB virus in 11 of the 12 who developed heterophile antibodies. Two of these patients, however, had a significant increase in antibody titre to cytomegalovirus and rubella virus, respectively. Of 15 patients who failed to develop heterophile antibodies, one had a high antibody titre to EB virus, the others generally having undetectable or low antibody titres. The insidious onset of the illness in many patients together with the fact that EB virus antibodies rose to high titres rapidly reduced the value of this investigation diagnostically.EB virus antibody was still present in the sera of five patients who had had well-authenticated heterophile-antibody-positive infectious mononucleosis some four to seven years previously. Twenty-seven out of 70 (39%) healthy nurses had antibody at a level of more than 1:10 to EB virus. The presence of EB virus antibody in different population groups appears to be related to such factors as age and socioeconomic status.     

Viral antibodies in infectious mononucleosis

Abstract Patients with Epstein-Barr virus (EBV) infectious mononucleosis (IM) usually develop heterophilic antibodies and some autoantibodies. Antibodies to rubella, measles, adeno-, entero-, herpes simplex, cytomegalo- and varicella-zoster viruses were titrated in sera from IM patients and matched healthy controls using the complement fixation test (CFT) and the haemagglutination inhibition test. Except for herpes simplex virus and cytomegalovirus, the IM sera had significantly higher arithmetical and geometrical mean antibody titres and showed in most cases higher antibody prevalences in the CFT. The titre rise was most pronounced for rubella and measles antibodies, between 2- and 3-fold. There were no cases of very high titres occasionally seen in IM. The IM sera had higher total IgG serum levels than the controls, 17.27 g/1 and 11.8 g/1, respectively ( P < 0.001). The present data show that in addition to previously reported high levels of some autoantibodies and of heterophilic antibodies, there is a more general increase in IgG antibodies to commonly occurring viruses. This increase is most likely due to the polyclonal activation of B-lymphocytes following the binding of EBV to the complement receptor CR2 (CD21). When due consideration is given to the possible occasional occurrence of a false positive rubella IgM test, the raised antibody-titres will most likely not interfere with routine diagnostics.     

Viral infections in renal allograft recipients treated with long-term immunosuppression.

Thirty-nine renal allograft recipients who had received continuous immunosuppression for six to 13 years were examined clinically and virologically for evidence of past or present viral infection. Twenty-five had common warts, usually on the hands. In most the warts had appeared about one year after transplantation; once present, they never disappeared. Six patients had had a zoster rash from two months to four years after transplantation. None had had jaundice, and there was no change in the frequency of colds or non-specific fibrile illness. Four patients had no cytomegalovirus complement-fixing antibodies throughout the observation period; in the other 35 the antibody titre had risen appreciably during the first three to four months after transplantation. Antibody titres were high (mean 64) at follow-up, being only slightly lower than the highest titres achieved during the immediate postoperative period. None of the patients had had symptomatic cytomegalovirus infection, and in only two was the virus isolated from the urine at follow-up; the titres were extremely low. No changes occurred in the frequency of herpes simplex eruptions. Although all patients had herpes simplex humoral antibody, none excreted the virus. Although cytomegalovirus antibody titres were high, virus excretion was rare, indicating that chronic cytomegalovirus infection in these patients is immunologically well controlled.     

Neutralizing antibodies against endogenous interferon in myasthenia gravis patients

Anti-cytokine antibodies (Abs) play an important role in the regulation of the immune response, both under normal conditions and in several autoimmune and neoplastic disorders. In the present study, we have investigated the occurrence and the clinical significance of natural neutralizing Abs (NAbs) against interferons (IFNs) alpha, beta, and gamma, as detected by bioassay, in 52 patients with myasthenia gravis (MG), and 43 sex- and age-matched healthy individuals. Patients showing titres > or = 1.3 Log t(1/10), confirmed in 2 consecutive samples collected two months apart, were considered positive. NAbs against any of the IFNs were not detected in healthy subjects. Of the 52 MG patients, 11 (21.1%) had NAbs against IFNalpha and three (5.8%) had NAbs against IFNbeta. None of these patients was found to be positive for NAbs against IFNgamma. Of the patients positive for NAbs against IFNalpha, eight (15.4%) had NAbs at titres > or =2 Log t(1/10). A positive association was observed between high titres of NAbs and the presence of thymoma. These data suggest the presence of a generalized activation of the humoral response in MG.     

Epstein-Barr virus and cytomegalovirus antibodies in infectious mononucleosis.

A method has been evolved for the demonstration of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infection in 83 cases of infectious mononucleosis. Serum samples were tested for EBV IgM, anti-VCA IgG, anti-EBNA, CMV IgM and CMV IgG antibodies. An acute-phase sample (or samples) and a convalescence sample were examined in each case, and in 44 cases an additional samples was examined 5-12 months after the illness. Since the different antibodies showed characteristic differences in both titre and persistence, a reliable serodiagnosis has become possible. Acute EBV infection is characterized by the presence of EBV-VCA IgG and EBV IgG antibodies and the lack of anti-EBNA. The latter becomes demonstrable as late as the 4th to 5th month after infection. Mean age of the patients was 19 years. EBV infection was demonstrated in 65%, CMV infection in 18% of the cases. In 12% double infection seemed to be probable.     

Specific antibodies to viruses HL-23 and BILN in the blood plasma of patients with acute myelogenous leukaemia and with potential preleukaemia

Blood plasma samples from patients with acute myelogenous leukaemia (AML) or potential preleukaemia and from control subjects were tested for antibodies to the viruses HL-23 and BILN by membrane immunofluorescence. Of 15 patients with untreated AML, three, each having a low peripheral leucocyte count at the time of sampling, had detectable antibodies. Antibodies were present in the plasma of 5 out of 8 AML patients being in remission as a result of chemotherapy. In these cases, the antibody levels significantly exceeded those demonstrated in the untreated cases. Of 12 patients with potential preleukaemia, five proved to be positive. Of the 7 antibody-negative patients, four developed manifest leukaemia within 12-18 months after the first testing. The results are suggestive of a favourable prognostic role of the presence of the antibodies under study. In the majority of the antibody-positive AML and potential preleukameia cases antibodies were detectable to both components of the HL-23 virus. Of 30 control subjects, three had demonstrable antibodies to the BILN virus.     

Serological status for N. caninum, bovine viral diarrhea virus, and infectious bovine rhinotracheitis virus at pregnancy testing and reproductive performance in beef herds

Neospora caninum, infectious bovine rhinotracheitis (IBR), and bovine viral diarrhea virus (BVDV) are important differentials for the diagnosis of infectious reproductive loss in beef herds. The objective of this study was to describe the serological status of both pregnant and non-pregnant beef cows from herds with varying levels of reproductive success. The study provided an opportunity to examine whether there were any associations between serological status for BVDV, IBR, and N. caninum and pregnancy status, as well as the subsequent risk of abortion, or stillbirth. Samples were collected from 2516 cows and heifers from 66 herds; 31 herds where the proportion pregnant was <90% and 35 randomly selected herds where the proportion pregnant was ≥90%. Of these samples 5.9% were positive for antibodies to N. caninum, 20.4% had titres >1:80 to IBR, 91.8% had titres ≥1:256 to BVDV type 1, and 23.9% had titres ≥1:256 to BVDV type 2. N. caninum antibody concentration was associated with an increased individual animal risk of non-pregnancy (OR_log S/P, 1.9; 95% CI, 1.2–2.9) and abortion (OR_pos/neg, 2.8; 95% CI, 1.1–7.5). The proportion of animals at pregnancy testing with antibodies to BVDV type 2 above 1:3000 (OR_{10% change in prevalence}, 2.3; 95% CI, 1.5–3.5) was also associated with an increased risk of abortion. No other measures of antibody status were associated with reduced reproductive performance in this group of herds. Antibodies to Mycobacterium avium spp.paratuberculosis were also measured; 0.7% of samples were positive (sample to positive (S/P) >0.25) and 3.6% were suspicious (S/P, 0.10–0.25).     

Persistence of influenza serum antibodies in humans following immunization with a bivalent A/Victoria and A/New Jersey vaccine.

The persistence of serum antibodies 1 year after immunization with a bivalent vaccine containing recombinant viruses that were antigenically identical with A/Victoria/3/75 (H3N2) and A/New Jersey/8/76 (Hsw1N1) viruses was measured in 128 persons aged 18 to 65 years. Serum samples were tested with the hemagglutination inhibition assay against the two vaccine antigens and against A/Texas/1/77 (H3N2) and A/USSR/90/77 (H1N1) viruses. Prior to vaccination 56% and 79% of the participants had been found to be seronegative to A/Victoria and A/New Jersey antigens respectively; the geometric mean antibody titres were low (1:5 to 1:11) except in persons aged 51 to 65 years, whose mean titre of antibody to the A/New Jersey antigen was 1:23, and persons aged 26 to 35 years, whose mean titre of antibody to the A/USSR antigen was 1:25. By 3 weeks after vaccination 85% of the seronegative persons had a fourfold or greater rise in titres of antibodies to the viruses in the vaccine, and 70% had a fourfold increase in titre of antibody to the A/Texas antigen. Of the persons aged 26 to 35 years (seronegative and seropositive) 68% had a fourfold or greater increase in titre of antibody to the A/USSR antigen. There was no change in the mean titres of 19 unvaccinated control subjects during the observation period. At 6 and 12 months after vaccination the titres of antibodies to the A/Victoria and A/New Jersey antigens had declined moderately in all age groups from those observed 3 weeks after vaccination. The rate of decline was similar for the various antibodies except that to the A/USSR antigen in persons 26 to 35 years of age, in whom the decline was much slower.     

Prevalence of antibodies to specific infectious agents in bovine fetuses from a slaughterhouse in Minnesota

Sera from 486 bovine fetuses, approximately 60 to 270 days of gestation, were collected at slaughter and tested for the presence of immunoglobulins (Ig). One hundred ten (27%) of the sera were positive for IgG and/or IgM. The earliest age at which fetuses tested positive for IgM and IgG was estimated to be 100 and 120 days, respectively. Ig concentration increased with increased age of the fetus. Sera that were positive for Ig were tested for the presence of specific antibodies to five different infectious agents. Bovine parvovirus antibodies were found in 99 of 110 sera (90%) by hemagglutination inhibition (HI) test. However, only 35 (31.8%) of these sera were positive by serum neutralization (SN) test. Antibodies to parainfluenza-3 virus were detected in 30 sera (27%) by HI test and in 20 sera (18%) by SN test. Five (4%) sera contained SN antibodies to bovine viral diarrhea virus. Only one (0.9%) serum sample contained SN antibodies to infectious bovine rhinotracheitis virus. None of the sera had antibodies against five Leptospira spp. Results of this study suggest that bovine parvovirus may be a potential cause of reproductive problems in cattle.     

Epstein-Barr virus infection in the neonatal period and in childhood

In an attempt to detect and characterize congenital, neonatal and early childhood EBV infections, a prospective sero-epidemiological study was undertaken in 112 newborn infants and their mothers, 25 additional newborns undergoing exchange transfusion, 114 randomly selected hospitalized infants aged 0 to 3 years, and 109 siblings and parents of these infants. Leukocyte culture was attempted in all the newborns and in 25 pre- and post-transfusion.The findings of EBV seroconversion in six patients without clearly apparent illness, infectious mononucleosis in only one case with significant EBV antibody rise, seroreversion in three cases in early childhood, higher newborn than maternal EBV antibody titres in three cases and the establishment of two permanent lymphoblastoid cell lines from newborns following exchange transfusion raise the possibility of abortive primary EBV infection in early life. Congenital or neonatal infections following exchange transfusions, however, could not be substantiated with certainty since the EBV antibodies did not persist at follow-up except possibly in two cases. Parenteral transmission of the EB virus by exchange transfusion at birth is probably prevented by the presence of EBV antibodies in either donor or recipient.     

Varicella morbidity in Czechoslovakia

Data are presented on varicella and herpes zoster morbidity notified in Czechoslovakia in the years 1970 to 1978. The notified varicella incidence is compared with serologically confirmed varicella incidence among the selected groups of children up to the age of 12 from the North-Moravia region. Comparative analysis revealed a considerable difference between the notified and serologically detected cases of varicella. The highest rate of notified varicella was recorded in children of 3 and 4 years of age, while the highest incidence of seropositive cases was detected among the 2-year-old children. The cumulative notified morbidity involved about 35% of 6-year-old and 45% of 12-year-old children, whereas specific antibodies against the varicella-zoster virus were found in about 60% of 6-year-old and 90% of 12-year-old children. The titres of virus-specific antibodies were determined by the method of indirect hemagglutination reaction. No serological methods are applicable for herpes zoster morbidity studies in the population.     

Incidence of Rubella Antibodies in Female Subjects

Sera from females aged 1 to 40 years were assayed for rubella virus antibodies. Results showed that by age 14 years, 60% had antibodies and that by 19 years, 70% were positive. This figure rose to 80% by 24 years of age and remained unchanged in older age groups.A comparison of the incidence of high and low levels of antibodies in each age group revealed that antibody levels fell between ages 20 and 40 years. Only 20% of individuals in the latter group had a high antibody level compared to 80% in the former.These results are discussed as they relate to the problems of reinfection and possible vaccination procedures.     

Indicators of immunity in children vaccinated with live poliomyelitis vaccine]

Serological examination of 1057 children, residents of Leningrad, vaccinated with poliomyelitis vaccine at the appropriate calendar dates according to the scheme, showed the presence of antibodies to the polioviruses in 81.5-99.1% of the cases. There were more serologically negative children against the virus type III, and much less--against the virus type II. The value of the mean geometrical titres somewhat decreased with the advance of the children's age and the time lapse after the vaccination and revaccination. The greatest antibody titres determined were against the poliovirus type II, and the least--against type III. No antibodies against the viruses of types I and III were revealed in case of deficiency against the poliovirus type II. The number of children with the absence of antibodies against the poliovirus of all the types was insignificant.     

Larval toxocariasis and its clinical manifestation in childhood in the Slovak Republic

Results are presented of 90 children aged 1-15 years hospitalized with toxocariasis. Blood count analysis and laboratory examination were done by routine clinical laboratory methods. Anti-Toxocara antibodies were detected in the serum of patients using an ELISA method. Demographic analysis of the children's families exposed to the risk of disease allowed estimation of age-specific rates for clinical toxocariasis. The probability of toxocaral infection and the intensity of its clinical manifestations in children are determined by the epidemiology of this zoonosis and by the risk factors in the family. The presence of high titres of specific IgG antibodies in all age categories correlates with the clinical manifestations of toxocariasis. The highest admission rate is in the age categories of 3-5 years (43.3%) and 6-10 years (36.7%). Laboratory findings show that the most conspicuous changes occur in the age category 1-5 years. The high percentage of seropositive dog-keeping and puppy-breeding families and the possibility of infection with repeated doses of larvae stimulate eosinophilia, which prevails in children under the age of five years. We present the percentage of patients whose parameters showed deviations from the reference values for a particular age category. Analyses of laboratory indices and of clinical manifestations will contribute to the accuracy of diagnosis and effectiveness of treatment of this disease.     

A serosurvey of viral infections in lions (Panthera leo), from Queen Elizabeth National Park, Uganda

Serum samples from 14 lions (Panthera leo) from Queen Elizabeth National Park, Uganda, were collected during 1998 and 1999 to determine infectious disease exposure in this threatened population. Sera were analyzed for antibodies against feline immunodeficiency virus (FIV), feline calicivirus (FCV), feline herpesvirus 1 (feline rhinotracheitis: FHV1), feline/canine parvovirus (FPV/CPV), feline infectious peritonitis virus (feline coronavirus: FIPV), and canine distemper virus (CDV) or for the presence of feline leukemia virus (FeLV) antigens. Ten lions (71%) had antibodies against FIV, 11 (79%) had antibodies against CDV, 11 (79%) had antibodies against FCV, nine (64%) had antibodies against FHV1, and five (36%) had antibodies against FPV. Two of the 11 CDV-seropositive lions were subadults, indicating recent exposure of this population to CDV or a CDV-like virus. No lions had evidence of exposure to FeLV or FIPV. These results indicate that this endangered population has extensive exposure to common feline and canine viruses.     

Antibodies to the hepatitis A virus in the healthy population of Moscow

Serum specimens collected from 1002 persons in Moscow were tested for the presence of antibodies to hepatitis A virus (anti-HAV antibodies) by solid-phase enzyme immunoassay. The prevalence of these antibodies increased progressively with age from 10% in children aged 5-9 years to over 90% in the age groups of 40-49 years and over, the 50% immunity level being established at the age of 18 years. 79% of infants under 1 year were found to be immune, which was obviously due to the placental transfer of antibodies from mother to child. In a considerable part of seropositive persons over 30 years high or medium antibody titers were detected. These age groups showed a stable proportion of the low, medium and high level of anti-HAV antibodies. The prevalence of such antibodies was not related to sex. The presence of an ample amount of anti-HAV antibodies was determined in all of 18 tested lots of commercial serum immunoglobulin obtained from 3 different manufacturers.     

Detection of serum antibodies against Helicobacter pylori using a chromatographic immunoassay in outpatients

OBJECTIVES: The presence of the antibodies against Helicobacter pylori was tested in 163 subjects (children and adults) in the outpatient department, in the years 2005 and 2006. METHODS: Of the 163 investigated patients 108 (66.3%) were females and 55 (33.7%) were males. The antibodies against Helicobacter pylori were determined by "One Step Helicobacter pylori Test Device (Serum/Plasma)" (ACON Laboratories, Inc.), a rapid, high quality chromatographic immunoassay using human antibodies against IgG immobilized and particles covered with Helicobacter pylori antigen, in contact with the serum of the tested subjects. RESULTS: Of the 163 investigated subjects, 60 (36.8%) presented a positive test suggesting the passage through the infection with Helicobacter pylori. The positive tests were found in adults, 1 case was a boy of 12 years and 5 cases were teenagers between 16 and 18 years. The incidence of the antibodies increased with age. Only 40% of the patients with positive test had a clinical diagnosis of gastritis or gastro-duodenal ulcer, the remaining patients presenting symptoms of chronic hepatitis, cholecystitis or urticaria. CONCLUSIONS: Antibody assay is considered by many authors as a simple, noninvasive, rapid method, applicable in the diagnosis of Helicobacter pylori infection. Other authors asserted that the performance of these assays is less satisfactory and the results should be confirmed by other tests, such as ureea breath test. High levels of antibodies against Helicobacter spp. were encountered in liver and biliary chronic diseases, suggesting a possible role of these bacteria in the development of hepatitis or cholecystitis.     

Antiribonucleoprotein antibodies in connective tissue diseases: estimation by counterimmunoelectrophoresis.

One hundred and seventy-two patients with various connective tissue diseases were investigated for the presence of serum antibodies to extractable nuclear antigen (ENA) and its major components, ribonucleo-protein (RNP) and Sm antigen. The counter-immunoelectrophoresis assay allowed independent detection and measurement of antibodies to the different components. All 13 patients with mixed connective tissue disease (MCTD) had anti-RNP antibody in high titres, 16% of patients with systemic lupus erythematosus (SLE) had low titres, and none of the patients with scleroderma had anti-RNP antibody. MCTD seems to be more benign than either SLE or scleroderma. The counterimmunoelectrophoresis assay is a simple and sensitive technique for confirming the diagnosis.     

Cytoplasmic islet-cell antibodies (ICA) and cytoplasmic complement- fixing antibodies (CF-ICA) in patients with newly detected and short-lasting diabetes mellitus type 1

The study aimed at assessing ICA and CF-ICA in the serum of patients with newly diagnosed and short-lasting diabetes mellitus type 1. Sixty patients with newly diagnosed diabetes type 1 (39 patients) and short-lasting diabetes of the same type (21 patients) aged between 2 and 34 years were classified. Anti-islet antibodies were detected with indirect immunoflourescence in specimens of fresh, frozen human pancreast in the tested group ICA were found in 53% of cases. At the time of diagnosis, ICA were found in 76% of children and in 14% of adult patients whereas respective data for diabetes mellitus lasting up to 2 years were 40% and 64%. Complement-fixing islet cytoplasmatic antibodies were found only in patients with ICA (47% of such cases). These antibodies were found in children with newly diagnosed diabetes mellitus (36%). In case of adults CF-ICA were detected in 7% of newly diagnosed diabetes mellitus cases and in 45% of cases with the disease lasting for 2 years. Titres of ICA ranged from 1:1 to 1:128 whereas titres CF-ICA from 1:1 to 1:8. No correlation between ICA titre and CF-ICA titre was noted.     

Pandemic Influenza A(H1N1)pdm09 Seroprevalence in Sweden before and after the Pandemic and the Vaccination Campaign in 2009

The immunity to pandemic influenza A(H1N1)pdm09 in Sweden before and after the outbreaks in 2009 and 2010 was investigated in a seroepidemiological study. Serum samples were collected at four time points: during 2007 (n = 1968), in October 2009 (n = 2218), in May 2010 (n = 2638) and in May 2011 (n = 2513) and were tested for hemagglutination inhibition (HI) antibodies. In 2007, 4.9% of the population had pre-existing HI titres ≥40, with the highest prevalence (20.0%) in 15–24 year-olds, followed by ≥80 year-olds (9.3%). The overall prevalence of HI titres ≥40 had not changed significantly in October 2009. In May 2010 the prevalence had increased to 48.6% with the highest percentages in 5–14 year-olds (76.2%) andlowest in 75–79 year-olds (18.3%). One year later the prevalence of HI titres ≥40 had increased further to 52.2%. Children 5–14 years had the highest incidence of infection and vaccine uptake as well as the highest post-pandemic protective antibody levels. In contrast, the elderly had high vaccine uptake and low attack rate but low levels of protective antibodies, underlining that factors other than HI antibodies are involved in protection against influenza A(H1N1)pdm09. However, for all age-groups the seroprevalence was stable or increasing between 2010 and 2011, indicating that both vaccine- and infection-induced antibodies were long-lived.