The importance of tick-borne encephalitis virus RNA detection for early differential diagnosis of tick-borne encephalitis. 2005

Ana Saksida, and Darja Duh, and Stanka Lotric-Furlan, and Franc Strle, and Miroslav Petrovec, and Tatjana Avsic-Zupanc
Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Zaloska 4, 1000 Ljubljana, Slovenia.

BACKGROUND Tick-borne encephalitis virus (TBEV) is one of the most important causes of human viral infections of the central nervous system in Europe. Currently, the diagnosis of TBE is based on the demonstration of specific antibodies in patient's serum, which appear only several weeks after the infection. OBJECTIVE To determine how successfully can viral RNA be detected by RT-PCR in the samples of body fluids of patients with TBE prior to and after the appearance of antibodies. METHODS Serum, whole blood and CSF samples from 34 patients with a serologically confirmed TBE were collected. Samples were tested for the presence of TBEV RNA by using RT-PCR method. RESULTS Viral RNA was detected in all blood and serum samples collected before the development of antibodies. After the appearance of IgM antibodies, the number of positive samples dropped by at least one third. After the development of IgG antibodies, only 3% of serum and 16% of blood samples tested positive for viral RNA. Samples of cerebrospinal fluid were shown to be inappropriate for the molecular diagnosis of TBE using this assay, since only one sample (10%) that was collected in the sero-negative phase of disease was found positive by the PCR assay. CONCLUSIONS RT-PCR is an efficient method for an early detection of TBEV in blood and serum samples collected prior to the appearance of antibodies. This method can be of valuable use for a differential diagnosis of TBEV infection in patients with febrile illness after a tick bite, particularly in regions where more than one tick-transmitted diseases are endemic.

UI MeSH Term Description Entries
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D004669 Encephalitis Viruses, Tick-Borne A subgroup of the genus FLAVIVIRUS that causes encephalitis and hemorrhagic fevers and is found in eastern and western Europe and the former Soviet Union. It is transmitted by TICKS and there is an associated milk-borne transmission from viremic cattle, goats, and sheep. Hemorrhagic Fever Virus, Omsk,Kyasanur Forest disease virus,Langat virus,Louping ill virus,Omsk hemorrhagic fever virus,Powassan virus,Al-Khurma Hemorrhagic Fever Virus,Al-Khurma virus,Al-Khurma virus (ALKV),Alkhurma Hemorrhagic Fever Virus,Alkhurma virus,Alkhurma virus (ALKV),Encephalitis Virus, Tick-Borne,Tick-Borne Encephalitis Virus,Tick-Borne Encephalitis Viruses,Viruses, Tick-Borne Encephalitis,Al Khurma Hemorrhagic Fever Virus,Al Khurma virus,Al Khurma virus (ALKV),Encephalitis Virus, Tick Borne,Encephalitis Viruses, Tick Borne,Louping ill viruses,Tick Borne Encephalitis Virus,Tick Borne Encephalitis Viruses
D004675 Encephalitis, Tick-Borne Encephalitis caused by neurotropic viruses that are transmitted via the bite of TICKS. In Europe, the diseases are caused by ENCEPHALITIS VIRUSES, TICK-BORNE, which give rise to Russian spring-summer encephalitis, central European encephalitis, louping ill encephalitis, and related disorders. Powassan encephalitis occurs in North America and Russia and is caused by the Powassan virus. ASEPTIC MENINGITIS and rarely encephalitis may complicate COLORADO TICK FEVER which is endemic to mountainous regions of the western United States. (From Joynt, Clinical Neurology, 1996, Ch26, pp14-5) Far Eastern Russian Encephalitis,Powassan Encephalitis,Central European Encephalitis,Encephalitis, Central European,Encephalitis, European Tick-Borne,Encephalitis, Far Eastern Russian,Encephalitis, Louping Ill,Encephalitis, Russian Spring-Summer,European Tick-Borne Encephalitis,Louping Ill Encephalitis,Powassan Virus Disease,Russian Spring-Summer Encephalitis,Tick-Borne Encephalitis,Disease, Powassan Virus,Encephalitis, European Tick Borne,Encephalitis, Powassan,Encephalitis, Russian Spring Summer,Encephalitis, Tick Borne,European Tick Borne Encephalitis,Powassan Encephalitides,Powassan Virus Diseases,Russian Spring Summer Encephalitis,Spring-Summer Encephalitis, Russian,Tick Borne Encephalitis,Tick-Borne Encephalitis, European,Virus Disease, Powassan,Virus Diseases, Powassan
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D000914 Antibodies, Viral Immunoglobulins produced in response to VIRAL ANTIGENS. Viral Antibodies
D012367 RNA, Viral Ribonucleic acid that makes up the genetic material of viruses. Viral RNA

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