Application of Enzyme Immunoassays for the Confirmation of Clinically Suspect Plague in Namibia, 1982

摘要

An outbreak of plague occurred in Ovamboland, northern Namibia, late in 1982. Blood cultures, sera and blood clots were tested to obtain laboratory confirmations for clinically suspect cases of the disease. Isolation of the bacillus (Yersinia pestis) was attempted from blood cultures; sera were tested for antibody by passive haemagglutination (PHA) and enzyme-linked immunosorbent assay (ELISHA). Sera and clots also were tested by ELISA for the specific F1 plague antigen. All the ELISHA procedures were based on a monoclonal antibody to F1 antigen to ensure specificity. ELISHA procedures increased laboratory confirmation of plague by 23% above the numbers achieved using blood cultures and PHA tests alone. The ELISHA to detect F1 antigen accounted for 86% of this increase by confirming cases where bacteriological isolation was not done. The ELISHA did not replace the requirement for bacteriological isolation, since seven bacteraemic patients did not demonstrate antigenaemia. (Reprints)