Yellow fever virus (YFV) is endemic in tropical and sub-tropical regions of the world, with around 180,000 human infections a year occurring in Africa. Serologic testing is the chief laboratory diagnostic means of identifying an outbreak and to inform the decision to commence a vaccination campaign. The World Health Organization disseminates the reagents for YFV testing to African reference laboratories, and the US Centers for Disease Control and Prevention (CDC) is charged with producing and providing these reagents. The CDC M-antibody capture ELISA is a 2-day test, requiring titration of reagents when new lots are received, which leads to inconsistency in testing and wastage of material. Here we describe the development of a kit-based assay (YF MAC-HD) based upon the CDC method, that is completed in approximately 3.5 h, with equivocal samples being reflexed to an overnight protocol. The kit exhibits >90% accuracy when compared to the 2-day test. The kits were designed for use with a minimum of equipment and are stored at 4 °C, removing the need for freezing capacity.
This kit is capable of tolerating temporary sub-optimal storage conditions which will ease shipping or power outage concerns, and a shelf life of >Top 15 hidden option key tips for mac. 6 months was demonstrated with no deterioration in accuracy. All reagents necessary to run the YF MAC-HD are included in the kit and are single-use, with 8 or 24 sample options per kit. Field trials are envisioned for the near future, which will enable refinement of the method. The use of the YF MAC-HD is anticipated to reduce materials wastage, and improve the quality and consistency of YFV serologic testing in endemic areas. Introduction Yellow fever virus (YFV) strain Asibi is the type species of the family Flaviviridae and was first isolated from a male patient in Ghana in 1927 ().
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Chiefly transmitted by Aedes spp. Mosquitoes (), it is a viscerotropic virus, causing high fever, severe headaches, back and body aches, and nausea and vomiting, which typically present 3-6 days post-exposure. While the conditions of most patients improve after about 48 hours, around 15% will develop a more severe form of the disease that starts following a brief remission of symptoms. These individuals experience high fever, bleeding, jaundice, eventual shock and multiple organ failure ().
Yellow fever appeared in Barbados in 1647 as a result of the slave trade () and the first outbreak in the US followed in 1668. Significant outbreaks occurred for more than 2 centuries in cities in the south and east of the country, with the last one recorded being in New Orleans in 1905 (). Once Aedes aegypti (formerly known as Stegomyia fasciatus) was identified as the chief vector of the disease (), mosquito control measures were adopted in developed countries that eliminated yellow fever as a public health concern.
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Today, yellow fever is most prevalent in tropical and subtropical Africa, but is also endemic in parts of S. A widely-used vaccine is available to prevent yellow fever infections, which was derived from the Asibi strain (). The 17-D vaccine is generally considered safe; however, vaccine-related adverse events have been documented (). While vaccination campaigns are effective in limiting yellow fever outbreaks in Africa, the sylvatic cycle propagated by wild primates is not affected, allowing YFV to persist. Numbers are estimated to be around 180,000 infections per year in Africa, with more than 25,000 deaths (). The efficacy of vaccination campaigns is dependent on a number of factors: the availability of vaccine; the percentage of the population that receives the vaccine; and the speed and accuracy with which the initial outbreak is identified. This last factor is critical because an outbreak can spread quite rapidly in the time between initial suspicion of yellow fever activity, and actual diagnosis.