IMMUNOGLOBULIN-M CAPTURE IMMUNOASSAY IN INVESTIGATION OF COXSACKIEVIRUS B5 AND B6 OUTBREAKS IN SOUTH-AUSTRALIA

An immunoglobulin M (IgM) capture enzyme immunoassay was used to detec t major overlapping outbreaks of disease in South Australia caused by coxsackieviruses B5 (CBV-5) and B6 (CBV-6). CBV-5-specific IgM was det ected in patients presenting in spring 1992 with acute febrile illness es, rash, severe acute respiratory disease, meningitis, myocarditis an d/or pericarditis, while tests for other viruses were negative. CBV-5 was isolated from an early case. In December 1992 it was noted that CB V-6 had replaced CBV-5 as the major cause of disease, The CBV-6 epidem ic continued until April 1993, Serum samples from 495 patients (276 in patients) were submitted for testing, CBV-6 infection was associated w ith lower respiratory tract infection and persistent cough. This study demonstrated success of the IgM enzyme immunoassay and the need for d iagnostic virology laboratories to look for CBV-6 infection in additio n to the other five CBVs.