Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 24, Number 5—May 2018
Dispatch

External Quality Assessment for Zika Virus Molecular Diagnostic Testing, Brazil

Carlo Fischer, Celia Pedroso, Alfredo Mendrone, Ana Maria Bispo de Filippis, Antonio Carlos Rosário Vallinoto, Bergmann Morais Ribeiro, Edison Luiz Durigon, Ernesto T.A. Marques, Gubio S. Campos, Isabelle F.T. Viana, José Eduardo Levi, Luciano Cesar Scarpelli, Mauricio Lacerda Nogueira, Michele de Souza Bastos, Nathalia C. Santiago Souza, Ricardo Khouri, Sanny M. Costa Lira, Shirley Vasconcelos Komninakis, Cécile Baronti, Rémi N. Charrel, Beate M. Kümmerer, Christian Drosten, Carlos Brites, Xavier de Lamballerie, Matthias Niedrig, Eduardo Martins Netto, and Jan Felix DrexlerComments to Author 
Author affiliations: German Centre for Infection Research, associated partner Charité–Universitätsmedizin, Berlin, Germany (C. Fischer, C. Drosten, J.F. Drexler); LAPI, Hospital Universitário Professor Edgard Santos, Salvador, Brazil (C. Pedroso, C. Brites, E.M. Netto); Fundação Pro-Sangue/Hemocentro de São Paulo, São Paulo, Brazil (A. Mendrone Jr., J.E. Levi); Instituto Oswaldo Cruz, Rio de Janeiro, Brazil (A.M.B. de Filippis); Federal University of Para, Belém, Brazil (A.C.R. Vallinoto); University of Brasília, Brasília, Brazil (B. Morais Ribeiro); University of São Paulo, São Paulo (E.L. Durigon, J.E. Levi, N.C.S. Souza); Oswaldo Cruz Foundation, Pernambuco, Brazil (E.T.A. Marques Jr., I.F.T. Viana); Universidade Federal da Bahia, Salvador (G.S. Campos); Diagnósticos da América—DASA, São Paulo (J.E. Levi, L.C. Scarpelli); Hospital Israelita Albert Einstein, São Paulo (J.E. Levi, S.M.C. Lira); Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil (M.L. Nogueira); Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil (M. de Souza Bastos); Fundação Oswaldo Cruz, Salvador, Brazil (R. Khouri); Federal University of São Paulo, São Paulo (S.V. Komninakis); Aix Marseille Université, Marseille, France (C. Baronti, R.N. Charrel, X. de Lamballerie); Assistance Publique-Hopitaux Marseille, Marseille (C. Baronti, R.N. Charrel, X. de Lamballerie); University of Bonn Medical Centre, Bonn, Germany (B.M. Kümmerer); Robert Koch Institute, Berlin, Germany (M. Niedrig)

Main Article

Figure 1

External quality assessment (EQA) performance and lower limits of detection (LODs) for Zika virus molecular diagnostic testing, Brazil. A) EQA performance of individual laboratories. Gray bars above the baseline indicate correctly tested samples; bars below the baseline indicate incorrectly tested samples. Laboratories are sorted by the quantity of correct samples and the numeric order of the laboratory identification numbers. Laboratory 8 tested only 9 of 12 samples. B) Projected 95% LODs of pa

Figure 1. External quality assessment (EQA) performance and lower limits of detection (LODs) for Zika virus molecular diagnostic testing, Brazil. A) EQA performance of individual laboratories. Gray bars above the baseline indicate correctly tested samples; bars below the baseline indicate incorrectly tested samples. Laboratories are sorted by the quantity of correct samples and the numeric order of the laboratory identification numbers. Laboratory 8 tested only 9 of 12 samples. B) Projected 95% LODs of participating laboratories under optimal conditions; C) projected 95% LODs of participating laboratories assuming a 5-fold loss in sensitivity. LODs were projected using the technical LOD of the Lanciotti et al. assay as analyzed previously (2), input and elution volumes, and real-time reverse transcription-PCR setups. Efficacy of RNA extraction was assumed to be 100%. Whiskers indicate 95% CIs. Dotted line indicates the lowest Zika virus RNA titer of an EQA specimen. Laboratories are grouped according to their EQA performance as excellent, medium, or problematic. LODs did not differ significantly among groups (p>0.05 by Kruskal-Wallis test)..

Main Article

References
  1. de Oliveira  WK, de França  GVA, Carmo  EH, Duncan  BB, de Souza Kuchenbecker  R, Schmidt  MI. Infection-related microcephaly after the 2015 and 2016 Zika virus outbreaks in Brazil: a surveillance-based analysis. Lancet. 2017;390:86170. DOIPubMedGoogle Scholar
  2. Lanciotti  RS, Kosoy  OL, Laven  JJ, Velez  JO, Lambert  AJ, Johnson  AJ, et al. Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis. 2008;14:12329. DOIPubMedGoogle Scholar
  3. Corman  VM, Rasche  A, Baronti  C, Aldabbagh  S, Cadar  D, Reusken  CB, et al. Assay optimization for molecular detection of Zika virus. Bull World Health Organ. 2016;94:88092. DOIPubMedGoogle Scholar
  4. Brasil  P, Pereira  JP Jr, Moreira  ME, Ribeiro Nogueira  RM, Damasceno  L, Wakimoto  M, et al. Zika virus infection in pregnant women in Rio de Janeiro. N Engl J Med. 2016;375:232134. DOIPubMedGoogle Scholar
  5. de Araújo  TVB, Rodrigues  LC, de Alencar Ximenes  RA, de Barros Miranda-Filho  D, Montarroyos  UR, de Melo  APL, et al.; investigators from the Microcephaly Epidemic Research Group; Brazilian Ministry of Health; Pan American Health Organization; Instituto de Medicina Integral Professor Fernando Figueira; State Health Department of Pernambuco. Association between Zika virus infection and microcephaly in Brazil, January to May, 2016: preliminary report of a case-control study. Lancet Infect Dis. 2016;16:135663. DOIPubMedGoogle Scholar
  6. Charrel  R, Mögling  R, Pas  S, Papa  A, Baronti  C, Koopmans  M, et al. Variable sensitivity in molecular detection of Zika virus in European expert laboratories: external quality assessment, November 2016. J Clin Microbiol. 2017;55:321926. DOIPubMedGoogle Scholar
  7. Baylis  SA, Hanschmann  KO, Schnierle  BS, Trösemeier  JH, Blümel  J; Zika Virus Collaborative Study Group. Harmonization of nucleic acid testing for Zika virus: development of the 1stWorld Health Organization International Standard. Transfusion. 2017;57(3pt2):74861. DOIPubMedGoogle Scholar
  8. Halai  UA, Nielsen-Saines  K, Moreira  ML, de Sequeira  PC, Junior  JPP, de Araujo Zin  A, et al. Maternal Zika virus disease severity, virus load, prior dengue antibodies, and their relationship to birth outcomes. Clin Infect Dis. 2017;65:87783. DOIPubMedGoogle Scholar
  9. Terzian  ACB, Schanoski  AS, Mota  MTO, da Silva  RA, Estofolete  CF, Colombo  TE, et al. Viral load and cytokine response profile does not support antibody-dependent enhancement in dengue-primed Zika virus–infected patients. Clin Infect Dis. 2017;65:12605. DOIPubMedGoogle Scholar
  10. Domingo  C, Escadafal  C, Rumer  L, Méndez  JA, García  P, Sall  AA, et al. First international external quality assessment study on molecular and serological methods for yellow fever diagnosis. PLoS One. 2012;7:e36291. DOIPubMedGoogle Scholar
  11. Domingo  C, Niedrig  M, Teichmann  A, Kaiser  M, Rumer  L, Jarman  RG, et al. 2nd International external quality control assessment for the molecular diagnosis of dengue infections. PLoS Negl Trop Dis. 2010;4:e833. DOIPubMedGoogle Scholar
  12. Niedrig  M, Linke  S, Zeller  H, Drosten  C. First international proficiency study on West Nile virus molecular detection. Clin Chem. 2006;52:18514. DOIPubMedGoogle Scholar
  13. Drexler  JF, Kupfer  B, Petersen  N, Grotto  RM, Rodrigues  SM, Grywna  K, et al. A novel diagnostic target in the hepatitis C virus genome. PLoS Med. 2009;6:e31. DOIPubMedGoogle Scholar
  14. Moreira-Soto  A, Sarno  M, Pedroso  C, Netto  EM, Rockstroh  A, Luz  E, et al. Evidence for congenital Zika virus infection from neutralizing antibody titers in maternal sera, north-eastern Brazil. J Infect Dis. 2017;216:15014. DOIPubMedGoogle Scholar
  15. Aiken  AR, Scott  JG, Gomperts  R, Trussell  J, Worrell  M, Aiken  CE. Requests for abortion in Latin America related to concern about Zika virus exposure. N Engl J Med. 2016;375:3968. DOIPubMedGoogle Scholar

Main Article

Page created: April 17, 2018
Page updated: April 17, 2018
Page reviewed: April 17, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external