Middle East respiratory syndrome coronavirus (MERS-CoV) infections in humans can cause asymptomatic to fatal lower respiratory lung disease. Despite posing a probable risk for virus transmission, asymptomatic to mild infections can go unnoticed; a lack of seroconversion among some PCR-confirmed cases has been reported. We found that a MERS-CoV spike S1 protein–based ELISA, routinely used in surveillance studies, showed low sensitivity in detecting infections among PCR-confirmed patients with mild clinical symptoms and cross-reactivity of human coronavirus OC43–positive serum samples. Using in-house S1 ELISA and protein microarray, we demonstrate that most PCR-confirmed MERS-CoV case-patients with mild infections seroconverted; nonetheless, some of these samples did not have detectable levels of virus-neutralizing antibodies. The use of a sensitive and specific serologic S1-based assay can be instrumental in the accurate estimation of MERS-CoV prevalence.
【저자키워드】 viruses, antibodies, coronavirus, spike, serology, Human, MERS, MERS-CoV, diagnostics, ELISA, S1, Middle East respiratory syndrome Coronavirus, Neutralizing, The Netherlands, South Korea, Qatar, Camels, 【초록키워드】 Infection, Lung disease, risk, virus transmission, cross-reactivity, Prevalence, Protein, sensitivity, Seroconversion, Asymptomatic, Surveillance, Microarray, mild infection, Middle East, PCR-confirmed, serum samples, virus-neutralizing antibodies, respiratory syndrome coronavirus, lack, reported, detectable, asymptomatic to mild, mild clinical symptom, PCR-confirmed patient, 【제목키워드】 detection, response, respiratory, sensitive, Middle East, Specific,