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PubMed1992

Baculovirus expression of the glycoprotein gene of Lassa virus and characterization of the recombinant protein.

A recombinant baculovirus was constructed that expresses the glycoprotein gene of Lassa virus (Josiah strain) under the transcriptional control of the polyhedrin promoter. The expressed protein (B-LSGPC) comigrated with the authentic viral glycoprotein as observed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), was reactive with monoclonal antibodies (MAbs) in Western blots, and was glycosylated. Although the recombinant protein was not processed into the mature glycoproteins, G1 and G2, it demonstrated reactivity with all known epitopes as measured by indirect immunofluorescence (IFA), and it was immunogenic, eliciting antisera in rabbits that recognized whole virus in IFAs. Regarding future applications to diagnostic assays, the recombinant glycoprotein proved to be an effective substitute for Lassa virus-infected mammalian cells in IFAs and it was able to distinguish sera from several human cases of Lassa fever, against a panel of known negative sera of African origin, in an enzyme immunoassay (EIA).

Animals↗
PubMed1993

Antigenic analysis of feline calicivirus capsid precursor protein and its deleted polypeptides produced in a mammalian cDNA expression system.

An entire open reading frame in a cDNA encoding the capsid protein gene of feline calicivirus (FCV) was subcloned into a mammalian expression vector. After transfection of the constructed plasmid (pMCV-II) into COS-7 cells, the expressed protein was detected by indirect immunofluorescence assay (IFA) using a panel of monoclonal antibodies (MAbs) to the capsid protein of FCV. All of the MAbs reacted with the transfected COS-7 cells in IFA. The 76 kDa capsid precursor protein was demonstrated in an immunoblot analysis, indicating that the translated precursor protein was not processed into the matured capsid protein in this expression system. Two in-frame deleted and a frameshift mutated cDNAs were generated by using restriction sites within the capsid protein coding sequence in pMCV-II to analyze the antigenic sites of the protein. The results of IFA using the MAbs and COS-7 cells transfected with the deleted or mutated cDNAs suggested that three neutralizing epitopes had a conformational nature and that the other four linear epitopes were related to 74 amino acid residues between positions 381 and 454 in the protein, in which high variation was known to be present among three strains of FCV.

Antibodies, Monoclonal↗
PubMed1995

Synthetic delivery system for tuberculosis vaccines: immunological evaluation of the M. tuberculosis 38 kDa protein entrapped in biodegradable PLG microparticles.

Tuberculosis remains a major public health burden which could be ameliorated by effective and well-defined subunit vaccines, particularly because the protective efficacy of current M. bovis BCG vaccines is both unpredictable and variable. The immunodominant 38 kDa antigen from Mycobacterium tuberculosis was entrapped in biodegradable poly (DL-lactide co-glycolide) (PLG) microparticles which served as a delivery system. Both cellular and humoral immune responses were assessed and compared with those obtained after immunization with the 38 kDa protein emulsified in incomplete Freund's adjuvant (IFA). Vaccination of mice with a single dose of antigen-loaded microparticles resulted in specific IgG titres peaking after five weeks comparable to those achieved after vaccination with protein emulsified in incomplete Freund's adjuvant (IFA). T-cell responses were found to be superior to those induced with antigen/IFA. The T- and B-cell epitope specificities ad judged with synthetic peptides were identical following immunization with antigen in microparticles or IFA. Differences in adjuvanticity were revealed by measuring antigen-specific IgG1, IgG2a and antigen-induced IFN-gamma secretion in vitro: substantially higher titres of IgG2a were observed following immunization with antigen/microparticles than with 38 kDa protein/IFA. This was paralleled by a tenfold higher secretion of IFN-gamma in mice injected with antigen/microparticles. Reduction in colony-forming units was not consistent in mice immunized with 38 kDa protein entrapped in microparticles which were subsequently infected with live tubercle bacilli. Taken together these results indicate that biodegradable PLG microparticles constitute a favorable candidate vaccine delivery system worthy of further assessment in the quest to develop better and defined agents protecting against tuberculosis.

Amino Acid Sequence↗
PubMed1991

Competitive enzyme-linked immunosorbent assay for heartwater using monoclonal antibodies to a Cowdria ruminantium-specific 32-kilodalton protein.

Hybridomas producing monoclonal antibodies (mAb) to Cowdria ruminantium were raised. Four mAbs of the IgG isotype reacted in western blots with a 32-kilodalton Cowdria protein (Cr32), which had previously been shown to be conserved and immunodominant. A fifth mAb of the IgM isotype recognized a 40-kDa Cowdria protein. The latter mAb was negative in an indirect fluorescent antibody test (IFA), whereas the other four were positive. mAb No. 4F10B4 showed the strongest signal in western blots using three different stocks of Cowdria. Immuno-gold labeling of Cowdria organisms in vitro using 4F10B4 showed that Cr32 has surface-exposed antigenic determinants. Using mAb 4F10B4, a competitive ELISA was developed which detected specific Cowdria antibodies in goat, sheep and cattle sera. Antibodies in animal sera competed with binding of mAb 4F10B4 to a crude sonicated Cowdria antigen obtained from infected endothelial cell cultures. The competition ELISA (CELISA) detected antibodies in 55 out of 70 (79%) goats experimentally infected with one of eight different Cowdria stocks. Fourteen out of the 15 sera which were shown negative in the CELISA were also negative in the IFA. Nevertheless, all 15 sera recognized some epitopes of the immunodominant Cowdria-specific 32 kDa protein as judged from their reaction with this protein in western blots. Overall, there was 89% agreement between CELISA and IFA considering all 70 goat sera. Moreover, antibodies were detected in nine out of nine sheep infected with one of three different stocks of Cowdria and in sera from calves experimentally infected by two different strains of heartwater. There were no cross-reactions with Ehrlichia phagocytophila antibodies in goat sera, nor with Anaplasma marginale antibodies in bovine sera. Lack of cross-reactivity and detection of antibodies to eight geographically widely distributed stocks of Cowdria, makes the competition ELISA a promising test for use in heartwater endemic areas.

Animals↗
PubMedDate not supplied

Evaluation of three commercial tests for Lyme disease.

A commercial indirect immunofluorescence assay (IFA), enzyme-linked immunosorbent assay (ELISA), and a passive hemagglutination kit were evaluated and compared with our in-house IFA and ELISA methods. Both IFA methods gave identical results but were less sensitive than ELISA methods. Likewise, the ELISA methods were comparable. The hemagglutination method gave a statistically significant difference when compared with our ELISA method (p = 0.018 McNemar test). It is recommended that the passive hemagglutination method should not be used in its current state.

Antibodies, Bacterial↗
PubMedDate not supplied

Evaluation of variables in immunofluorescence procedures for the detection of antibodies against human herpesvirus 6 (HHV-6).

Ten human sera were used to study different parameters, namely, methods of smear preparation and fixation, and age of infected HSB-2 cells in order to optimize indirect immunofluorescence assay (IFA) and anticomplement immunofluorescence (ACIF) procedures to measure antibody levels against HHV-6. Results showed a greater sensitivity of rapid smear drying and methanol fixation over conventional acetone smear preparation. Cells harvested 6 days after infection and fixed with methanol exhibited a sharper and more intense fluorescence. IFA titers were higher than those obtained with ACIF, although the latter procedure enabled the distinction between three fluorescent sites. Reactivity pattern of individual sera against infected cells was variable and indicated that the human immune response to HHV-6 is directed against different antigens. An easier interpretation and a better definition of the fluorescence of HSB-2 cell line infected with HHV-6 strain Dv is obtained with the following conditions: cells should be harvested at 5-8 days after infection (at the giant cell stage of infection), cell smears have to be dried quickly before fixation with methanol at -20 degrees C, and finally, they should be stained by IFA.

Acetone↗
PubMed1992

Comparison of enzyme-linked immunosorbent and indirect immunofluorescence assays for the detection of human T-cell lymphotropic virus type-I antibodies in sera from rural Haiti.

Serum samples were obtained from 340 healthy individuals without evidence of neurologic disease living in rural Haiti. Sera were screened for antibodies to human T-cell lymphotropic virus type I (HTLV-I) using two commercially available enzyme immunoassays (EIA) and by an indirect immunofluorescence assay (IFA) using a mixture of uninfected H9 cells and HTLV-I-infected MT-2 cells. Repeatedly positive samples were confirmed by Western blot (WB). Results with the two EIA systems were concordant and detected 13 positive samples, each of which was confirmed by WB. Only 9 (69%) of 13 WB-positive sera were detected by IFA, and four additional samples, positive by IFA, could not be confirmed by WB. The prevalence of HTLV-I seropositivity in this selected rural Haitian population was 3.8% (13 of 340).

Adolescent↗
PubMedDate not supplied

Rift Valley fever on the east coast of Madagascar.

In March 1990, a Rift Valley fever virus (RVFV) outbreak was suspected in the district of Fenerive on the east coast of Madagascar after an abnormally high incidence of abortions and disease in livestock. Sera from humans and cattle were tested for RVFV antibodies by immunofluorescence assay (IFA) and ELISA-IgM capture. Sera and mosquitoes collected in the same area were tested for virus isolation by tissue culture and suckling mouse intracerebral inoculation, and for antigen detection by an ELISA antigen capture assay. Among cattle from the area, RVFV antibody prevalence was 58.6% by IFA and 29.6% by ELISA-IgM. In contrast, human populations in the same area had a lower RVFV antibody prevalence, with 8.01% IFA and 5.4% IgM-positive sera. No RVFV antigen was detected and virus isolation was unsuccessful from the sera and mosquito pools tested. Different hypotheses concerning the emergence and diffusion of RVFV in this area and the occurrence of the outbreak are discussed.

Adolescent↗
PubMed1993

Detection of antibodies to herpes simplex virus type 2 with a mammalian cell line expressing glycoprotein gG-2.

The gene (US4) coding for herpes simplex virus type 2 (HSV-2) glycoprotein G (gG-2) was cloned and constitutively expressed in Chinese hamster ovary (CHO) cells. The expression vector containing the dihydrofolate reductase (dhfr) gene, and the HSV-2 US4 gene under the control of the Simian virus 40 early promoter (SV40 EP), was transfected into dhfr-deficient CHO cells. The transfected cells were selected and amplified using methotrexate (MTX). To demonstrate that the gG-2 produced in these transformed cells had antigenic determinants in common with the native glycoprotein, CHO cells expressing gG-2 were used in an immunofluorescent assay (IFA) for the detection of HSV-2 type-specific antibodies in human serum samples. Seven of eight serum samples from adults with prior episodes of culture proven HSV-2 infections were found to be positive by the IFA method whereas none of seven serum samples from young children with culture documented HSV-1 infections were positive by IFA. Thus the recombinant CHO : gG-2 cells have diagnostic utility in an HSV-2 specific serologic assay.

Journal Article↗
PubMed2006

Malaria epidemiology in low-endemicity areas of the Atlantic Forest in the Vale do Ribeira, São Paulo, Brazil.

We describe a seroepidemiological survey of malaria prevalence in two areas of low endemicity: Intervales State Park and Alto Ribeira State Tourist Park (PETAR). Both are located in the Vale do Ribeira in the state of São Paulo, Brazil. In this study, 318 subjects from both areas had their blood analyzed for the presence of malaria parasites by thin and thick blood smears. One hundred and sixty-three (51.2%) of the subjects were from Intervales State Park and 155 (48.7%) were from PETAR. We analyzed all the samples by indirect immunofluorescent assay (IFA) to detect antibodies against asexual forms of Plasmodium vivax and Plasmodium malariae and enzyme immunosorbent assay (ELISA) to detect the presence of antibodies against circumsporozoite proteins (CSP) from P. vivax VK210, human P. vivax-like/Plasmodium simiovale, P. vivax VK247 and Plasmodium brasilianum/P. malariae. The presence of Plasmodium species was detected by polymerase chain reaction (PCR). Eighteen of the subjects analyzed had positive IFA results for IgM against P. malariae antigens, and three others were positive for P. vivax antigens. Positivity of IgG antibodies against P. vivax detected by IFA was high in samples from both Intervales State Park and PETAR (32.0% and 49.0%, respectively), while positivity for P. malariae was lower (16.0% and 19.3% in Intervales State Park and PETAR, respectively). ELISA tests showed a higher prevalence of antibodies against P. vivax VK210 (35.0%) in samples from Intervales State Park and against human P. vivax-like (29.7%) in samples from PETAR. PCR reactions revealed the presence of parasites in several of the samples analyzed. In Intervales State Park, one subject was infected by P. malariae and two by Plasmodium falciparum, while in PETAR, one subject was positive for P. falciparum and three for both P. falciparum and P. vivax parasites. The areas where these parks are located belong to the Atlantic Forest habitat, and inhabitants frequently, see monkeys. Our data suggest that monkeys may constitute a natural reservoir for malaria in both areas.

Adult↗
PubMed2005

Parvovirus B19 viral loads in relation to VP1 and VP2 antibody responses in diagnostic blood samples.

BACKGROUND: Human parvovirus B19 infection is characterised by high peak viral load levels followed by episodes of prolonged viremia. The risk of transmission of parvovirus B19 by blood or blood products has been increasingly recognised and parameters that can predict the risk of transmission are subject of interest. OBJECTIVES: This study aimed to study correlations between B19 viral DNA loads and antibody responses to the viral antigens VP1 and VP2 in clinical serum samples. STUDY DESIGN: A panel of 1610 serum samples from patients clinically suspected from acute B19 infection were analysed. Antibodies were measured by the parvovirus anti-VP1 immuno-fluorescence assay (IFA) and the anti-VP2 enzyme immunoassay (EIA) from Biotrin. B19 viral loads were measured by a real-time PCR using the external WHO standard for DNA quantification. RESULTS: Positive IgM responses were found in 154 (9.6%) of the 1610 sera tested. Based on the PCR results in a subset of 312 sera, the anti-VP2 EIA IgM showed a better combination of sensitivity/specificity (91%/94%) compared to the anti-VP1 IFA (66%/97%). B19 DNA levels in the sera strongly correlated with the levels of IgM antibodies, all sera with high viral loads (>10(6)IU/ml) having VP2 EIA IgM ratios above 3.0. CONCLUSIONS: The B19 VP2 IgM ELISA is superior to the B19 VP1 IgM IFA if verified by PCR. Anti-VP2 IgM antibodies in sera are indicative for the presence B19 DNA and can be used to predict high levels of B19 DNA in diagnostic sera.

Adolescent↗
PubMed2004

Improved specificity for Giardia lamblia cyst quantification in wastewater by development of a real-time PCR method.

The protozoan parasite Giardia lamblia is the most common cause of waterborne disease outbreaks associated with drinking water in the United States. The conventional method used for the enumeration of Giardia cysts in water is based on immunofluorescence with monoclonal antibodies. It is tedious and time-consuming and has the major drawback to be non-specific for the only species infecting humans, G. lamblia. We have developed a real-time polymerase chain reaction (PCR) method using fluorescent TaqMan technology, which improved the specificity of G. lamblia cyst quantification compared to the immunofluorescence assay (IFA). However, this PCR was not totally specific for G. lamblia species and amplified Giardia ardeae target as well. This method showed a sensitivity of 0.45 cysts per reaction and an efficiency of 95% in purified suspensions. We have then applied this quantification method to raw wastewater, a medium containing numerous debris, particles and PCR inhibitors. The adaptation to these environmental samples was realized by a screening of three cyst purification methods and six DNA extraction protocols. Real-time quantification was accomplished by the simultaneous amplification of unknown samples and a tenfold serial dilution of purified G. lamblia cysts. For all samples, the concentrations observed with TaqMan PCR method were compared to the IFA values. Giardia spp. cysts were detected in all non-spiked raw wastewater samples with IFA procedure and the concentrations of Giardia spp. cysts used for the comparison between the two methods ranged between 3.3x10(2)/l and 4.3x10(3)/l. The highest TaqMan PCR/IFA ratios were observed when Percoll/sucrose flotation was combined with DNA extraction protocol optimized for cyst wall lysis, impurities adsorption on a resin, and double step protein digestion and column purification. The concentrations observed with this TaqMan PCR method ranged from 2.5x10(2) to 2.4x10(3) G. lamblia cysts/l and only one sample resulted in a no amplification curve. Thus, we developed a TaqMan PCR method increasing the rapidity and specificity of G. lamblia cyst quantification. The combination of Percoll/sucrose flotation and DNA extraction optimized protocol before TaqMan assay has provided a good indication of the G. lamblia contamination level in raw sewage samples.

Animals↗
PubMed2005

CpG oligodeoxynucleotides activate dendritic cells in vivo and induce a functional and protective vaccine immunity against a TERT derived modified cryptic MHC class I-restricted epitope.

The use of synthetic peptides derived from tumor-associated Ags is attractive for the development of antitumoral vaccines as far as strong adjuvants are found to render them immunogenic. Here, we investigated the possibility to enhance the CD8 response against the human and mouse shared TERT(572Y) HLA-A*0201 restricted modified cryptic peptide by using ODN-CpG as adjuvant. Humanized transgenic mice were immunized with the TERT(572Y) modified cryptic peptide in the presence of ODN-CpG and compared to mice immunized in IFA. By contrast with IFA, we first showed that, in vivo, ODN-CpG leads to the recruitment of dendritic cells in the lymph nodes draining the injection site. Those cells and especially the CD11c+ CD11b- CD8a+ lymphoid and the CD11c+ B220+ plasmacytoid dendritic cells were activated as shown by up-regulation of CD40 at their cell surface. Immunization against TERT(572Y) peptide in the presence of ODN-CpG rather than IFA led to a strong CD8 response and can delayed mortality in an induced tumor model. Study of the CD8 response obtained after antigenic challenge suggested that a functional memory response is induced upon vaccination with ODN-CpG. Thus, MHC class I-restricted epitope in combination of ODN-CpG is a promising and rather simple cancer vaccine formulation.

Adjuvants, Immunologic↗
PubMed2005

Protection by recombinant viral proteins against a respiratory challenge with virulent avian metapneumovirus.

Protection by recombinant avian metapneumovirus (aMPV) N or M proteins against a respiratory challenge with virulent aMPV was examined. N, M or N+M proteins were administered intramuscularly (IM) with incomplete Freund's adjuvant (IFA) or by the oculonasal (ON) route with cholera toxin-B (CTB). Each turkey received 40 or 80 microg of each recombinant protein. Birds were considered protected against challenge if the challenge virus was not detectable in the choanal swabs by RT-PCR. At a dose of 40 microg/bird, N protein given with IFA by the IM route protected eight out of nine birds. M protein at the same dose protected three out of seven birds, while a combination of N+M proteins (40 microg each) protected three out of four birds. At a dose of 80 microg of each of N and M proteins per bird given with IFA by the IM route, 100% protection was achieved. ON immunization with a mixture of N and M proteins induced partial protection when the proteins were given with CTB; no detectable protection was noted without CTB. N and M proteins induced anti-aMPV antibodies, although protection against virulent virus challenge did not appear to be associated with the level or presence of antibodies.

Animals↗
PubMed2006

White-tailed deer (Odocoileus virginianus) develop spirochetemia following experimental infection with Borrelia lonestari.

Borrelia lonestari is considered a putative agent of southern tick-associated rash illness (STARI) and is known to occur naturally only in lone star ticks (Amblyomma americanum) and white-tailed deer (Odocoileus virginianus). We used a low passage isolate of B. lonestari (LS-1) to inoculate white-tailed deer, C3H mice, Holstein cattle, and beagles. Animals were monitored via examination of Giemsa and acridine orange stained blood smears, polymerase chain reaction (PCR), indirect fluorescent antibody (IFA) test, and/or culture isolation. Spirochetes were visualized in blood smears of both deer on days post-inoculation (DPI) 6, 8, 12 and one deer on DPI 15. Whole blood collected from deer tested PCR positive starting on DPI 4 and remained positive as long as DPI 28. Both deer developed antibody titers of >64, with a maximum IFA titer of 1024. The organism was reisolated from the blood of both deer on DPI 6 and one deer on DPI 12. All isolation attempts from mice, calves, or dogs were negative, although one of seven mice was transiently PCR positive. Mice and dogs developed an IFA titer > or =64, while calves lacked a detectable antibody response. These preliminary experimental infection trials show that white-tailed deer are susceptible to infection with B. lonestari and develop a spirochetemia following needle-inoculation, while C3H mice, calves, and dogs do not. Results suggest that deer may serve as a vertebrate reservoir host. Tick transmission studies are needed to confirm that this organism can be maintained in a natural cycle involving deer and A. americanum.

Animals↗
PubMed2006

Prevalence of antibodies to Encephalitozoon cuniculi in horses from Brazil.

Encephalitozoon cuniculi has been associated with natural cases of abortion and stillbirth in horses. However, little is known about the prevalence of this parasite in horses. We examined sera from 559 horses from Brazil for antibodies to E. cuniculi using the indirect immunofluorescent antibody (IFA) test and the direct agglutination test (DAT). We found that 79 (14.1%) were positive in the IFA test and 70 (12.5%) were positive in the DAT. Compared to the IFA as the "gold standard" the sensitivity of the DAG was 94.0% and the specificity was 96.1%. Our study indicates that horses in Brazil are frequently exposed to E. cuniculi.

Agglutination Tests↗
PubMed1996

Antibodies to carbonic anhydrase in endometriosis: prevalence, specificity, and relationship to clinical and laboratory parameters.

OBJECTIVE: To investigate the presence and clinical association of serum autoantibodies to carbonic anhydrase (CA) in women with and without endometriosis. DESIGN: Sera were tested in an ELISA against human and bovine CAI and/or CAII isoenzymes and by Western immunoblotting of trypsin-digested fragments of human CAII as antigens. The ELISA positivity was defined as mean + 2 SD of 100 control sera. Positive sera also were tested for the presence of antiendometrial antibodies and antinuclear antibodies (ANA) by indirect immunofluorescence assays (IFA) on endometrial (ECC) and HEp-2 cells, antibodies to single-stranded (ss) and double-stranded (ds) DNA by the Farr-type RIA and Crithidia IFA, and extractable nuclear antigens (Sm, nRNP, Ro, and La) by an ELISA. PATIENTS: Sera from 319 patients with laparoscopic diagnosed pelvic endometriosis (100 stage I, 95 stage II, 67 stage III, and 57 stage IV), 100 with other gynecologic disorders, and 100 control women were used. RESULTS: In the ELISA, 113 of 319 (35.4%) endometriosis sera had elevated immunoglobulin G antibodies against nondenatured CA isoenzymes. The reactivity of sera from the endometriosis group was significantly higher (35%) in all four subgroups of patients than each of the nonendometriosis sera (< 12% and < 6%, respectively). No stage-dependent variation of an autoantibody pattern was evident. However, anti-CA autoantibodies were present in 66.3% of women with endometriosis-associated infertility. The frequency of anti-CA autoantibodies was significantly higher (by 51.7%) in women with antiendometrial antibodies detectable by IFA. In addition, in sera positive for anti-CA antibodies, the frequency of ANA also was increased (20/113 [17.6%]) with titers of 1:40 to 1:1,080. The ANA-positive sera were negative for anti-ssDNA, anti-dsDNA, anti-Sm, anti-nRNP, and anti-La. However, three sera were positive for anti-Ro antibodies. Immunoblotting study of autoantibody reactivity with trypsin-digested subfragments of human CAII revealed consistent immunoreactivity with 14 to 6.2-kd range CAII peptides. CONCLUSIONS: [1] A subgroup of patients with endometriosis have autoantibodies directed to native and linear epitopes of the CA protein. [2] Prevalence of anti-CA antibodies was associated with antiendometrial antibodies and ANA. [3] Anti-CA antibodies were associated with a higher predictive value of the disease when all patient subgroups were considered together.

Animals↗
PubMed1981

IgM enzyme-linked immunosorbent assay test for the diagnosis of congenital Toxoplasma infection.

An IgM enzyme-linked immunosorbent assay, developed for detection of IgM antibodies to Toxoplasma gondii, was evaluated to define its usefulness for diagnosis of congenital Toxoplasma infection. Sera from 51 infants suspected of having congenital Toxoplasma infection but in whom this diagnosis was ruled out were negative in the IgM-ELISA test. Fifty of them were also negative in the IgM-fluorescent antibody test; the one which was positive was from an infant with congenital syphilis who had circulating rheumatoid factor. Of 55 sera from newborn infants with proved congenital Toxoplasma infection, the IgM-ELISA test was positive in 43 (72.7%), whereas the IgM-IFA test was positive in only 14 (25.4%). Of those sera obtained during the first 30 days of life the infected infants, 81.2% were positive in the IgM-ELISA test, whereas only 25% were positive in the IgM-IFA test. The Igm-ELISA test avoids the false-positive results owing to RF and the false-negative results owing to competition from high levels of maternal IgG antibody which occur in the IgM-IFA test. We conclude that the IgM-ELISA test is highly sensitive and specific for diagnosis of congenital Toxoplasma infection.

Child, Preschool↗