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Diagnostic agreement between oral fluid and serum assays to detect measles IgG antibody in healthcare providers
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  • Mei Dong,
  • Jingyi Sun,
  • Hui Xie,
  • Jie Liu,
  • Yiting WANG,
  • Yin Fu,
  • Jianping Dong,
  • Fang Huang
Mei Dong
Beijing Center for Disease Prevention and Control
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Jingyi Sun
Beijing Haidian Section of Peking University Third Hospital
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Hui Xie
Beijing Center for Disease Prevention and Control
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Jie Liu
Chaoyang District Center for Disease Prevention and Control
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Yiting WANG
Beijing Center for Disease Prevention and Control
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Yin Fu
Beijing Center for Disease Prevention and Control
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Jianping Dong
Beijing Haidian Section of Peking University Third Hospital
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Fang Huang
Beijing Center for Disease Prevention and Control, Beijing Preventive Medicine Research Center

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Abstract

Background: An easy-to-use, low-risk, and non-invasive method to detect the measles antibody, such as oral fluid (OF) assay, is required in the clinic. Methods: We tested the measles IgG antibody in the serum and OF of healthcare providers enrolled from four hospitals in Beijing, China, between March and December in 2018. We also tested the pre- and post-vaccination antibodies in selected participants. Serum and OF antibodies were detected by indirect and capture EIA, respectively. Results: Overall, 550 pairs of serum and OF samples were collected from 495 participants, including 55 pre- and post-vaccination pairs. ROC analysis showed a high diagnostic value of OF assay (AUC = 0.84, P < 0.01). The positive and negative consistency rates with serum were 90.0% and 67.9%, respectively (κ = 0.53). The sensitivity and specificity of the OF assay were 90.2% and 67.9%, respectively. Positive measles IgG rates in paired serum and OF were 83.6% and 80.2%, respectively. There were no significant differences in the OF assay between different genders (P > 0.05) and vaccination histories (P = 0.12). Statistically significant differences were identified in participants with different histories of measles contacts and measles infections. In different age groups, the positive OF measles antibody rates ranged from 71.6% to 89.7% (P = 0.01), with participants ≥ 40 years old having the highest positive rate. After vaccination, increased measles antibody levels and positive rates were observed by both serum and OF assays. Conclusions: There was a relatively high agreement between serum and OF measles antibody assays.