Solving Public Health Problems

What to know

  • The Arbovirus Reference Collection (ARC) contains materials that can be used to develop and perform diagnostic assays and conduct research.
  • By donating to ARC, you're making it easier for public health laboratorians and researchers to access materials for important public health work.
Laboratorian testing for an arboviral disease.

ARC supports YF test kit development

Even with an effective vaccine, yellow fever (YF) continues to be a public health problem. For example, during 2016 YF outbreaks in Angola and Democratic Republic of Congo, international exportation of YF occurred. The outbreak response exhausted the limited global supply of YF vaccine.

Situations like this require rapid detection of cases so that people can be vaccinated quickly. Often YF outbreaks occur in remote locations or resource-limited tropical countries that may lack staff trained to calibrate reagents or freezers for storing some reagents. In addition, the most common, front-line diagnostic test takes 2 days to perform.

To overcome these challenges, CDC researchers developed the YF MAC-HD kit1, which relies on the following ARC materials:

  • Inactivated YF antigen
  • Normal antigen
  • YF positive control
  • Conjugate

Key benefits to public health

The YF MAC-HD kit provides lab staff with a reliable test for use during outbreaks.

  • The kit allows for rapid (half-day) YF serologic diagnosis, critical during a YF outbreak for quick and effective mobilization of vaccine stocks.
  • A kit format allows for standardization of YF serologic testing within and across laboratories performing the test.

Easy-to-use kit

  • Tests for IgM antibodies to YF
  • Includes pre-measured reagents and ready-to-use plates
  • Allows for assay completion in 3.5 hours
  • Tests 8 or 24 serum samples per plate
  • Kit (see photo) used by African and South American regional reference and national laboratories of the World Health Organization (WHO) Global Yellow Fever Laboratory Network. The kit is only available through the WHO.
Photo of a yellow fever virus MAC-ELISA kit
CDC developed the YF kit, which is manufactured in partnership with ATCC.

ARC supports YF assay development

The YF vaccine is a safe and effective and has been available for more than 80 years. Reactions to the vaccine are generally mild. Rarely, people develop severe, sometimes life-threatening reactions to the vaccine. During a YF outbreak, public health professionals may need to distinguish between individuals infected with wild-type YF and those experiencing a reaction to the vaccine.

Wild-type YF infection and YF vaccination adverse events are clinically and serologically indistinguishable. CDC researchers developed the YF 17D-specific real-time PCR assay2 to differentiate between YF infection and a vaccine reaction. The assay uses Locked-nucleic acid (LNA) bases to distinguish single nucleotide differences.

Locked-nucleic acid and DNS monomers.
The assay uses LNA bases to distinguish single nucleotide differences.

Researchers used the following ARC materials to develop the assay:

  • 17 different isolates of YF virus
  • YF positive RNA controls

Assay benefits public health

During a YF outbreak, the YF 17D real-time PCR assay

  • Distinguishes between wild-type YF and 17D (vaccine) strains
    • Wild-type and 17D YF strains are genetically different by <10 nucleotides
  • Uses LNA bases capable of distinguishing single nucleotide differences
    • Highly specific
    • Incorporated into probe
  • Determines the nature and extent of the outbreak
  • Assists with decision-making by clinicians and public health officials
  • Can be used to monitor people during outbreak vaccination campaigns for vaccination adverse events.

Donate specimens to improve public health

We'd like to collaborate with you! You can support public health by depositing your isolates in CDC's Arbovirus Reference Collection (ARC). The ARC offers long-term curation, maintenance, and distribution of valuable isolates. Contact the ARC staff about depositing your isolates for long-term curation, maintenance, and distribution.

Reagents‎

If you need reagents, visit our Arboviral Reagent Ordering System. Only U.S. public health laboratories are granted access to the ordering system.

References and Resources

References

  1. Basile AJ, Goodman C, Horiuchi K, Laven J, Panella AJ, Kosoy O, Lanciotti RS, Johnson BW. Development and validation of an ELISA kit (YF MAC-HD) to detect IgM to yellow fever virus. J Virol Methods. 2015;225: 41-8.
  2. Hughes HR, Russell BJ, Mossel EC, Kayiwa J, Lutwama J, Lambert AJ. Development of a real-time reverse transcription-PCR assay for global differentiation of yellow fever virus vaccine-related adverse events from natural Infections. J Clin Micro. 2018;56(6):e00323-18.

Resource

ATCC Yellow Fever Surveillance Kits

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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)