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Topic:Serology

Serology in horse research involves the study and analysis of blood serum to detect the presence of antibodies or antigens associated with infectious diseases and other health conditions. It is a diagnostic tool used to identify immune responses to pathogens, vaccination status, and exposure to specific diseases. Serological tests in equine research can include enzyme-linked immunosorbent assays (ELISA), complement fixation tests, and virus neutralization tests. These tests help in understanding the epidemiology of diseases, monitoring herd health, and informing vaccination strategies. This page compiles peer-reviewed research studies and scholarly articles that explore the methodologies, applications, and implications of serological testing in equine medicine.
Horses are susceptible to natural, but resistant to experimental, infection with the liver fluke, Fasciola hepatica.
Veterinary parasitology    April 2, 2020   Volume 281 109094 doi: 10.1016/j.vetpar.2020.109094
Quigley A, Sekiya M, Garcia-Campos A, Paz-Silva A, Howell A, Williams DJL, Mulcahy G.Fasciola hepatica is a common parasite of livestock in Ireland, causing significant economic losses and affecting animal welfare. A previous abattoir study of 200 horses led to an estimated 9.5 % prevalence of infection in horses slaughtered in Ireland. However, the epidemiology and pathogenic significance of this infection in this species is not well-described. The objectives of this study were to determine the susceptibility of horses to oral challenge infection with F. hepatica metacercariae, and to document the course of the infection along with serological and biochemical response. We att...
Borna disease outbreak with high mortality in an alpaca herd in a previously unreported endemic area in Germany.
Transboundary and emerging diseases    March 29, 2020   doi: 10.1111/tbed.13556
Schulze V, Große R, Fürstenau J, Forth LF, Ebinger A, Richter MT, Tappe D, Mertsch T, Klose K, Schlottau K, Hoffmann B, Höper D, Mundhenk L....Borna disease virus 1 (BoDV-1) is the causative agent of Borna disease, an often fatal neurologic condition of domestic mammals, including New World camelids, in endemic areas in Central Europe. Recently, BoDV-1 gained further attention by the confirmation of fatal zoonotic infections in humans. Although Borna disease and BoDV-1 have been described already over the past decades, comprehensive reports of Borna disease outbreaks in domestic animals employing state-of-the-art diagnostic methods are missing. Here, we report a series of BoDV-1 infections in a herd of 27 alpacas (Vicugna pacos) in t...
Comparison of serological and molecular tests for detection of Trypanosoma evansi in domestic animals from Ghardaïa district, South Algeria.
Veterinary parasitology    March 19, 2020   Volume 280 109089 doi: 10.1016/j.vetpar.2020.109089
Benfodil K, Büscher P, Abdelli A, Van Reet N, Mohamed-Herif A, Ansel S, Fettata S, Dehou S, Bebronne N, Geerts M, Balharbi F, Ait-Oudhia K.Trypanosoma evansi (T. evansi) is a hemoflagellate parasite that affects a broad range of mammalian hosts and that causes a disease called surra. Diagnosis of surra based on clinical symptoms alone is inaccurate. Therefore, a variety of serological and molecular diagnostic tests are used to assist in the detection of T. evansi infections. The aim of this study was to compare the diagnostic performance of four serological tests (CATT/T.evansi, immune trypanolysis, ELISA with purified variant surface glycoprotein RoTat 1.2 and with whole cell lysate) and two molecular PCR tests targeting sequenc...
Transplacental Transmission of Theileria equi Is Not a Common Cause of Abortions and Infection of Foals in Israel.
Animals : an open access journal from MDPI    February 21, 2020   Volume 10, Issue 2 341 doi: 10.3390/ani10020341
Tirosh-Levy S, Gottlieb Y, Mimoun L, Mazuz ML, Steinman A.Although the main route of transmission of is through tick feeding, transplacental transmission is also possible and may lead to abortion, or to the birth of a sick or carrier foal. The aim of this study was to evaluate the role of as a cause of abortions in Israel and the risk of foals being infected at a young age. Eight aborting mares were serologically evaluated for exposure to via the immunofluorescence antibody test (IFAT) and their aborted fetuses were evaluated using PCR and qPCR. In addition, five mares and their foals (aged 4-6 months) from a highly endemic farm were tested for i...
Evidence of circulation of West Nile virus in Culex pipiens mosquitoes and horses in Morocco.
Acta tropica    February 20, 2020   Volume 205 105414 doi: 10.1016/j.actatropica.2020.105414
Assaid N, Mousson L, Moutailler S, Arich S, Akarid K, Monier M, Beck C, Lecollinet S, Failloux AB, Sarih M.West Nile virus (WNV) is one of the most widely distributed mosquito-borne viruses in the world. In North Africa, it causes human cases of meningoencephalitis with fatalities in Algeria and in Tunisia, whereas only horses were affected in Morocco. The aims of this study were to detect WNV in mosquitoes and to determine seroprevalence of WNV in Moroccan horses by the detection of IgG antibodies. A total of 1455 mosquitoes belonging to four different species were grouped by collection site, date, and sex with 10 specimens per pool and tested for 38 arboviruses using a high-throughput chip based ...
Acute kidney injury due to Leptospira interrogans in 4 foals and use of renal replacement therapy with intermittent hemodiafiltration in 1 foal.
Journal of veterinary internal medicine    January 30, 2020   Volume 34, Issue 2 1007-1012 doi: 10.1111/jvim.15713
Fouché N, Graubner C, Lanz S, Schweighauser A, Francey T, Gerber V.Four 2-month-old foals were presented to an equine hospital with acute kidney injury caused by Leptospira interrogans infection. Clinical signs were nonspecific and included lethargy, fever, and unwillingness to nurse. The most important hematologic and clinicopathologic findings were azotemia, anemia, thrombocytopenia, hyponatremia, and hypochloremia. The diagnosis was based on urinary real-time PCR, serology using a microscopic agglutination test, or both. The most important serovars involved were L. interrogans serogroup australis serovar Bratislava and Australis. Treatment consisted of IV ...
Treatment Efficiency of Combination Therapy With Diminazene Aceturate and Quinapyramine Sulfate in a Horse With Dourine.
Journal of equine veterinary science    January 2, 2020   Volume 87 102905 doi: 10.1016/j.jevs.2019.102905
Davkharbayar B, Davaasuren B, Narantsatsral S, Battur B, Punsantsogvoo M, Battsetseg B, Mizushima D, Inoue N, Suganuma K.Dourine is a lethal protozoan disease of equids, and it is caused by Trypanosoma equiperdum infection via coitus. To date, treatment strategies against the dourine are not recommended because of the frequent relapses; therefore, the World Organisation for Animal Health recommends the stamping-out policy for the control of dourine. Our previous studies have revealed a number of horses with dourine in Mongolia that is the fifth largest horse-breeding country. It is difficult to apply the stamping-out policy for cases of dourine in Mongolia because of an inadequate livestock guarantee system. The...
Pre-foaling season questionnaire: supplemental material to the article ‘Challenges in using serological methods to explore historical transmission risk of Chlamydia psittaci in a workforce with high exposure to equine chlamydiosis’.
Communicable diseases intelligence (2018)    December 16, 2019   Volume 43 doi: 10.33321/cdi.2019.43.64
Jones B, Taylor K, Lucas RM, Merritt T, Chicken C, Heller J, Carrick J, Givney R, Durrheim DN.No abstract available
Challenges in using serological methods to explore historical transmission risk of Chlamydia psittaci in a workforce with high exposure to equine chlamydiosis.
Communicable diseases intelligence (2018)    December 16, 2019   Volume 43 doi: 10.33321/cdi.2019.43.65
Jones B, Taylor K, Lucas RM, Merritt T, Chicken C, Heller J, Carrick J, Givney R, Durrheim DN.This report describes the challenges encountered in using serological methods to study the historical transmission risk of from horses to humans. In 2017, serology and risk factor questionnaire data from a group of individuals, whose occupations involved close contact with horses, were collected to assess the seroprevalence of antibodies to and identify risk factors associated with previous exposure. 147 participants were enrolled in the study, provided blood samples, and completed a questionnaire. On ELISA testing, antibodies to the Chlamydia genus were detected in samples from 17 participa...
Evaluation of multiple allergen simultaneous (sIgE) testing compared to intradermal testing in the etiological diagnosis of atopic dermatitis in horses.
Journal of veterinary science    November 28, 2019   Volume 20, Issue 6 e60 doi: 10.4142/jvs.2019.20.e60
Wilkołek P, Szczepanik M, Sitkowski W, Rodzik B, Pluta M, Taszkun I, Gołyński M.Although intradermal testing (IDT) is commonly used in the etiological diagnosis of allergies, in vitro testing for specific IgE (sIgE) is an attractive alternative. Currently, new laboratory techniques in veterinary allergological practice, including multiple allergen simultaneous tests (MASTs), gradually supersede in vivo tests. Both, serological (sIgE) and IDTs in fourteen atopic Malopolski horses were performed. Correlation and agreement between test results were evaluated. Receiver operating characteristic analysis showed that sIgE to had the best diagnostic performance (Area under the R...
Influence of penicillin treatment of horses with strangles on seropositivity to Streptococcus equi ssp. equi-specific antibodies.
Journal of veterinary internal medicine    November 26, 2019   Volume 34, Issue 1 294-299 doi: 10.1111/jvim.15668
Pringle J, Storm E, Waller A, Riihimäki M.Antibiotic treatment of horses with strangles is reported to impair the development of immunity to subsequent exposure to Streptococcus equi ssp equi (S. equi). However, apart from a single clinical report, evidence-based studies for this hypothesis are lacking. Objective: To determine whether penicillin treatment during clinical strangles influences the development or persistence of seropositivity to S. equi-specific antibodies. Methods: A natural outbreak of strangles with 100% morbidity in 41 unvaccinated mature Icelandic horses. Methods: A prospective longitudinal study of acute clinical s...
Serological detection and risk factors for equine piroplasmosis in the semiarid region of Pernambuco, Northeastern Brazil. Souza EAR, Araujo AC, Pires LCSR, Freschi CR, Azevedo SS, Machado RZ, Horta MC.Equine piroplasmosis, an economically important disease in horses, has so far not been reported in Pernambuco state, Brazil. This study aimed to evaluate the seroprevalence of anti-Babesia caballi and anti-Theileria equi antibodies based on the detection of these agents in equine blood and in ticks on horses in the municipality of Petrolina, Pernambuco, northeastern Brazil. Blood samples were drawn from 393 horses and sera were examined by ELISA. The presence of tick infestations was evaluated, and 101 ticks were subjected to DNA amplification for the detection of Babesia spp. by polymerase ch...
Silent Circulation of the Saint Louis Encephalitis Virus among Humans and Equids, Southeast Brazil.
Viruses    November 5, 2019   Volume 11, Issue 11 1029 doi: 10.3390/v11111029
Barbosa Costa G, Marinho PES, Vilela APP, Saraiva-Silva AT, Crispim APC, Borges IA, Dutra AGS, Lobato ZIP, Dos Reis JKP, de Oliveira DB, Drumond BP....Saint Louis encephalitis virus (SLEV) is a mosquito-borne flavivirus that occurs throughout the Americas, and is considered a public health threat. In Brazil, SLEV has been detected from human cases associated with dengue-like disease, but no neurological symptoms were reported. Furthermore, the epidemiology of SLEV in human populations is still poorly explored in the country. We reported serological and molecular detection of SLEV in a healthy population of equids and humans from rural areas in Southeast Brazil. A plaque reduction neutralization test was applied, and neutralizing antibodies w...
Serological evidence of leptospirosis in Iran; A systematic review and meta-analysis.
Microbial pathogenesis    November 4, 2019   Volume 138 103833 doi: 10.1016/j.micpath.2019.103833
Khalili M, Sakhaee E, Bagheri Amiri F, Safat AA, Afshar D, Esmaeili S.Leptospirosis is a neglected infectious zoonotic disease that affects domestic animals and wildlife as well as humans. Although leptospirosis is known as an endemic disease in Iran, there is no accurate information on the overall prevalence of this disease in humans and animals. The aim of this systematic review and meta-analysis was to estimate the seroprevalence of leptospirosis among human and domestic and wild animals in Iran. A systematic review of English and Persian articles (since 1998 to December 2017) was conducted using Google Scholar, Medline/PubMed, Science Direct, Scopus, Web of ...
Multifocal outbreak of equine influenza in vaccinated horses in Argentina in 2018: Epidemiological aspects and molecular characterisation of the involved virus strains.
Equine veterinary journal    October 4, 2019   Volume 52, Issue 3 420-427 doi: 10.1111/evj.13176
Olguin-Perglione C, Vissani MA, Alamos F, Tordoya MS, Barrandeguy M.Equine influenza is an important cause of respiratory disease of horses worldwide. The equine influenza virus (EIV) undergoes antigenic drift through the accumulation of amino acid substitutions in the viral proteins, which may lead to vaccine breakdown. Objective: To describe the epidemiological findings and the molecular characteristics of the EIV detected during the multifocal outbreak that occurred in Argentina between March and July 2018 and evidence a vaccine breakdown. Methods: Observational, descriptive study. Methods: Virus was detected in nasopharyngeal swabs using real-time reverse ...
Evaluation of serological responses in horses challenged with Burkholderia pseudomallei using current diagnostic tests for glanders.
Veterinaria italiana    September 30, 2019   Volume 55, Issue 3 261-267 doi: 10.12834/VetIt.1701.9026.2
Wernery U, Rodriguez Caveney M, Wernery R, Raghavan R, Laroucau K, Syriac G, Thomas SM, John J, Joseph M, Jose S, Joseph S, Woo P.Six horses were challenged experimentally with a strain of Burkholderia pseudomallei isolated from a fatal case of the infection in a dromedary camel years earlier in the Emirate of Dubai. Three horses were inoculated subcutaneously and in 3 the bacterium was administered by the oral route. Four of the horses became serologically positive based on reactions to one or more of the OIE described tests for glanders. B. pseudomallei was re-isolated from the 4 serological positive horses. Only one of the subcutaneously infected horses, developed fever for 3 days. The white blood cell values and the ...
Serological, molecular and hematological diagnosis in horses with clinical suspicion of equine piroplasmosis: Pooling strengths.
Veterinary parasitology    September 20, 2019   Volume 275 108928 doi: 10.1016/j.vetpar.2019.108928
Camino E, Dorrego A, Carvajal KA, Buendia-Andres A, de Juan L, Dominguez L, Cruz-Lopez F.Equine piroplasmosis (EP) is a tick-borne protozoan disease caused by Theileria equi and/or Babesia caballi. Clinical signs (fever, pale mucosal membranes, jaundice), anemia and hyperbilirubinemia have been associated with the disease. EP is widespread, has a significant economic impact on the equine industry and remains endemic in Spain. This study was carried out with samples belonging to 140 horses residing in Spain and showing common clinical signs of EP. A blood smear microscopic examination and a comparison between the different results obtained by competitive Enzyme-Linked Immunosorbent...
Co-reactivity between related and unrelated environmental allergens in equine allergen-specific IgE serology testing in the UK.
Veterinary dermatology    August 29, 2019   Volume 30, Issue 6 544-e165 doi: 10.1111/vde.12786
Forsyth J, Halliwell RE, Harrand R.Identification of environmental allergens in horses with allergic disease facilitates allergen avoidance and targeted immunotherapy. Objective: To evaluate allergenic co-reactivity between 44 environmental allergens. Methods: Horses with suspected allergic disease (n = 344) whose sera were submitted for environmental allergen testing. Methods: Allergen-specific IgE serological assays were performed using 44 allergens divided into six taxonomically related groups: house dust/storage mites, moulds, insects, grass, tree and weed pollens. Using pairwise comparisons, odds ratios (ORs) were calcul...
Fasciola hepatica in UK horses.
Equine veterinary journal    July 21, 2019   Volume 52, Issue 2 194-199 doi: 10.1111/evj.13149
Howell AK, Malalana F, Beesley NJ, Hodgkinson JE, Rhodes H, Sekiya M, Archer D, Clough HE, Gilmore P, Williams DJL.Fasciola hepatica (liver fluke) affects grazing animals including horses but the extent to which it affects UK horses is unknown. Objective: To define how liver fluke affects the UK horse population. Methods: Descriptive, cross-sectional, observational study. Methods: An F. hepatica excretory-secretory antibody detection ELISA with a diagnostic sensitivity of 71% and specificity of 97% was validated and used to analyse serum samples. An abattoir study was performed to determine prevalence. A case-control study of 269 horses compared fluke exposure between horses with liver disease and control...
Serological Evidence of Anaplasma phagocytophilum and Spotted Fever Group Rickettsia spp. Exposure in Horses from Central Italy.
Pathogens (Basel, Switzerland)    June 26, 2019   Volume 8, Issue 3 doi: 10.3390/pathogens8030088
Ebani VV.Anaplasma phagocytophilum and Rickettsia spp. are tick-borne bacteria of veterinary and human concern. In view of the One-Health concept, the present study wanted to evaluate the spreading of these pathogens in horses living in central Italy. In particular, the aim of the investigation was to verify the exposure to A. phagocytophilum in order to update the prevalence of this pathogen in the equine population from this area, and to spotted fever group (SFG) Rickettsia spp. to evaluate a possible role of horses in the epidemiology of rickettsiosis. Indirect immunofluorescent assay was carried ou...
Surveillance of the equine infectious anemia virus in Eastern and Central Saudi Arabia during 2014-2016.
Veterinary world    May 29, 2019   Volume 12, Issue 5 719-723 doi: 10.14202/vetworld.2019.719-723
Alnaeem AA, Hemida MG.Equine infectious anemia virus (EIAV) is one of the most important threats to the equine industry globally. This is due to the poor performance of the affected horses, which requires euthanization of the infected animals upon the infection confirmation. Infected animals remain carriers throughout their life. EIAV infection has been reported in many parts of the world, including North America, Europe, Asia, and Africa. However, the EIAV status is never assessed in horses in the Gulf area, especially in the Kingdom of Saudi Arabia (KSA). Objective: This study aimed to perform molecular and serol...
Epidemiological characterization of Leptospira spp. infection in working horses and in an occupationally exposed population in six Colombian police stations.
Biomedica : revista del Instituto Nacional de Salud    May 1, 2019   Volume 39, Issue s1 19-34 doi: 10.7705/biomedica.v39i1.4475
Calderón JC, Astudillo M, Romero MH.Introduction: Police working horses are in close contact with their managers and the general population during recreational and patrol activities, which can favor the transmission of leptospirosis among the horses and the occupationally exposed personnel. Objective. To characterize epidemiologically leptospirosis through serology, urine culture and PCR in working horses and in the occupationally exposed population in six police stations in Colombia. Materials and methods. We tested 153 castrated male horses and 123 people in six police stations in the municipalities of Manizales, Pereira, Arme...
Specific detection and differentiation of tick-borne encephalitis and West Nile virus induced IgG antibodies in humans and horses.
Transboundary and emerging diseases    April 29, 2019   Volume 66, Issue 4 1701-1708 doi: 10.1111/tbed.13205
Rockstroh A, Moges B, Berneck BS, Sattler T, Revilla-Fernández S, Schmoll F, Pacenti M, Sinigaglia A, Barzon L, Schmidt-Chanasit J, Nowotny N....Tick-borne encephalitis virus (TBEV) and West Nile virus (WNV) are important arthropod-borne zoonotic flaviviruses. Due to the emergence of WNV in TBEV-endemic regions co-circulation of both viruses is increasing. Flaviviruses are structurally highly similar, which leads to cross-reacting antibodies upon infection. Currently available serological assays for TBEV and WNV infections are therefore compromised by false-positive results, especially in IgG measurements. In order to discriminate both infections novel diagnostic methods are needed. We describe an ELISA to measure IgG antibodies specif...
Spatial distribution and risk factors for equine infectious anaemia in the state of Mato Grosso, Brazil.
Revue scientifique et technique (International Office of Epizootics)    April 10, 2019   Volume 37, Issue 3 971-983 doi: 10.20506/37.3.2900
Barros ML, Borges AMC, Oliveira De ACS, Lacerda W, O Souza De A, Aguiar DM.The prevalence of equine infectious anaemia (EIA) in the three biomes of the state of Mato Grosso (Amazon, Cerrado and Pantanal) was estimated. Serum samples were collected from 3,858 equines in 1,067 herds between Septemberand December 2014. The agar gel immunodiffusion (AGID) assay was used to detect EIA virus antibodies, and if a herd contained a seropositive animal itwas classified as a focus. The prevalence rates were 17.2% (95% confidence interval [CI]: 14.9-19.8%) for herds and 6.6% (95% CI: 5.8-7.5%) for animals. The Pantanal region showed the highest prevalence rates: 36.1% (95% CI: 3...
Abortion in donkeys associated with Salmonella abortus equi infection.
Equine veterinary journal    April 10, 2019   Volume 51, Issue 6 756-759 doi: 10.1111/evj.13100
Wang H, Liu KJ, Sun YH, Cui LY, Meng X, Jiang GM, Zhao FW, Li JJ.Salmonella enterica subspecies enterica serovar abortus equi (S. abortus equi) is well known as the aetiological agent of equine abortion. However, abortion caused by S. abortus equi has not been previously described in donkeys. Objective: To investigate whether S. abortus equi was correlated with an abortion outbreak consisting of 61 abortions. Methods: Investigation of the clinical cases using pathoanatomical, bacteriological, serological and molecular approaches. Methods: Autopsies on nine aborted foetuses were performed. Tissue specimens from seven aborted foetuses and two mares were cu...
Leptospirosis in horses: A European perspective.
Equine veterinary journal    April 6, 2019   Volume 51, Issue 3 285-286 doi: 10.1111/evj.13022
Malalana F.No abstract available
Molecular evidence of Anaplasma phagocytophilum and Theileria equi coinfection in horses from Rio de Janeiro, Brazil.
Veterinary and animal science    March 20, 2019   Volume 7 100055 doi: 10.1016/j.vas.2019.100055
Dos Santos TM, Roier ECR, Pires MS, Santos HA, Vilela JAR, Peckle M, Paulino PG, Baldani CD, Massard CL.The present study aims to determine the frequencies of Theileria equi and Anaplasma phagocytophilum antibodies among horses from the state of Rio de Janeiro, Brazil, and to detect the presence of DNA of these pathogens through molecular methods. A total of 98 serum samples of horses from the municipality of Seropedica were tested by indirect immunofluorescence antibody (IFA) to detect anti-A. phagocytophilum and anti-T. equi IgG antibodies. In addition, quantitative real-time PCR (qPCR) was used to detect these pathogens in the DNA extracted from the whole blood and buffy coat of horses. Bivar...
Toxoplasma gondii Seroprevalence in Horses from Ukraine: an Investigation Using Two Serological Methods.
Acta parasitologica    March 18, 2019   Volume 64, Issue 4 687-692 doi: 10.2478/s11686-019-00040-0
Rissanen K, Galat M, Kovalenko G, Rodnina O, Mikharovskyi G, Must K, Jokelainen P.Horses are recognized as important hosts for the zoonotic parasite Toxoplasma gondii, mainly because meat of infected horses can be a source of human T. gondii infections. However, the baseline knowledge on equine T. gondii infections is limited and lacking from many countries. This seroepidemiological study was set in Ukraine, a country where little is known about T. gondii prevalence in any host species. Methods: We investigated 78 serum samples from horses, collected from Kyiv and Lviv regions of Ukraine, using a commercial enzyme-linked immunosorbent assay (ELISA) and a commercial modified...
Assessment of equine piroplasmids in the Nhecolândia sub-region of Brazilian Pantanal wetland using serological, parasitological, molecular, and hematological approaches.
Ticks and tick-borne diseases    March 8, 2019   Volume 10, Issue 3 714-721 doi: 10.1016/j.ttbdis.2019.03.002
Campos JBV, André MR, Gonçalves LR, Freschi CR, Santos FM, de Oliveira CE, Piranda EM, de Andrade GB, Macedo GC, Machado RZ, Herrera HM.Brazilian Pantanal is the world´s largest wetland ecosystem, where cattle's ranching is the most important economic activity. The objective of this study was to compile some epidemiological features on equine piroplasmids from the Nhecolândia sub-region of Pantanal wetland through the evaluation of the patterns of T. equi and B. caballi infections in different groups of horses; identification of the tick species that infest horses; and to study phylogenetic relationships among Theileria equi 18S rRNA gene sequences. During October 2015, blood and serum samples were collected from 170 horses ...
Validation of an immunoblot assay employing an objective reading system and used as a confirmatory test in equine infectious anaemia surveillance programs.
Journal of virological methods    January 23, 2019   Volume 266 77-88 doi: 10.1016/j.jviromet.2019.01.012
Equine infectious anaemia (EIA) is a blood borne disease that is listed among the notifiable diseases of the World Organisation for Animal Health (OIE). EIA is also regulated by the OIE for the international trading provisions and is generally subject to control programmes. Since 2011, Italy has been conducting a surveillance plan based on a three-tier diagnostic system, using a serological ELISA as screening test, an agar gel immunodiffusion test (AGIDT) as a confirmatory method, and an immunoblot (IB) as an alternative confirmatory assay for discordant results between the first two tests. As...
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