Detection of an immunoglobulin M response in the elderly for early diagnosis of respiratory syncytial virus infection.

The indirect fluorescent-antibody technique was compared with indirect and mu-capture enzyme-linked immunosorbent assays for the detection of respiratory syncytial virus (RSV) immunoglobulin M (IgM) in the elderly. Sera from 47 patients (mean age, 70 years) with acute lower respiratory tract infections caused by RSV were investigated. Specific IgM was detected in 81% (38 of 47) of the patients. The fluorescent-antibody technique, which gave 70% positive results, proved to be the most sensitive of the three methods. An IgM response was seldom seen in sera from the elderly within the first week of disease, but was present in 85% of sera (33 of 39) collected between days 11 and 30 of disease. In some patients it persisted for more than 6 weeks. Detection of IgM was found to be a useful tool for the diagnosis of RSV infections in elderly patients.