Detection and persistence of specific IgM antibody to Coxiella burnetii by enzyme-linked immunosorbent assay: a comparison with immunofluorescence and complement fixation tests.

An enzyme-linked immunosorbent assay (ELISA) for specific IgM antibody to Coxiella burnetii was compared with the indirect immunofluorescence (FA) test in studies of 130 serum samples from 38 patients with Q fever. The IgM fractions obtained after rate zonal-density gradient ultracentrifugation of 37 serum samples from 12 patients were also studied in a complement fixation test (CF-DG). Specific IgM antibody to C burnetii was detected by all three methods in sera collected two to eight weeks after the onset of symptoms. The longest period for which specific IgM was shown to persist was 17 weeks by ELISA and FA and 10 weeks by CF-DG. The ELISA is performed with a single dilution of convalescent-phase serum and offers advantages over the subjective FA and the technically tedious CF-DG methods. The estimation of C burnetii-specific IgM by ELISA or FA is useful for the confirmation of infection when a rising titer of complement-fixing antibody cannot be demonstrated because acute-phase blood samples are not available.