Usefulness of a single-assay chemiluminescence test (Tularaemia VIRCLIA IgG + IgM monotest) for the diagnosis of human tularemia. Comparison of five serological tests

  • África Cubero
  • Carlos Durántez
  • Ana Almaraz
  • Luis Fernández-Lago
  • María P. Gutiérrez
  • María J. Castro
  • Miguel A. Bratos
  • María Simarro
  • Gabriel A. March
  • Antonio Orduña
Original Article


The aim of this work was to ascertain the usefulness of a new commercially-available single-assay chemiluminescence test (CHT) for the diagnosis of human tularemia (Tularaemia VIRCLIA IgG + IgM monotest, Vircell, Santa Fe, Granada, Spain). A total of 773 sera from 773 patients including 364 initial sera from patients with diagnosed tularemia, patients with suspected tularemia not confirmed (100), healthy people (152), patients with serology positive to Brucella (97), patients diagnosed with other infectious diseases (30), and patients diagnosed with autoimmune diseases (30) were included. All sera were tested by CHT, “in-house” microagglutination test (MAT), immunochromatographic test (ICT) (Virapid Tularaemia, Vircell, Santa Fe Granada, Spain), and “in-house” ELISA IgG, and ELISA IgM. Of the total initial sera, 334 (sensitivity 91.8%) were positive in the CHT, 332 (sensitivity 91.2%) in the MAT, 330 (sensitivity 90.7%) in the ICT, and 328 (sensitivity 90.1%) in the ELISA IgG and ELISA IgM tests. The specificity of the CHT was 96.7%; of the MAT, 100%; of the ICT, 98.7%; and of the ELISA IgG and ELISA IgM, 97.4%. In the group of patients with serology positive to Brucella, at least 12.4% of sera were positive in tularemia tests (12.4% in ELISA IgM, 13.4% in MAT, 14.4% in ICT, and 15.5% in CHT and ELISA IgG). In conclusion, CHT presents a sensitivity and specificity in early diagnosis of human tularemia, similar to MAT, ICT, and ELISA IgG and ELISA IgM. Its single assay design allows lower costs, especially in areas of low endemicity or inter-epidemic periods.



The authors wish to thank Prof. C. Nolan for collaborating with revising the English version.


This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflicts of interest

We declare no conflicts of interest.

Ethical approval and informed consent

Written informed consent was taken by the participants and the study was approved by the Ethics Committee of the Valladolid Clinic University Hospital and the Faculty of Medicine of the University of Valladolid (reference CEIC-PI-16-478). All sera were anonymized in relation to patient data.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • África Cubero
    • 1
  • Carlos Durántez
    • 1
  • Ana Almaraz
    • 1
  • Luis Fernández-Lago
    • 2
  • María P. Gutiérrez
    • 1
  • María J. Castro
    • 3
  • Miguel A. Bratos
    • 1
    • 4
  • María Simarro
    • 1
  • Gabriel A. March
    • 1
    • 4
  • Antonio Orduña
    • 1
    • 4
  1. 1.Department of Microbiology, Faculty of MedicineUniversity of ValladolidValladolidSpain
  2. 2.Department of MicrobiologyUniversity of SalamancaSalamancaSpain
  3. 3.Faculty of NurseryUniversity of ValladolidValladolidSpain
  4. 4.Service of MicrobiologyHospital Clínico UniversitarioValladolidSpain

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