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Paradigm Shift Intervention Monitoring
CDC Lab Confirmed Illinois MERS Retraction
Final Interpretation: All positive and indeterminant specimens were screened by MERS-CoV_Jordan MNt and/or re-screened by MERS-CoV IFA. Two criteria constitute a positive result: HKU5.2N ELISA must be positive and the MERS-CoV_Jordan IFA or MNt must be positive.
The recent CDC retraction of a MERS positive classification of the Illinois contact, in spite of testing positive in ELISA and IFA tests, contradicts the recently published definition in the CDC paper on cases, contacts, and unlinked HCWs in the 2012 MERS outbreak at a Jordan ICU who were antibody tested.
The above comments (in red) are the results from that study, which showed that 7 of 124 serum samples were positive for ELISA and IFA tests, demonstrating the specificity of the testing. The comments in blue are from table 1 which summarizes testing and notes that the final interpretation requires a positive result on the ELISA test, which is confirmed by a positive on the IFA or mico-neutralization test (MNT).
In the May 28 CDC telebriefing, the discussion of the results from the Illinois contact indicated he tested positive on the ELISA and IFA tests, which was defined as a positive in the above paper. Only 7 of 124 serum samples from Jordan were positive based in this criteria, demonstrating specificity and the linkage between a positive test result and epidemiological linkage to at least 1 of the 2 PCR confirmed cases, which is also true for the Illinois contact of the Indiana case, who was MERS PCR and sequence confirmed.
The positive result was announced in the May 17 telebriefing, which also indicated that testing was in progress for additional contacts in Indiana. Results from that testing have not been forthcoming. After the May 29 telebriefing, Recombinomics asked CDC media for the ELISA titer of the Illinois contact, as well as Indiana contacts, and CDC media refused via e-mail to answer any of the e-mailed questions posed.
The CDC retraction of the positive classification of the Illinois case, even though the test results met their published definition of a serologically lab confirmed positive, raises serious concerns that many additional contacts were also positive based on the CDC published definition, which requires a positive ELISA and confirmation by IFA or neutralization test..
The withholding of the serological data on Indiana and Florida contacts, as well as the clumsy retraction, raises serious pandemic concerns.