E3 PreliminaryModerate confidencePEM not requiredMethods-PaperPeer-reviewedMachine draft
Routine use of mu-antibody-capture ELISA for the serological diagnosis of Coxsackie B virus infections.
McCartney, R A, Banatvala, J E, Bell, E J · Journal of medical virology · 1986 · DOI
Quick Summary
This study tested a new blood test (mu-antibody-capture ELISA) to detect recent Coxsackie B virus infections by looking for IgM antibodies, which indicate fresh infection. Researchers tested 760 patients with various conditions including chest pain, heart inflammation, and myalgic encephalomyelitis (ME), plus 304 healthy controls, and found that this IgM test could reliably identify recent Coxsackie B infections without the confusion caused by old antibodies from past infections.
Why It Matters
ME/CFS patients and researchers have long sought reliable diagnostic methods to identify viral triggers of illness, particularly enterovirus infections. This study established a practical, reproducible laboratory approach to distinguish recent Coxsackie B infections from past exposure, potentially enabling better characterisation of the role these viruses play in ME/CFS and related post-viral conditions.
Observed Findings
- CBV-specific IgM ELISA positivity was elevated in myalgic encephalomyelitis patients (31%) compared to healthy controls (9%)
- CBV IgM positivity was also elevated in myo/pericarditis (33%), chest pain (22%), and myalgia/Bornholm disease (19%) relative to controls
- Concordant positive IgM and neutralisation test results indicated recent CBV infection, while discordant results (positive IgM, negative NT) suggested recent non-CBV enterovirus infection
- Cross-reactions with other enteroviruses, including hepatitis A, occurred but did not significantly confound adult patient diagnosis
Inferred Conclusions
- IgM ELISA is a reliable screening tool for identifying recent Coxsackie B infections and addresses the diagnostic problem of interpreting persistently elevated neutralising antibody titres
- Coxsackie B virus infections are more frequent in patients with cardiac, chest, and ME/CFS-related symptoms than in the general population
- Combining IgM ELISA with confirmatory neutralisation testing enables differentiation between recent CBV infection and recent infection with other enteroviruses
Remaining Questions
- Does Coxsackie B virus actually cause ME/CFS symptoms or is it merely a marker of altered immunity in these patients?
- What is the temporal relationship between CBV infection and symptom onset in positive ME/CFS patients?
What This Study Does Not Prove
This study does not prove that Coxsackie B virus causes ME/CFS—it only develops a diagnostic tool and observes associations. The study is cross-sectional and cannot establish causality, temporal relationships, or whether CBV infection is a trigger, cofactor, or incidental finding in ME/CFS patients. The relatively modest elevation of CBV IgM in ME/CFS patients (31%) compared to controls (9%) suggests infection frequency but does not demonstrate pathogenic significance.
Tags
Symptom:PainFatigue
Biomarker:AutoantibodiesBlood Biomarker
Phenotype:Infection-Triggered
Method Flag:Weak Case DefinitionExploratory Only
Metadata
- DOI
- 10.1002/jmv.1890190302
- PMID
- 3016163
- Review status
- Machine draft
- Evidence level
- Early hypothesis, preprint, editorial, or weak support
- Last updated
- 8 April 2026
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
Spotted an error in this entry? Report it →