nal von minden 870004N-01 NADAL Borreliosis Ag Test Instruction Manual
- June 3, 2024
- nal von minden
Table of Contents
- Intended Use
- Introduction and Clinical Significance
- Test Principle
- Reagents and Materials Supplied
- Additional Materials Required
- Storage & Stability
- Warnings and Precautions
- Specimen Collection and Preparation
- Test Procedure
- Result Interpretation
- Quality Control
- Limitations
- Performance Characteristics
- References
- Our Teams
- References
- Read User Manual Online (PDF format)
- Download This Manual (PDF format)
870004N-01 NADAL Borreliosis Ag Test
Instruction Manual NADAL® Borreliosis Ag Test
(test cassette)
REF 870004N-01/870004N-05
Intended Use
The NADAL® Borreliosis Ag Test is a membrane-based immunoassay for the rapid, direct detection of Borrelia antigens (B. garinii, B. afzelii and B. burgdorferi sensu stricto and B. spielmanii) in ticks. The test is developed for the examination of small to medium-sized ticks (≤8 mm) only. A positive result with this test indicates the presence of Borrelia in the tick.
Introduction and Clinical Significance
Over 800 species of ticks are known worldwide, which can be divided into two
main families: the hard ticks and soft ticks. Soft ticks are usually to be
found in the tropics and subtropics. Hard ticks, however, including the castor
bean tick, are spread around the world and are carriers of Lyme borreliosis
disease and tick-borne encephalitis (TBE). While TBE viruses are in the
salivary glands of ticks and can be transmitted directly to the the victim
through the tick bite, Borrelia are initially located in the midgut of the
tick. Borrelia reach the salivary glands while the tick is sucking blood and
are transmitted to the victim only after a few hours. Thus, there is no great
risk of a Borrelia infection within the first few hours after being bitten by
the tick. The excretion of pathogens begins as early as two hours after being
bitten by the tick and reaches its peak only after 72 hours.
Symptoms of Lyme borreliosis disease in humans can be divided into three
stages.
- Several days to weeks after infection: characteristic skin redness, so-called erythema chronicum migrans, appears around the tick bite and spreads into a ring shape. It occurs in about 70 percent of cases and is followed by general flulike sysmptoms, such as profuse sweating, fever, headaches, and muscular and joint pain.
- A few weeks to months later: Inflammation of the nerves and meninges are possible. A strong, burning pain around the original site of the tick bite and redness, which can spread over the whole body, frequently occur. Swelling of joints, as well as impairments of the locomotor system, the psyche and the cognitive abilities may appear. In some cases, paralysis of, for instance, facial muscles and less often inflammation of the heart and heart rhythm disorder occur.
- Months to years after the infection: Cases of chronic or recurring inflammation of joints, mostly in the knees and ankles (lyme arthritis) or skin changes, known as acrodermatitis chronica atrophicans herxheimer occur.
Test Principle
The NADAL® Borreliosis Ag Test is a membrane-based immunoassay for the rapid,
direct detection of Borrelia antigens in ticks.
The test principle involves polyclonal antibodies, which are used as capture
antibodies, along with conjugated Borrelia antibodies on the internal test
strip to detect Borrelia antigens in the sample.
First, the extracted tick material is added to the sample well of the test
cassette. The sample migrates along the internal test strip by capillary
action. If Borrelia antigens are present in the sample, an antibody-antigen-
antibody complex is formed in the test line region and as a result, a coloured
line appears. The appearance of a test line indicates a positive result. If
the sample does not contain Borrelia antigens, no antibodyantigen-antibody
complex is produced and no coloured line develops in the test line region. The
test result should be considered negative.
The appearance of a coloured line in the control line region serves as a
procedural control, indicating that the proper volume of specimen has been
added and membrane wicking has occurred.
Reagents and Materials Supplied
- 1/5 NADAL® Borreliosis Ag test cassette(s) (incl. pipette(s) and desiccant)
- 1/5 tick tube(s) containing buffer (0.2 ml)
- 1/5 stick(s)
- 1 tick removal device
- 1 package insert
Additional Materials Required
- Timer
Storage & Stability
The test kit should be stored at 2-30°C until the expiry date printed on the packaging. The test cassette should remain in the sealed foil pouch until use. Do not freeze the test kit.
Warnings and Precautions
- Carefully read through the test procedure prior to testing. Failure to follow the instructions will lead to inaccurate test results.
- Do not use the test beyond the expiration date indicated on the package.
- Do not use the test if the foil pouch is damaged.
- Do not reuse tests.
- Do not add samples to the reaction area (result area).
- In order to avoid contamination, do not touch the reaction area (result area).
- Avoid cross-contamination of specimens by using a new tick tube for each specimen obtained.
- Do not substitute or mix components from different test kits.
- Do not eat, drink or smoke in the area where specimens and test kits are handled.
- Wear protective clothing such as laboratory coats, disposable gloves and eye protection when specimens are being assayed.
- Handle all specimens as if they contain infectious agents. Observe established precautions for microbiological risks throughout all procedures and standard guidelines for the appropriate disposal of specimens.
- The test kit contains products of animal origin. Certified knowledge of the origin and/or sanitary state of the animals does not completely guarantee the absence of transmissible pathogenic agents. It is therefore recommended that these products be treated as potentially infectious, and handled in accordance with usual safety precautions (e.g., do not ingest or inhale).
- Humidity and temperature can adversely affect test results.
- Used testing materials should be discarded according to local regulations.
- The tick must be crushed thoroughly, as Borrelia are located in the tick’s colon.
- Keep the sample well of the test cassette clear of any tick particles.
- Only use the stick for the purpose described in the package insert.
- Immediately remove the stick from the reagent mixture after crushing the tick.
Specimen Collection and Preparation
Remove the tick carefully and ensure that the head is also removed.
The use of the tick removal device is recommended. After removing the tick and
before starting the test, you can store the tick in the supplied specimen
collection tube. Testing of the tick directly after the removal yields the
best results. A thorough crushing of the tick is
crucial for optimal testing results, as Borrelia to be verified are located in
the tick’s colon.
Test Procedure
The optimal test procedure depends on the size of a tick. The test is developed for the examination of small to mediumsized ticks (≤8 mm) only.
-
Place the tick into the tick tube containing buffer.
-
Crush the tick with the supplied stick until the tick’s colon is crushed and the liquid takes on colour. Use the sharp and the dull sides of the stick for this purpose. Then remove the stick.
-
When ready to perform the test, open the foil pouch and remove the test cassette. Place it on a clean, flat surface.
-
Fill the pipette with the tickbuffer mixture. Ensure that you do not take up any tick particles.
-
Add the tick-buffer mixture to the sample well of the test cassette. Ensure that you do not add any tick particles to the sample well, as they may obstruct it. The liquid will start to migrate along the internal test strip. 6. Read the test result after 10 minutes. Do not interpret the result after more than 20 minutes.
Result Interpretation
Positive:
Two coloured lines appear on the membrane. One line appears in the control
line region (C) and the other line appears in the test line region (T). The
line in the test line region (T) indicates that Borrelia antigens have been
detected in the tick.
The less Borrelia antigens are present in the tick, the weaker the test line
is (T). Even a weak test line should be interpreted as a positivie test
result. The control line is not a reference line and may have a different
colour intensity as the test line.
Negative:
Only one coloured line appears in the control line region (C). No apparent
coloured line appears in the test line region (T). No Borrelia antigens have
been detected in the tick.
Invalid:
The control line fails to appear. Results from any test which has not produced
a control line at the specified reading time must be discarded.
Please review the procedure and repeat he test with a new test cassette. If
the problem persists, discontinue using the test kit immediately and contact
your local distributor.
Note: Insufficient specimen volume, incorrect operating procedure or
expired tests are the most likely reasons for the control line failure.
Quality Control
A coloured line appearing in the control line region (C) is considered an
internal procedural control. It confirms sufficient specimen volume, adequate
membrane wicking and
correct procedural technique.
Limitations
- The test is developed for the examination of small to medium-sized ticks (≤8 mm) only.
- A positive result with this test indicates the presence of Borrelia in the tick.
Performance Characteristics
A comparative study has investigated which Borrelia species in spiked ticks
can be detected with the help of the NADAL® Borreliosis Ag Test in comparison
with the polymerase chain reaction (PCR). The following Borrelia species: B.
garinii, B. afzelii, B. burgdorferi sensu stricto and B. spielmanii were
detected with both test systems (comparison study 2012/2013).
The NADAL® Borreliosis Ag Test
Sensitivity: 92.86%
Specificity: 95.83%
Positive predictive value: 86.67%
Negative predictive value: 97.87%
Total Test Performance: 95.16%
References
- J. Eckert, K.T. Friedhoff, H. Zahner, P. Deplazes: “Textbook of parasitology for veterinary medicine”, Enke Verlag, 2nd full. revised Edition 2008 W.
- Luttmann, K. Bratke, M. Küpper, D. Myrtek: “The Experimenter Immunology”, Spektrum Akademischer Verlag, p.110 f., 3rd edition 2009.
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Our Teams
Germany :
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Fax: +49 941 290 10-50
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Laboratory Diagnostics Team:
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nal von minden GmbH
Carl-Zeiss-Strasse 12 • 47445 Moers • Germany
www.nal-vonminden.com • info@nal-
vonminden.com
Fon: +49 2841 99820-0 • Fax: +49 2841 99820-1
References
- nal von minden GmbH - Spezialist für hochwertige in-vitro Diagnostik
- nal von minden GmbH - Spezialist für hochwertige in-vitro Diagnostik
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