Rotavirus and adenovirus detecting method: sensitivity and specificity of rapid antigen testing: prospective study in one region of Ireland

Rotavirus and Adenovirus are common causes of gastroenteritis in children younger than 3 years worldwide. Rapid Antigen Testing (RAT) is a quick and easy tool to detect virus antigen in stool samples and is more specific than sensitive (higher specificity and lesser sensitivity). Reverse transcription-polymerase chain reaction (RT-PCR) and PCR are more sensitive and specific than RAT. Sensitive and specific tools are required for true diagnosis. We aim to determine sensitivity and specificity of RAT versus PCR testing of rotavirus and adenovirus. From November 18th 2016 to November 18th 2017, all children up to 3 years of age who presented to Mayo University Hospital with vomiting and diarrhoea had their stool tested for rotavirus and adenovirus by RAT in Galway University Hospital Laboratory (GUHL) and by PCR testing in the National Virus Reference Laboratory (NVRL) in Dublin; 143 stool samples were tested for Adenovirus, 126 (88%) tested negative at NVRL, two false positive at GUHL, specificity (98.5%). Seventeen were adenovirus positive in the NVRL, two false negative in GUHL, sensitivity (88%); 144 samples were tested for rotavirus, 108 (75%) were RV negative in the NVRL, one false positive at GUHL, specificity (99%); 36 samples were rotavirus positive in the NVRL, ten (28%) false negative in GUHL, sensitivity (72%). RAT has higher specificity than sensitivity and may be useful for mass screening at times of rotavirus or adenovirus outbreaks. PCR remains more sensitive and specific than RAT and is still required for true diagnosis.