Rapid serologic diagnosis of dengue virus infection using a commercial capture ELISA that distinguishes primary and secondary infections.

D W Vaughn United States Army Medical Component-Armed Forces Research Institute of Medical Science, Bangkok, Thailand.

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A Nisalak United States Army Medical Component-Armed Forces Research Institute of Medical Science, Bangkok, Thailand.

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T Solomon United States Army Medical Component-Armed Forces Research Institute of Medical Science, Bangkok, Thailand.

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S Kalayanarooj United States Army Medical Component-Armed Forces Research Institute of Medical Science, Bangkok, Thailand.

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M D Nguyen United States Army Medical Component-Armed Forces Research Institute of Medical Science, Bangkok, Thailand.

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R Kneen United States Army Medical Component-Armed Forces Research Institute of Medical Science, Bangkok, Thailand.

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A Cuzzubbo United States Army Medical Component-Armed Forces Research Institute of Medical Science, Bangkok, Thailand.

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P L Devine United States Army Medical Component-Armed Forces Research Institute of Medical Science, Bangkok, Thailand.

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A commercial capture ELISA for specific IgM and IgG antibodies produced during dengue infection (PanBio Dengue Duo) showed excellent sensitivity (99%, n = 78) using sera collected at hospital discharge compared with established ELISA and hemagglutination inhibition (HAI) assays. Furthermore, the ELISA was able to diagnose 79% of the dengue cases using sera collected at hospital admission. The ELISA also showed high specificity (92%) in paired sera from patients without flavivirus infection (n = 26), although 45% of the patients with Japanese encephalitis (n = 20) showed elevation of IgG but not IgM. The IgG capture ELISA showed good correlation with the HAI assay (r = 0.83, P < 0.0001), and IgG levels could be used to distinguish between primary and secondary infection, with 100% of primary infections and 96% of secondary infections being correctly classified. This ELISA should prove useful in the clinical diagnosis of dengue infections.

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