Dengue Virus Antibody/Antigen Panel, Serum – Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog

Useful For

Aiding in the diagnosis of dengue virus infection by detection of IgM and IgG antibodies and the nonstructural protein 1 (NS1)

Profile Information

Test ID
Reporting Name
Available Separately
Always Performed

DENG
Dengue Virus Ab, IgG, S
No
Yes

DENM
Dengue Virus Ab, IgM, S
No
Yes

DENS1
Dengue NS1 Ag, S
Yes, (DNSAG)
Yes

INT69
Dengue Interpretation
No
Yes

Reporting Name

Dengue Virus Ab/Ag Panel, S

Specimen Type

Serum

Specimen Required

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.

Specimen Minimum Volume

0.8 mL

Specimen Stability Information

Specimen Type
Temperature
Time
Special Container

Serum
Refrigerated (preferred)
14 days

 
Frozen 
14 days

Clinical Information

Dengue virus (DV) is a globally distributed flavivirus with 4 distinct serotypes (DV-1, -2, -3, -4). It is primarily transmitted by the Aedes aegypti mosquito, which is found throughout the tropical and subtropical regions of over 100 countries. DV poses a significant worldwide public health threat with approximately 2.5 to 3 billion people residing in DV endemic areas, among whom 100 to 200 million individuals will be infected, and approximately 30,000 patients will succumb to the disease, annually.

Following dengue infection, the incubation period varies from 3 to 7 days, and while some infections remain asymptomatic, the majority of individuals will develop classic dengue fever. Symptomatic patients become acutely febrile and present with severe musculoskeletal pain, headache, retro-orbital pain, and a transient macular rash, most often observed in children. Fever defervescence signals disease resolution in most individuals. However, children and young adults remain at increased risk for progression to dengue hemorrhagic fever and dengue shock syndrome, particularly during repeat infection with a new DV serotype.

Detection of dengue-specific IgM and IgG-class antibodies remains the most commonly utilized diagnostic method. Seroconversion occurs approximately 3 to 7 days following exposure, and therefore, testing of acute and convalescent sera may be necessary to make the diagnosis. Detection of the DV nonstructural protein 1 (NS1) has emerged as an alternative biomarker to both serologic- and molecular-based techniques for diagnosis of acute DV infection. NS1 antigenemia is detectable within 24 hours and up to 9 days following symptoms onset. This overlaps with the DV viremic phase, and NS1 is often detectable prior to IgM seroconversion. Concurrent evaluation (as performed in this profile) for the NS1 antigen alongside testing for IgM- and IgG-class antibodies to DV provides optimal diagnostic potential for both early and late dengue disease.

Reference Values

IgG: Negative

IgM: Negative

NS1: Negative

Reference values apply to all ages.

Interpretation

The presence of IgG-class antibodies to dengue virus (DV) is consistent with exposure to this virus sometime in the past. By 3 weeks following exposure, nearly all immunocompetent individuals should have developed IgG antibodies to DV.

The presence of IgM-class antibodies to DV is consistent with acute-phase infection.

IgM antibodies become detectable 3 to 7 days following infection and may remain detectable for up to 6 months or longer following disease resolution.

The absence of IgM-class antibodies to DV is consistent with lack of infection. However, specimens collected too soon following exposure may be negative for IgM antibodies to DV. If DV remains suspected, a second specimen, collected approximately 10 to 12 days following exposure should be tested.

The presence of dengue nonstructural protein 1 (NS1) antigen is consistent with acute-phase infection with dengue virus.

The NS1 antigen is typically detectable within 1 to 2 days following infection and up to 9 days following symptom onset.

NS1 antigen may also be detectable during secondary dengue virus infection, but for a shorter duration of time (1-4 days following symptom onset).

The absence of dengue NS1 antigen is consistent with the lack of acute-phase infection.

The NS1 antigen may be negative is samples collected immediately following dengue virus infection (<24-48 hours) and is rarely detectable following 9 to 10 days of symptoms.

Clinical Reference

1. Bhatt S, Gething PW, Brady OJ, et al: The global distribution and burden of dengue. Nature. 2013 Apr 25;496:504-507. doi: 10.1038/nature12060

2. Dengue–an infectious disease of staggering proportions. Lancet. 2013 Jun 22;381(9884):2136. doi: 10.1016/S0140-6736(13)61423-3

3. Rigau-Perez JG, Clark GG, Gubler DJ, Reiter P, Sanders EJ, Vorndam AV: Dengue and dengue haemorrhagic fever. Lancet. 1998 Sep 19;352(9132):971-977

4. Tang KF, Ooi EE: Diagnosis of dengue: an update. Expert Rev Anti Infect Ther. 2012 Aug;10(8):895-907. doi: 10.1586/eri.12.76

5. Guzman MG, Kouri G: Dengue diagnosis, advances and challenges. Int J Infect Dis. 2004 Mar;8(2):69-80

Day(s) Performed

Tuesday

Report Available

Same day/1 to 7 days

CPT Code Information

86790 x 3

LOINC Code Information

Test ID
Test Order Name
Order LOINC Value

DENVP
Dengue Virus Ab/Ag Panel, S
In Process

Result ID
Test Result Name
Result LOINC Value

INT69
Dengue Interpretation
69048-7

DENG
Dengue Virus Ab, IgG, S
29661-6

DENM
Dengue Virus Ab, IgM, S
29663-2

DENS1
Dengue NS1 Ag, S
75377-2

Method Name

Enzyme-Linked Immunosorbent Assay (ELISA)

Test Classification

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

Forms

If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.

Testing Algorithm

See Mosquito-borne Disease Laboratory Testing.

Special Instructions

• Mosquito-borne Disease Laboratory Testing