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Test ID DENVP Dengue Virus Antibody/Antigen Panel, Serum

Useful For

An aid in the diagnosis of dengue virus infection

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 No Yes
INT69 Dengue Interpretation No Yes

Reporting Name

Dengue Virus Ab/Ag Panel, S

Specimen Type

Serum


Specimen Required


Container/Tube: 

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL


Specimen Minimum Volume

0.8 mL (DENS1: 0.4 mL and DENG, DENM, INT69: 0.4 mL)

Specimen Stability Information

Specimen Type Temperature Time
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) and 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/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. As an adjunct to serologic testing, identification of early DV infection may be made by detection of the DV NS1 antigen. NS1 antigenemia is detectable within 24 hours of infection and up to 9 days following symptom onset. The DV NS1 antigen can be detected using DNSAG / Dengue Virus NS1 Antigen, Serum by enzyme immunoassay.

 

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 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

IgG:

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. 

 

IgM:

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 drawn too soon following exposure may be negative for IgM antibodies to DV. If DV remains suspected, a second specimen, drawn approximately 10 to 12 days following exposure should be tested.

 

Nonstructural protein 1 (NS1):

The presence of dengue 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;496:504-507

2. Dengue--an infectious disease of staggering proportions. Lancet 2013;381:2136

3. Rigau-Perez JG, Clark GG, Gubler DJ, et al: Dengue and dengue haemorrhagic fever. Lancet 1998;352:971-977

4. Tang KF, Ooi EE: Diagnosis of dengue: an update. Expert Rev Anti Infect Ther 2012;10:895-907

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

Day(s) and Time(s) Performed

Tuesday; 9 a.m.

Analytic Time

Same day/1 day

CPT Code Information

IgG: 86790

IgM: 86790

NS1: 86790

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 U.S. Food and Drug Administration.

Testing Algorithm

The following algorithms are available in Special Instructions:

-Assessment for Zika Virus Infection in Nonpregnant Individuals

-Assessment for Zika Virus Infection in Pregnant Women