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Test ID DNSAG Dengue Virus NS1 Antigen, Serum


Specimen Required


Container/Tube: 

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.5 mL


Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Secondary ID

36781

Useful For

An aid in the diagnosis of dengue virus infection

Highlights

Detection of the dengue virus nonstructural protein 1 (NS1) antigen is suggestive of recent exposure and/or acute infection with dengue virus.

 

This test should be used for diagnostic purposes only.

 

Dengue NS1 antigenemia overlaps with dengue virus viremia and can be used as an acute phase marker for infection.

Profile Information

Test ID Reporting Name Available Separately Always Performed
DENS1 Dengue NS1 Ag, S No Yes
DNAGI Dengue Ag Interpretation No Yes

Testing Algorithm

See Mosquito-borne Disease Laboratory Testing in Special Instructions.

Method Name

Enzyme-Linked Immunosorbent Assay (ELISA)

Reporting Name

Dengue Virus NS1 Ag, S

Specimen Type

Serum

Specimen Minimum Volume

0.4 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 14 days
  Frozen  14 days

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross reject

Icterus

Mild OK; Gross reject

Other

NA

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, 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 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 (DENGM) provides optimal diagnostic potential for both early and late dengue disease.

Reference Values

Negative

Reference values apply to all ages.

Interpretation

Positive:

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).

 

Negative:

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

 

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

Cautions

Results should be used in conjunction with clinical presentation and exposure history.

 

Though uncommon, false-positive nonstructural protein 1 (NS1) results may occur in individuals with active infection due to other flaviviruses, including West Nile virus and yellow fever virus.

 

Negative NS1 antigen results may occur if the specimen was collected greater than 7 days following symptom onset. Serologic testing for the presence of IgM and IgG antibodies to DV is recommended in such cases.

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 Jun 22;381(9884):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

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

86790-NS1 Ag

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DNSAG Dengue Virus NS1 Ag, S 75377-2

 

Result ID Test Result Name Result LOINC Value
DENS1 Dengue NS1 Ag, S 75377-2
DNAGI Dengue Ag Interpretation 69048-7

NY State Approved

Yes