Serological studies on a case of laboratory dengue infection

One of the authors (Y.O.), who had previously been immunized with Japanese encephalitis (JE) vaccine, showed symptoms of typical dengue fever 6 days after accidental infection with a newly isolated dengue type 4 virus strain from a patient with dengue hemorrhagic fever (DHF) in Thailand. His sera were examined by hemagglutination inhibition (HI), complement fixation (CF) and neutralization (N) tests. The JE N antibody titers of his sera were high even on the first day of the illness and remained almost constant during the next year. Antibodies that reacted with dengue viruses were detected from a very early stage of the illness by all three serological tests. In addition, his convalescent phase sera showed high titers against all 4 types of dengue virus. These data suggest that the dengue infection caused secondary stimulation of antigens of flavivirus. Sedimentation analysis of antibodies in Y.O.'s serum (day 9) was carried out and IgM antibody that reacted only with dengue type 4 virus and homologous infecting virus was separated. These findings clearly demonstrated that the laboratory infection of Y.O. was primary dengue infection with dengue type 4 virus.