Comparative sensitivity of laboratory methods to diagnose dengue virus infections at Husada Hospital, Jakarta

Several methods are available for diagnosis of dengue virus infections including a new commercially available dengue blot IgG assay. We conducted a study to compare the sensitivity of the dengue blot with the conventional diagnostic methods. Serum samples from suspected dengue patients were collected for virus isolation and the following serological assays: the hemagglutination-inhibition assay, an IgM/IgG enzyme-linked immunosorbent assay, and the dengue blot. When suspected dengue samples were tested by all methods, viral isolation detected the fewest dengue infections (10.5%), while the IgM/IgG ELISA was the most successful (46.3%) in diagnosing dengue infections. In a specific comparison between the IgM/IgG ELISA and the dengue blot, the dengue blot had an overall sensitivity of 48.8%, with a specificity of 88.7%. When patients were classified by their serological response, the dengue blot had a sensitivity of only 1.7% in those patients with a primary or recent dengue infection, however in secondary infections, the sensitivity of the dengue blot improved to 93.5%. Testing convalescent samples from patients with primary infections, only slightly changed the sensitivity of the dengue blot. The diagnosis of dengue is needed rapidly by clinicians to insure prompt treatment of patients. The dengue blot provides a rapid and easily performed assay, especially sensitive in secondary dengue infections which are most common in hospitalized cases in Asia.