Laboratory diagnosis of dengue virus infection by reverse transcriptase polymerase chain reaction (RT-PCR) and IgM-capture enzyme-linked immunosorbent assay (ELISA).

Dengue virus infections are a major public health problem in most tropical and sub-tropical countries of the world. Dengue is occasionally imported by travelers who visit tropical areas and become infected with dengue virus. Laboratory diagnosis is essential for confirming the diagnosis of this virus. For purposes of confirmation, detection of specific IgM by IgM-capture enzyme-linked immunosorbent assay (ELISA) and of dengue virus genome by reverse transcriptase polymerase chain reaction (RT-PCR) have recently been used. In the present study, we tested serum specimens from dengue-suspected Japanese cases, by IgM-capture ELISA, RT-PCR, HI, and virus isolation. Serum samples collected before or on the day of defervescence were positive by RT-PCR, though no PCR-positive samples were obtained after fever day 1. IgM-capture ELISA was positive as early as disease day 4, and all samples but one were IgM-positive when collected on disease day 5 or later. In light of these findings, we recommend that both RT-PCR and IgM-capture ELISA be performed, irrespective of the stage of dengue illness. Combination of RT-PCR and IgM-capture ELISA increases the ability to diagnose dengue virus infection, even in the only that a single serum specimen from the patient is available.