Molecular Tests for Dengue Virus

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Key points

  • Dengue virus RNA can usually be detected by nucleic acid amplification tests (NAAT) during the first 7 days of illness.
  • A positive NAAT (e.g. RT-PCR) result confirms current dengue virus infection.
  • A negative NAAT result does not rule out infection.
  • People should also be tested for the presence of IgM antibodies against dengue virus to determine possible recent dengue exposure.
Lab technician loading a test tray into a real time PCR machine.

Nucleic acid amplification test (NAAT)

What the test is

A NAAT is a generic term referring to molecular tests used to detect viral genomic material (nucleic acids). NAATs are a preferred method of diagnosis because they can provide confirmed evidence of infection.

How and when NAAT should be used during infection

  • For symptomatic patients during the first 7 days of illness, serum samples should be tested with a NAAT and for IgM antibody with enzyme-linked immunosorbent assay (ELISA) since both tests can be performed in serum.
    • Performing both tests enables detection of more cases than performing just one test.
  • After day 7 of illness, fewer cases can be detected by NAAT.

Specimen types

Please refer to the instructions for use manual of your NAAT product for a list of the validated or approved specimen types. Not all specimen types are validated for use with every NAAT product.

  • Serum (preferred)
  • Plasma
  • Whole blood
  • Cerebrospinal fluid (CSF)

Keep in mind

Serum specimens have been the most extensively validated and are the preferred sample for NAAT testing. For some NAAT products, specimen types such as urine, amniotic fluid, or CSF may only be valid if tested in parallel to a case-matching serum sample. Testing of CSF is only recommended in cases with encephalitic disease.

Interpretation of results

  • A positive NAAT result confirms dengue virus infection.
  • A negative NAAT result does not rule out infection.

Additional Considerations

  • Antigen testing can be used instead of NAAT, and a negative RT-PCR sample can be tested by NS1 antigen test. IgM antibody testing should be used in combination with NAAT or NS1 antigen tests.
  • If NAAT and NS1 antigen tests are negative or unavailable, and IgM antibody result from the acute phase sample is also negative, a convalescent phase specimen is needed to make a diagnosis of dengue virus infection.
  • If an acute phase specimen is negative by these tests and the patient does not submit a convalescent specimen, diagnosis of dengue is not confirmed.

Availability

Commercial

Commercial diagnostic kits and clinical laboratory NAATs, including the CDC DENV-1-4 Real-Time RT-PCR Assay, are available in the United States and worldwide for Clinical Laboratory Improvement Amendments (CLIA)-certified public health laboratories.

CDC

CDC provides reagents and guidance to public health laboratories. CDC also may provide confirmatory testing if requested by public health laboratories. Learn more about submitting specimens for dengue virus tests.

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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
  • Sharp TM, Fischer M, Muñoz-Jordán JL, et al. Dengue and Zika Virus Diagnostic Testing for Patients with a Clinically Compatible Illness and Risk for Infection with Both Viruses. MMWR Recomm Rep 2019;68(No. RR-1):1–10. DOI: http://dx.doi.org/10.15585/mmwr.rr6801a1external icon.