Dengue Fever: Its Laboratory Diagnosis, with Special Emphasis on IgM Detection

Overview

Rapid diagnosis of dengue is crucial for proper patient care. As IgM antibody appears early during the disease course, its detection is a valuable tool for rapid diagnosis. We evaluated and compared two commercial tests, the PanBio Rapid Immunochromatographic Card Test (Brisbane, Australia) and the PanBio Microwell IgM ELISA with an IgM Capture ELISA (National Institute of Virology, Pune, India). A total of 154 samples from individuals with febrile illness having dengue fever (DF)-like symptoms were tested. The NIV IgM Capture ELISA (MAC-ELISA) showed a high positivity rate (38.9%) as compared to the PanBio Rapid (22.7%) and the PanBio IgM ELISA (20.7%). The NIV MAC-ELISA showed a high sensitivity (96%) as compared to PanBio Rapid (73%) and PanBio IgM ELISA (72%). But the specificity was low (81%) when compared to PanBio Rapid (95%) and PanBio IgM ELISA (97%) using the latent class analysis model. The MAC-ELISA, though a three-day procedure, should be a valuable screening test because of its high sensitivity rates. But rapidity gets compromised, as batch testing is required along with technical difficulty in performance. The “Rapid” test is an easier option in small peripheral laboratories in India because of its obvious advantages.