Molecular Tests for Dengue Virus

Key points

  • Dengue virus RNA can usually be detected by nucleic acid amplification tests (NAAT) for 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.
An image of a technician loading a test tray into a 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, any serum sample should be tested with a NAAT and for IgM antibody since both tests can be performed in serum.
    • Performing both tests can detect more cases than performing just one test.
  • After day 7 of illness, few cases can be detected by NAAT.

Specimen types

  • 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. Plasma and whole blood have not been as well documented. 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 ELISA should be used in combination with NAAT or NS1 tests.
  • If NAAT and NS1 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, the patient's diagnosis is unconfirmed.

Availability

Commercial

Commercial diagnostic kits and clinical laboratory NAATs, including the CDC DENV-1-4 multiplex assay, are available in the United States and worldwide and available to 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.