Detection of the dengue non-structural 1 antigen in cerebral spinal fluid samples using a commercially available enzyme-linked immunosorbent assay

Abstract

The involvement of the central nervous system in dengue infections has been reported in countries where the disease in endemic. The purpose of this study was to determine whether an enzyme-linked immunosorbent assay kit designed to detect the dengue NS1 antigen in serum was able to detect this antigen in cerebral spinal fluid (CSF) samples from patients with fatal outcomes. To evaluate the sensitivity of the kit, 26 dengue-positive CSF samples were used. The Pan-E Dengue Early kit was able to detect the NS1 antigen in 13 of 26 dengue-positive CSF samples, resulting in a sensitivity of 50% (95% confidence interval, 29.9-70.1%) and specificity of 100% (95% confidence interval, 75.3-100%). The kit was able to detect the NS1 antigen in CSF of individuals who had died of dengue. When used in combination with IgM, the detection rate rose to 92.3%. This study reports a method for rapidly detecting the dengue virus in CSF, thereby increasing the diagnosis of dengue fever cases with unusual neurological manifestations.

Dengue in Patients with Central Nervous System Manifestations, Brazil

“…Since the reintroduction of dengue virus (DENV) into Brazil in the 1980s, >60% of the reported dengue cases in this region of the Western Hemisphere have occurred there (2). As the disease has become more common, unusual clinical signs, some of which involve the central nervous system, have been observed in dengue patients (2)(3)(4). We therefore assessed prevalence of dengue neurologic cases from Ceará State, Brazil, a region where dengue is endemic.…”

Postmortem Diagnosis of Dengue as an Epidemiological Surveillance Tool

“…The immunohistochemical and NS1Ag ELISA tests made the largest contribution to diagnosis, as reported by Araújo and others 15 and Tomashek and others. 21 Therefore, in this study, the NS1Ag test was critical despite the predominance of DENV-4 in 2012, which is difficult to detect with the NS1Ag test.…”

“…15 Dengue IgM Capture ELISA (Panbio Diagnostics) was performed on samples according to the manufacturer's instructions. 16 Samples were determined to be positive or negative using an index value calculated according to the manufacturer's instructions.…”

Severe coinfection of melioidosis and dengue fever in northeastern Brazil: first case report

“…The Epidemiological Surveillance of Ceará has a protocol with the Central Laboratory of Public Health of Ceará State Virology Section and the Death Verification Service (DVS), where in all the cases referred to the DVS that present bleeding, pleural effusion, or other manifestations suggestive of hemorrhage, even when dengue is not suspected, material (blood, cerebrospinal fluid, and viscera) is harvested and sent to Central Public Health Laboratory of Ceará (LACEN) where PCR and viral isolation are performed 9 . It is a routine for suspected cases in Ceará to go through Epidemiological Surveillance and DVS.…”