Evaluation of immunological markers in serum, filter-paper blood spots, and saliva for dengue diagnosis and epidemiological studies

J Clin Virol. 2008 Nov;43(3):287-91. doi: 10.1016/j.jcv.2008.07.016. Epub 2008 Sep 9.


Background: Numerous immunological approaches exist to diagnose dengue or detect dengue virus (DENV) infections.

Objectives: To determine the best immunological markers and specimen types for dengue diagnosis and for measuring incidence of DENV infection in community-based studies.

Study design: In one study, acute- and convalescent-phase samples were collected from hospitalized suspected pediatric dengue cases in Managua, Nicaragua, from September 2003 to February 2004. A second study examined specimens collected in a community setting in Managua before and after the 2003-2004 dengue season to measure incidence of DENV infection. In both studies, detection of anti-DENV IgM, IgA, and IgG in serum, filter-paper blood spots, and saliva was compared to a gold standard performed on serum samples.

Results: For dengue diagnosis, the highest sensitivity and specificity was obtained by measuring IgM or IgA in serum or filter-paper blood spots; intermediate and poor results were obtained in saliva for IgM and IgA, respectively. Detection of IgG alone in serum, filter-paper blood spots, or saliva functioned best for measuring DENV infection.

Conclusions: Detection of IgM and IgA in serum and filter-paper blood spots yielded optimal results for diagnosis of dengue cases, whereas IgG was the best marker for measuring incidence of DENV infection.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Antibodies, Viral / analysis*
  • Antibodies, Viral / blood*
  • Blood / immunology*
  • Child
  • Child, Preschool
  • Dengue / diagnosis*
  • Dengue / epidemiology
  • Female
  • Humans
  • Immunoglobulin A / analysis
  • Immunoglobulin A / blood
  • Immunoglobulin G / analysis
  • Immunoglobulin G / blood
  • Immunoglobulin M / analysis
  • Immunoglobulin M / blood
  • Infant
  • Male
  • Nicaragua / epidemiology
  • Saliva / immunology*
  • Sensitivity and Specificity
  • Seroepidemiologic Studies
  • Serologic Tests
  • Serum / immunology*


  • Antibodies, Viral
  • Immunoglobulin A
  • Immunoglobulin G
  • Immunoglobulin M