Two Basic Methods
During first 4 to 5 days, Virus is detected in serum, plasma, Circulating blood cells and tissues Can be detected by Virus isolation, Nucleic acid detection and Antigen detection (NS1 Ag)
After the acute phase...?
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Dengue infection in a person not previously infected with flavivirus nor immunized with a flavivirus vaccine. Primary antibody response (IgM - slow increase).
Detectable in
IgM levels peak at 2 weeks after the onset of symptoms. Declines to undetectable levels over 2 to 3 months. Anti dengue serum IgG is detectable at low titres at the end of 1st week of illness, increasing slowly thereafter and is still detectable after several months and even for life.
Previous infection with a dengue virus/ vaccination with non-dengue flavivirus vaccine. Antibody titres rise rapidly ( IgG). IgG detectable at high levels in the acute stage appearing before or simultaneously with IgM, peaks at 2 weeks after the onset of symptoms and declines over 3-6 months. Early convalescent stage IgM levels are significantly lower in secondary infections than in primary.
NS1 antigen ELISA - sensitivity 86% and specificity 100%
VIRUS ISOLATION