Test Id : DENGM
Dengue Virus Antibody, IgG and IgM, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Aiding in the diagnosis of dengue virus infection
Highlights
Detection of antibodies to dengue virus is suggestive of recent exposure and/or infection with dengue virus.
This test should be used for diagnostic purposes only.
Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| DENG | Dengue Virus Ab, IgG, S | No | Yes |
| DENM | Dengue Virus Ab, IgM, S | No | Yes |
| DNABI | Dengue Ab Interpretation | No | Yes |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For information see:
Method Name
A short description of the method used to perform the test
Enzyme-Linked Immunosorbent Assay (ELISA)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Dengue Fever
Break Bone Fever
Flavivirus
Mosquito-borne infection
Mosquito
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For information see:
Specimen Type
Describes the specimen type validated for testing
Serum
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Sarstedt Aliquot Tube 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
0.4 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
| Heat-inactivated specimen | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Aiding in the diagnosis of dengue virus infection
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For information see:
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Dengue virus (DV) is a globally distributed flavivirus with 4 distinct serotypes (DV-1, -2, -3, -4). It is primarily transmitted by the Aedes aegypti mosquito, which is found throughout the tropical and subtropical regions of over 100 countries. DV poses a significant worldwide public health threat with approximately 2.5 to 3 billion people residing in DV endemic areas, among whom 100 to 200 million individuals will be infected, and approximately 30,000 patients will succumb to the disease, annually.
Following dengue infection, the incubation period varies from 3 to 7 days, and while some infections remain asymptomatic, the majority of individuals will develop classic dengue fever. Symptomatic patients become acutely febrile and present with severe musculoskeletal pain, headache, retro-orbital pain, and a transient macular rash, most often observed in children. Fever defervescence signals disease resolution in most individuals. However, children and young adults remain at increased risk for progression to dengue hemorrhagic fever and dengue shock syndrome, particularly during repeat infection with a new DV serotype.
Detection of dengue-specific IgM and IgG-class antibodies remains the most commonly utilized diagnostic method. Seroconversion occurs approximately 3 to 7 days following exposure, and therefore, testing of acute and convalescent sera may be necessary to make the diagnosis. As an adjunct to serologic testing, identification of early DV infection may be made by detection of the DV nonstructural protein 1 (NS1) antigen. NS1 antigenemia is detectable within 24 hours of infection and up to 9 days following symptom onset. The DV NS1 antigen can be detected by ordering DNSAG / Dengue Virus NS1 Antigen, Serum.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Dengue virus antibody, IgG: Negative
Dengue virus antibody, IgM: Negative
Reference values apply to all ages.
Interpretation
Provides information to assist in interpretation of the test results
The presence of IgG-class antibodies to dengue virus (DV) is consistent with exposure to this virus sometime in the past. By 3 weeks following exposure, nearly all immunocompetent individuals should have developed IgG antibodies to DV.
The presence of IgM-class antibodies to DV is consistent with acute-phase infection.
IgM antibodies become detectable 3 to 7 days following infection and may remain detectable for up to 6 months or longer following disease resolution.
The absence of IgM-class antibodies to DV is consistent with lack of infection. However, specimens collected too soon following exposure may be negative for IgM antibodies to DV. If DV remains suspected, a second specimen collected approximately 10 to 12 days following exposure should be tested.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Test results should be used in conjunction with clinical evaluation, including exposure history and clinical presentation.
False-positive results, particularly with the dengue virus IgG enzyme-linked immunosorbent assay, may occur in persons infected with other flaviviruses, including Zika virus, West Nile virus, and St. Louis encephalitis virus. Obtaining a detailed exposure history and additional laboratory testing may be necessary to determine the infecting virus.
Positive test results may not be valid in persons who have received blood transfusions or other blood products within the last several months.
The significance of a negative result in an immunosuppressed patient is unclear.
Supportive Data
A total of 200 prospective serum samples submitted for dengue virus (DV) IgM and IgG testing by the Focus Diagnostics DV IgM and IgG enzyme immunoassays (EIA) were also tested by the InBios IgM and IgG DV assays. The results were compared and the data summarized in Tables 1 and 2.
Table 1. Comparison of the InBios and Focus (Quest) Diagnostics DV IgM EIA
| InBios DV IgM EIA | Focus (Quest) Diagnostics DV IgM EIA | |
| Positive | Negative | |
| Positive | 14 | 0 |
| Negative | 1 | 184 |
| Equivocal | 1 | 0 |
Sensitivity: 87.5% (14/16); 95% CI: 62.7%-97.7%
Specificity: 100% (184/184); 95% CI: 97. 5%-100%
Agreement: 99% (198/200); 95% CI: 96.1%-99.9%
Table 2. Comparison of the InBios and Focus (Quest) Diagnostics DV IgG EIA
| InBios DV IgG EIA | Focus (Quest) Diagnostics DV IgG EIA | |
| | Positive | Negative |
| Positive | 34 | 0 |
| Negative | 0 | 164 |
| Equivocal | 2 | 0 |
Sensitivity: 94.4% (34/36); 95% CI: 80.9%-99.4%
Specificity: 100% (164/164); 95% CI: 97.2%-100%
Agreement: 99% (198/200); 95% CI: 96.1%-99.9%
An additional 42 serum samples positive for IgG-class antibodies to West Nile virus (n=24), St. Louis encephalitis virus (n=9), and California (LaCrosse) virus (n=9) were also tested by the InBios DV IgG EIA and the data are summarized below in Table 3.
Table 3. Cross-reactivity of the InBios DV IgG EIA with antibodies to West Nile virus, St. Louis encephalitis virus, and California (LaCrosse) virus
| InBios DV IgG EIA | West Nile virus IgG positive | St. Louis encephalitis virus positive | California (LaCrosse) virus positive |
| Positive | 18 | 7 | 1 |
| Negative | 2 | 0 | 8 |
| Equivocal | 4 | 2 | 0 |
Note that the InBios DV IgG EIA shows significant cross-reactivity with antibodies to West Nile virus and St. Louis encephalitis virus.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Centers for Disease Control and Prevention (CDC). Clinical Testing Guidance for Dengue. Updated August 26, 2024. Accessed December 11, 2024, Available at www.cdc.gov/dengue/hcp/diagnosis-testing/index.html
2. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. Geneva: World Health Organization; 2009
3. Khan MB, Yang ZS, Lin CY, et al. Dengue overview: An updated systemic review. J Infect Public Health. 2023;16(10):1625-1642. doi:10.1016/j.jiph.2023.08.001
Method Description
Describes how the test is performed and provides a method-specific reference
Dengue virus IgM:
In this enzyme-linked immunosorbent assay (ELISA), samples and controls are diluted in sample dilution buffer and incubated in microtiter wells coated with antihuman IgM antibodies. This incubation is followed by incubation with dengue-derived recombinant antigens (DENRA) and normal cell antigen separately. After incubation and washing, the wells are treated with a DEN-specific monoclonal antibody labeled with horseradish peroxidase (HRP). After a second incubation and washing step, the wells are incubated with tetramethylbenzidine (TMB) substrate. Acid stop is added, and absorbance at 450 nm is read. The ratio of absorbencies of the DENRA and the control antigen wells determines whether the result is positive or negative.(Package insert: InBiOS DENV Detect IgM CAPTURE ELISA. InBios International, Inc; Revision 10/2019)
Dengue virus IgG:
In this enzyme-linked immunosorbent assay, controls and diluted samples are incubated in microtiter wells coated with monoclonal antibody bound to dengue-derived recombinant antigens (DENRA). After incubation and washing, wells are treated with IgG antibody labeled with horseradish peroxidase. After a second incubation and washing, wells are incubated with tetramethylbenzidine substrate. Acid stop is added, and absorbance at 450 nm is measured. The ratio of the absorbencies of the DENRA and the control wells determines whether a result is positive or negative.(Package insert: InBiOS DENV Detect IgG ELISA. InBios International, Inc; Revision 05/01/2018)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Tuesday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
IgM-86790
IgG-86790
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| DENGM | Dengue Virus Ab, IgG and IgM, S | 87546-8 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| DENG | Dengue Virus Ab, IgG, S | 29661-6 |
| DENM | Dengue Virus Ab, IgM, S | 29663-2 |
| DNABI | Dengue Ab Interpretation | 69048-7 |