New development in the diagnosis of dengue infections.

Introduction: Dengue is of major concern around the world. Having no pathognomonic features that reliably distinguish it from other febrile illnesses, laboratory diagnosis is important for confirmation. Ideally, a dengue diagnostic test should be sensitive, specific and applicable from the onset of disease to 10 days post-infection.

Areas covered: In this review, the pro and cons of currently available diagnostic arrays as well as evaluations that have been conducted by numerous groups using both in-house and commercialized kits were assessed and reviewed. We also probed into the challenges and hurdles of applying these assays worldwide. This review also glimpsed at newer technologies that may be invaluable in the future of dengue diagnostics.

Expert opinion: To diagnose dengue, an understanding of the complex immune responses and the clinical features of this disease is essential. The MAC-ELISA currently remains the assay of choice but needs further evaluation and confirmation. Viral RT-PCR and NS1 have gained interest but their inconsistencies and great variability are of concern. Combinations of these tests have improved sensitivity but specificity issues still exist. Consequently, the favorable method of diagnosing dengue currently is to run multiple tests or obtain a paired sample so that more than one parameter is detected or a rising titer is demonstrated.