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2006-07-21Zeitschriftenartikel DOI: 10.1186/1471-2334-6-120
Clinical features and pitfalls in the laboratory diagnosis of dengue in travellers
dc.contributor.authorWichmann, Ole
dc.contributor.authorStark, Klaus
dc.contributor.authorShu, Pei-Yun
dc.contributor.authorNiedrig, Matthias
dc.contributor.authorFrank, Christina
dc.contributor.authorHuang, Jyh-Hsiung
dc.contributor.authorJelinek, Tomas
dc.date.accessioned2018-05-07T13:07:49Z
dc.date.available2018-05-07T13:07:49Z
dc.date.created2009-04-30
dc.date.issued2006-07-21none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/reiRGh54C96No/PDF/23AvfHgjga4VM.pdf
dc.identifier.urihttp://edoc.rki.de/176904/397
dc.description.abstractBackground: Several enzyme-linked immunosorbent assay (ELISA)-kits are commercially available for the rapid diagnosis of dengue infection, and have demonstrated good sensitivity and specificity in paired serum samples. In practice, however, often only one blood sample is available from febrile travellers returning from dengue endemic areas. Methods: To evaluate the diagnostic value of positive dengue antibody-titres performed by a standard ELISA (PanBio IgM- and IgG-ELISA) in single serum samples (regarded as "probable infection"), 127 positive samples were further analyzed using envelope/membrane IgM-, and nonstructural protein 1 IgM- and IgG-ELISAs, immunofluorescence assays, and real-time reverse transcription polymerase chain reaction assays (RT-PCR). A combination of the test-results served as the diagnostic "gold standard". A total of 1,035 febrile travellers returning from dengue-endemic countries with negative dengue-serology and RT-PCR served as controls to compare clinical and haematological features. Results: Overall, only 64 (positive predictive value = 50%) of the probable cases were confirmed by additional analysis and 54 (42.5%) were confirmed to be "false-positive". Rash was the only clinical feature significantly associated with confirmed dengue fever. The combination of thrombocytopenia and leucopenia was present in 40.4% of confirmed and in 6.1% of false-positive cases. Thus, the positive predictive value for the combination of positive PanBio-ELISA plus the two haematological features was 90.5%. Conclusion: The examination of paired serum samples is considered the most reliable serodiagnostic procedure for dengue. However, if only one blood sample is available, a single positive ELISA-result carries a high rate of false-positivity and should be confirmed using a second and more specific diagnostic technique. In the absence of further testing, platelet and white blood cell counts are helpful for the correct interpretation.eng
dc.language.isoeng
dc.publisherRobert Koch-Institut, Infektionskrankheiten / Erreger
dc.subjectHumanseng
dc.subjectAdolescenteng
dc.subjectAdulteng
dc.subjectAgedeng
dc.subjectMiddle Agedeng
dc.subjectChildeng
dc.subjectPreschooleng
dc.subjectFemaleeng
dc.subjectMaleeng
dc.subjectBlood Cell Counteng
dc.subjectDengue/bloodeng
dc.subjectDengue/diagnosiseng
dc.subjectDengue/immunologyeng
dc.subjectDengue/virologyeng
dc.subjectEnzyme-Linked Immunosorbent Assay/methodseng
dc.subjectFalse Positive Reactionseng
dc.subjectImmunoglobulin G/bloodeng
dc.subjectImmunoglobulin M/bloodeng
dc.subjectRetrospective Studieseng
dc.subjectTraveleng
dc.subject.ddc610 Medizin
dc.titleClinical features and pitfalls in the laboratory diagnosis of dengue in travellers
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-100492
dc.identifier.doi10.1186/1471-2334-6-120
dc.identifier.doihttp://dx.doi.org/10.25646/322
local.edoc.container-titleBMC Infectious Diseases
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttp://www.biomedcentral.com/1471-2334/6/120
local.edoc.container-publisher-nameBioMed Central
local.edoc.container-volume6
local.edoc.container-issue120
local.edoc.container-year2006

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