The inability of a dengue NS1 ELISA to detect Zika infections

Monique Da Rocha Queiroz Lima,Luciana Santos Barbosa,Flavia Barreto Dos Santos,Rivaldo Venâncio-Da-Cunha,Thiara Manuele Alves Souza,Jéssica Badolato Corrêa Da Silva,Izilyanne H Romanholi Facco,Priscila Conrado Guerra Nunes,Thais Chouin-Carneiro,Márcia Dal Fabbro,Elzinandes Azeredo

doi:10.1038/s41598-019-55160-4

Monique Da Rocha Queiroz Lima, Luciana Santos Barbosa + Show 9 more

Open Access

https://doi.org/10.1038/s41598-019-55160-4

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Abstract

The presence of dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV) in Brazil, may result in a difficult diagnosis due to the signs and symptoms shared by those. Moreover, as DENV and ZIKV belong to the same family, serological assays may show a high rate of cross-reactivity. Here, we evaluated a Dengue NS1 capture assay for early and differential diagnosis of dengue during the Zika epidemic occurred in Brazil in 2016. Samples (n = 227) from 218 patients included sera, plasma and urine from previously confirmed acute cases of Zika, dengue and Zika/dengue co-infections. Nine of those patients presented two specimens. The Dengue NS1 test was very specific for dengue diagnosis (99.32%), even in the co-circulation with ZIKV, and exhibited a high accuracy in not detecting acute Zika infections (92.43%). Our findings showed that the dengue NS1 capture test analyzed here was not able to recognize the ZIKV NS1 and its potential for cross-reaction.

Highlights

The presence of dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV) in Brazil, may result in a difficult diagnosis due to the signs and symptoms shared by those
ZIKV/DENV co-infections were identified in 10.57% (24/227) of the samples (DENV-1/ZIKV, n = 14, DENV-4/ZIKV, n = 8 and non-structural protein 1 (NS1)-DENV/ ZIKV, n = 2) Table 1
The alphaviruses CHIKV and MAVY were investigated as differential diagnosis due to their occurrence and circulation in Brazil

Summary

Introduction

The presence of dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV) in Brazil, may result in a difficult diagnosis due to the signs and symptoms shared by those. We evaluated a Dengue NS1 capture assay for early and differential diagnosis of dengue during the Zika epidemic occurred in Brazil in 2016. The Dengue NS1 test was very specific for dengue diagnosis (99.32%), even in the co-circulation with ZIKV, and exhibited a high accuracy in not detecting acute Zika infections (92.43%). The tests should have maximum sensitivity, specificity and be simple, to provide an early support to patients by accurately differentiating dengue from Zika and other febrile diseases[11,12]. Some studies have demonstrated high sensitivity and limited cross-reactivity, suggesting that NS1 may represent an efficient differential assay between DENV and ZIKV infections[24,25], as it has group-specific epitopes that potentially differentiates those viruses[12].

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