Dengue Fever Test

What is a dengue fever test?

Dengue fever is a viral infection spread to people through bites from infected mosquitos. You can't catch the virus from a person who is sick with dengue fever.

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A dengue fever test checks a sample of your blood to see if you have the virus. The test is used if you have symptoms of dengue fever and have been in an area where mosquitos carry the virus.

The dengue virus is most common in parts of the world with tropical and subtropical climates, including:

• South and Central America
• The Caribbean, including Puerto Rico and the U.S. Virgin Islands
• Asia
• The Middle East
• The Pacific Islands
• Africa

Outbreaks of dengue fever are rare in the U.S. mainland. But small outbreaks have been reported in parts of Florida and Texas.

Most people who get the dengue virus won't become sick. People who do get sick may have mild to severe symptoms that usually begin four to ten days after a bite from an infected mosquito. The most common symptom is a sudden high fever. There is no specific medicine that can cure or treat dengue fever, but most people will recover after about a week.

Some people who get sick with dengue will develop severe dengue disease. Severe dengue can cause internal bleeding and shock, which can be life-threatening.

Infants and pregnant women have a higher risk for developing severe dengue. The risk is also higher for people who have had dengue and then get it again. That's why it's so important to get a dengue fever test if you have symptoms after being in an area where the virus is common.

There are two main types of dengue fever blood tests:

• Antibody tests check your blood sample for proteins, called antibodies, that your immune system makes to fight viruses and other germs. Your body needs time to make specific antibodies to fight dengue. So, these tests are most accurate when they are done four days or more after your symptoms begin.
• Molecular tests look for genetic material from the dengue virus in your blood sample. A PCR test (polymerase chain reaction) is a type of molecular test that's used to check for dengue. These tests can be done during the first seven days after your symptoms begin. Tests done later than that may not have accurate results.

One type of PCR test can check for dengue along with two other viruses that mosquitos carry. These viruses, chikungunya and zika, are common in the same places as the dengue virus, and they cause similar symptoms. Your provider can order this test from your state or local public health department.

Other names: dengue virus antibody, dengue virus by PCR

What is it used for?

A dengue fever test is used to find out if you have the dengue virus. It is mostly used for people who have symptoms related to dengue fever and have recently traveled to an area where dengue infections are common.

Why do I need a dengue fever test?

You may need to be tested for the dengue virus if you have symptoms of dengue fever and have been in an area where the virus is common. Symptoms usually show up four to ten days after being bitten by an infected mosquito.

Symptoms of dengue fever include a sudden high fever (104°F or higher) with any of these other symptoms:

• Nausea and vomiting
• Rash
• Eye pain, typically behind the eyes
• Headache
• Joint, bone or muscle pain

Symptoms of severe dengue may begin 24 to 48 hours after the fever has gone away. Get medical help right away if you or a family member has any of these warning signs of severe dengue:

• Abdominal (belly) pain or tenderness
• Vomiting (at least 3 times in 24 hours)
• Bleeding from the nose or gums
• Vomiting blood or blood in stool (poop)
• Feeling tired, restlessness, or irritable

What happens during a dengue fever test?

Your health care provider will ask about your symptoms and your recent travels. If an infection is suspected, you will get a blood test to check for the dengue virus.

During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don't need any special preparations for a dengue fever test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If you had a molecular test (a PCR test):

• A positive test result means that the test found genetic material from the virus in your blood sample. You most likely have a dengue infection.
• A negative test result means that the dengue virus wasn't found in your blood sample. You probably don't have dengue. But it's possible that there wasn't enough virus in your blood sample for the test to find. That might happen if the test was done more than seven days after your symptoms began. If your molecular test result is negative, your provider will usually order an antibody test to confirm that you don't have dengue.

If you had an antibody test, your test results may be reported as positive or negative. Or they may be given as a measurement of the dengue antibodies found in your blood sample.

• A positive test result means that antibodies for the dengue virus were found. You probably have a dengue infection, but you may need another test to confirm the results. That's because the antibody test may have found antibodies that fight other similar viruses that mosquitos carry. Your provider may order another type of blood test to find out exactly which type of viral infection you have.
• A negative test result means that dengue antibodies weren't found in your blood sample. Dengue may not be causing your symptoms. But a negative result could mean that you were tested before your body had time to make enough antibodies to show on the test. So, your provider may order another antibody test to check again.

If you have dengue fever, your provider can tell you how to treat your symptoms. Always follow your provider's instructions. In general, care for dengue fever includes:

• Getting plenty of rest.
• Drinking lots of fluids.
• Taking acetaminophen to control fever and relieve pain. Do not take aspirin, ibuprofen, or naproxen sodium, because they can increase the risk of bleeding.
• Watching carefully for symptoms of severe dengue. Dengue fever can become severe within hours. Get medical help right away if you develop the symptoms of severe dengue.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a dengue fever test?

A vaccine is available for children ages 9 to 16 who:

• Have already had dengue fever. The vaccine helps protect against future dengue infections or from getting severe dengue disease. Before getting the vaccine, a child must have a blood test to confirm a past dengue infection. That's because the vaccine can be harmful to a child who has never had dengue fever.
• Live in areas where dengue is common. These areas include Puerto Rico, the U.S, Virgin Islands, the U.S. territories of American Samoa, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. The vaccine isn't approved for children traveling to these areas to visit.

If you travel to an area where dengue is common, you can reduce the risk of infection by preventing mosquito bites.

References

1. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Dengue: Dengue Vaccine; [cited Dec 16]; [about 1 screens]. Available from: https://www.cdc.gov/dengue/vaccine/index.html
2. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Dengue: Reasons to Get Vaccinated; [cited May 28]; [about 2 screens]. Available from: https://www.cdc.gov/dengue/vaccine/reasons-to-vaccinate.html
3. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Preventing Dengue; [updated May 17; cited Nov 8]; [about 2 screens]. Available from: https://www.cdc.gov/dengue/prevention/
4. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c-. Dengue Fever; [cited Nov 9]; [about 8 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/dengue-fever/symptoms-causes/syc-
5. Mayo Clinic: Mayo Medical Laboratories [Internet]. Mayo Foundation for Medical Education and Research; c-. Test ID: DENGM: Dengue Virus Antibody, IgG and IgM, Serum: Clinical and Interpretive; [cited Nov 9]; [about 3 screens]. Available from: https://www.mayocliniclabs.com/test-catalog/overview/#Clinical-and-Interpretive
6. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c. Dengue; [reviewed Aug; cited Nov 9]; [about 2 screens]. Available from: https://www.merckmanuals.com/home/infections/arboviruses-arenaviruses-filoviruses/dengue
7. Johns Hopkins Medicine [Internet]. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; c. Health: Blood Test; [cited Nov 17]; [about 3 screens]. Available from: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/blood-test
8. Schaefer TJ, Panda PK, Wolford RW. Dengue Fever. [Updated Apr 22; cited Nov 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK/
9. Testing.com [Internet]. Seattle (WA): OneCare Media; c. Dengue Fever Testing; [modified Nov 9; cited Nov 9]; [about 7 screens]. Available from: https://www.testing.com/tests/dengue-fever-test/
10. Testing.com [Internet]. Seattle (WA): OneCare Media; c. Shock; [cited Nov 9]; [about 1 screen]. Available from: https://www.testing.com/glossary/#shock
11. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c. Dengue fever: Overview; [reviewed Aug 25; cited Nov 9]; [about 3 screens]. Available from: https://ufhealth.org/dengue-fever
12. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c. Health Encyclopedia: Dengue Fever; [cited Nov 9]; [about 6 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=P
13. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c. Health Information: Dengue Fever; [updated Feb 9; cited Nov 9]; [about 2 screens]. Available from: https://patient.uwhealth.org/healthwise/article/en-us/abk
14. World Health Organization [Internet]. Geneva (SUI): World Health Organization; c. Dengue and severe dengue; Jan 10 [cited Nov 9]; [about 4 screens]. Available from: http://www.who.int/en/news-room/fact-sheets/detail/dengue-and-severe-dengue

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Molecular testing—a PCR test that detects the presence of the virus itself is generally considered the most reliable means of diagnosis. A positive result from a PCR is considered conclusive. A negative result on a PCR test may indicate that no infection is present or that the level of virus is too low to detect, as may happen if the test was performed after the 7-day window during which the virus is present in the sample collected for this test. A negative PCR result is followed by antibody testing (below).

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Antibody testing—antibody tests may be reported as positive or negative, or may be reported as an antibody titer with an interpretation of which type(s) of antibody (IgG or IgM) is present.

Positive IgM and IgG tests for dengue antibodies detected in an initial blood sample mean that it is likely that the person became infected with dengue virus within recent weeks. IgM antibody tests can be positive if a person has been infected with a similar virus, such as chikungunya (called cross-reaction). If an initial IgM antibody test is positive, a second test called the Plaque Reduction Neutralization Test (PRNT) is used to confirm the presence of antibodies to dengue virus and to help rule out other viral infections.

If the IgG is positive but the IgM is low or negative, then it is likely that the person had an infection sometime in the past. If the dengue IgG antibody titer increases four-fold or greater (e.g., titer of 1:4 to a titer of 1:64) between an initial sample and one taken 2 to 4 weeks later, then it is likely that a person has had a recent infection.

Negative tests for IgM and/or IgG antibodies may mean that the individual tested does not have a dengue infection and symptoms are due to another cause, or that the level of antibody may be too low to measure. The person may still have a dengue infection – it may just be that it is too soon after initial exposure to the virus to produce a detectable level of antibody.

The following table summarizes results that may be seen with antibody testing:

IgM Result IgG Result Possible Interpretation Positive Negative Current infection Positive Positive Current infection Low or negative or not tested Four-fold increase in samples taken 2-4 weeks apart Recent infection Low or negative Positive Past infection Negative Negative Too soon after initial exposure for antibodies to develop or symptoms due to another cause

Sources Used in Current Review

( July Updated). Dengue and severe dengue. World Health Organization Fact sheet. Available online at https://www.who.int/mediacentre/factsheets/fs117/en/. Accessed on 1/22/17.

Shepherd, S. and Hinfey, P. ( October 5 Updated). Dengue. Medscape Drugs and Diseases. Available online at https://emedicine.medscape.com/article/-overview#showall. Accessed on 1/22/17.

Couturier, M. and Hillyard, D. ( December Updated). Dengue Fever Virus. ARUP Consult. Available online at https://arupconsult.com/content/dengue-fever-virus. Accessed on 1/22/17.

(© –). Dengue Virus Antibody/Antigen Panel, Serum. Mayo Clinic Mayo Medical Laboratories. Available online at https://www.mayomedicallaboratories.com/test-catalog/Overview/. Accessed on 1/22/17.

Hata, D. J. ( June). Dengue Fever – An Update. Mayo Clinic Mayo Medical Laboratories Hot Topics. Available online at https://www.mayomedicallaboratories.com/articles/hot-topic//06-01-dengue-fever/index.html. Accessed on 1/22/17.

( April 12). CDC DENV-1-4 Real-Time RT-PCR Assay for Detection and Serotype Identification of Dengue Virus. CDC. Available online at https://www.cdc.gov/dengue/resources/rt-pcr/cdcpackageinsert.pdf. Accessed on 1/22/17.

( January 20 Updated). Dengue Laboratory Guidance and Diagnostic Testing. CDC. Available online at https://www.cdc.gov/dengue/clinicallab/laboratory.html. Accessed on 1/22/17.

(February 7, ) Centers for Disease Control and Prevention, Division of Vector-Borne Diseases. Revised diagnostic testing for Zika, chikungunya, and dengue viruses in US Public Health Laboratories. Available online at https://www.cdc.gov/zika/pdfs/denvchikvzikv-testing-algorithm.pdf. Accessed March .

Sources Used in Previous Reviews

De Paula, S. and Fonseca, B. (). Dengue: a review of the laboratory tests a clinician must know to achieve a correct diagnosis. The Brazilian Journal of Infectious Diseases: an Official Publication of the Brazilian Society of Infectious Diseases. Available online at https://europepmc.org/abstract/MED/. Accessed June .

Lima, M. et al. (). Comparison of three commercially available Dengue NS1 Antigen Capture Assays for acute diagnosis of Dengue in Brazil. PLoS Neglected Tropical Diseases. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC/. Accessed 5/30/.

Rathakrishnan, A., Sekaran, S. (). New development in the diagnosis of dengue infections. Expert Opinion on Medical Diagnostics. Available online at https://www.ncbi.nlm.nih.gov/pubmed/. Accessed 6/1/.

Sood, R. (© ). Textbook of Medical Laboratory Technology. Jaypee Brothers Publishers. New Dehli, India. Pp 780-787.

World Health Organization. () Dengue Guidelines for Diagnosis, Treatment, Prevention and Control. PDF available for download at https://whqlibdoc.who.int/publications//_eng.pdf. Accessed 5/15/.

(October 5, ) Centers for Disease Control and Prevention. Dengue. Available online at https://www.cdc.gov/Dengue/. Accessed June .

Cuzzubo A, et al. Use of Recombinant Envelope Proteins for Serological Diagnosis of Dengue Virus Infection in an Immunochromatographic Assay. Clin Vaccine Immunol November vol. 8 no. 6 -. Available online at https://cvi.asm.org/content/8/6/.full. Accessed June .

(September 30, ) Mayo Clinic. Dengue Fever. Available online at https://www.mayoclinic.com/health/dengue-fever/DS. Accessed June .

(January 23, ) National Institute of Allergy and Infectious Diseases. Dengue Fever. Available online at https://www.niaid.nih.gov/topics/denguefever/Pages/default.aspx. Accessed June .

CDC. Yellow Book. Dengue Fever & Dengue Hemorrhagic Fever. Available online at https://wwwnc.cdc.gov/travel/yellowbook//chapter-3-infectious-diseases-related-to-travel/dengue-fever-and-dengue-hemorrhagic-fever. Accessed July .

Florida Department of Health. Dengue Fever. Available online at https://www.doh.state.fl.us/environment/medicine/arboviral/Dengue.html. Accessed July .

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