Development of Dengue-type NS1 ELISA for Rapid Detection and Differentiation of Dengue Serotypes during Early Infection

Dengue fever, caused by infections with the dengue virus (DENV), affects nearly four hundred million people globally every year. Early diagnosis and management can reduce the morbidity and mortality rates of severe forms of dengue disease as well as decrease the risk of wider outbreaks. Although early diagnosis of dengue can be achieved using a number of commercial NS1 detection kits, none of these can differentiate among the four dengue virus serotypes. In this study, we developed a Dengue-type NS1 ELISA by pairing a serotype-cross-reactive mAb with one of four serotype-specific mAbs in order to facilitate the rapid detection of NS1 antigens and the simultaneous differentiation of dengue serotypes. A total of 146 serum samples obtained from patients suspected to be in the acute phase of dengue infection were used to evaluate the clinical application of our novel test for the detection and serotyping of DENV. The overall sensitivity rate of our test was 84.85%, and the sensitivity rates for serotyping were as follows: DENV1 (88.2%, 15/17), DENV2 (94.7%, 18/19), DENV3 (75%, 12/16), and DENV4 (66.6%, 6/9). Moreover, there was no cross-reactivity among serotypes, and no cross-reactivity was observed in sera from non-dengue patients. Thus, our test not only enables the rapid detection of the dengue virus, but it can also distinguish among specific serotypes during the early stages of infection. These results indicate that our Dengue-type NS1 ELISA is a convenient tool that may help elucidate the epidemiology of dengue outbreaks and facilitate the clinical management of dengue infections.