To evaluate the accuracy of a common dengue virus serological assay and assess the impact of immunity to non-dengue flaviviruses on its performance, particularly in the context of rising flavivirus co-circulation.
Key Findings:
The dengue IgG ELISA had a specificity of 58%, significantly lower than previously reported values of 93%-100%, raising concerns for clinical interpretation.
46% of individuals with false-positive IgG results had detectable neutralizing antibodies against other flaviviruses, indicating cross-reactivity.
A higher IgG cut point improved the test accuracy in the studied population, suggesting a need for revised testing protocols.
Interpretation:
Immunity to non-dengue flaviviruses significantly impacts dengue surveillance, emphasizing the necessity for careful interpretation of serological results to guide public health decisions.
Limitations:
The study was limited to a specific geographic area, which may not represent broader populations, potentially affecting the applicability of results.
The reliance on a single serological assay may not capture the full spectrum of flavivirus immunity, necessitating further research.
Conclusion:
Accurate serological testing is critical for determining vaccine eligibility and understanding dengue immunity, especially in regions with multiple flavivirus exposures, to inform public health strategies.
by Camila D Odio, Christina Yek, Chloe M Hasund, Somnang Man, Piseth Ly, Sreynik Nhek, Sophana Chea, Chanthap Lon, Charlie Voirin, Rekol Huy, Rithea Leang, Chea Huch, Elaine W Lamirande, Stephen S Whitehead, Fabiano Oliveira, Jessica E Manning, Leah C Katzelnick
