The results confirmed that IgM detection is a reliable serological diagnostic test in primary dengue virus infections.
Objectives: We have studied the sensitivity of IgM antibody detection in paired serum samples of 43 patients with either with primary dengue (PD) or secondary dengue (SD).
Results and conclusions: Specific IgM was detected in all the cases with primary dengue virus infection on disease day 9 or later.
Our studies suggest that the chemokine storm that follows severe primary dengue infection associates mostly to development of disease rather than protection against severe infection.
In conclusion, laboratories in endemic areas interested in distinguishing acute primary dengue infections from acute secondary infections can use the methodology we have described here.
Higher levels of IL-6 (p = 0.018) and IL-8 (p = 0.06) were observed in secondary cases compared to primary dengue cases.
These studies suggest that the chemokine storm that follows severe primary dengue infection associates mostly to development of disease rather than protection.
However, those hypothesis fail to explain the occurrence of DSS in patients having primary dengue infection and their relevance to the pathophysiology of DSS disease is discussed [8], [10].
Other studies have suggested the increased frequency of this allele in patients with primary dengue infection [19] and its probable association in the development of severe clinical disease [20].
The main caveat is that depending on how long the patient is sick before the first sample is collected, it may be possible to detect anti-dengue specific IgG at the time of the first medical visit in a primary dengue infection.
A primary dengue infection is defined as the absence of specific anti-dengue IgG antibodies in the first serum samples during the acute phase, with anti-dengue IgM, virus isolation and/or virus RNA being present, and dengue virus IgG being detected in a later sample.
