LABORATORY DIAGNOSIS OF ACUTE DENGUE-FEVER DURING THE UNITED-NATIONS MISSION IN HAITI, 1995-1996

We evaluated laboratory methods to confirm a clinical diagnosis of den gue. Acute sera were collected from personnel (n = 414) supporting the United Nations Mission in Haiti and presenting with febrile illness c onsistent with dengue fever or no apparent underlying cause. Dengue vi rus was recovered from 161 of 379 acute sera by inoculation into C6/36 cell culture. While 93 of 414 acute sera had detectable IgM antibodie s, the IgM capture ELISA (MAC ELISA) had a sensitivity of only 13% com pared with the virus isolation gold standard. If presumptive dengue fe ver cases were identified by both virus isolation and the presence of IgM, virus isolation and the MAC ELISA had clinical sensitivities of 6 9% and 40%, respectively. This study suggests that a combination of la boratory methods that target virus or subviral components as well as a nti-viral IgM antibodies may be necessary for sensitive laboratory dia gnosis with acute sera.