Table 1.

Current laboratory techniques for the diagnosis of acute human flavivirus infections.

Methods	Advantages	Critical Evaluation
RT-PCR	Diagnosis is performed by detection of viral nucleic acids. Specificity and sensitivity. Rapidity. RT-PCR diagnosis test kits.	Positivity often limited to the acute stage of disease (2–7 days). Flavivirus infection can cause a weak or no viremia.
Virus isolation	Direct pathogen detection plays a key role in diagnosing flavivirus infection	Biosafety Laboratory considerations (BSL levels 2 to 4). Requirement of cultured cell lines for viral growth. Virus identification using specific detection tools. Time consuming.
Viral antigen capture	Diagnosis of acute dengue virus infection based on soluble NS1 capture. Rapid diagnosis test kits.	Only available for dengue. False-dengue positivity has been documented.
Serology	Diagnosis is performed by IgM and IgG capture or virus neutralization assays. Qualitative and quantitative serologic diagnosis tests. Licensed rapid serologic diagnosis test kits.	Specificity and sensitivity. Complexity of serological flavivirus diagnosis. False interpretation of dengue diagnostic serology tests during secondary dengue infection. Virus neutralization assays require BSL levels 2 to 4. Serological assays performed in BSL are time consuming. Detection of antibodies does not exclude convalescent patients who may develop other illnesses with similar symptoms