Differentiating Secondary Dengue Cases using Capture IgG and IgM-based Approaches

Dengue caused by the Dengue virus (DENV) is a vector-borne viral disease. It is a major public health issue in endemic regions such as India, where secondary infections pose a higher risk of severe illness due to antibody-dependent enhancement. Differentiating primary and secondary infections is cru...

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Main Authors: P.R. Asish, Gladys Rachel, V. Sindhuja, Josephine Pradhan, Sauvik Dasgupta, Girish Kumar Chethrapilly Purushothaman
Format: Article
Language:English
Published: Journal of Pure and Applied Microbiology 2025-06-01
Series:Journal of Pure and Applied Microbiology
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Online Access:https://microbiologyjournal.org/differentiating-secondary-dengue-cases-using-capture-igg-and-igm-based-approaches/
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author P.R. Asish
Gladys Rachel
V. Sindhuja
Josephine Pradhan
Sauvik Dasgupta
Girish Kumar Chethrapilly Purushothaman
author_facet P.R. Asish
Gladys Rachel
V. Sindhuja
Josephine Pradhan
Sauvik Dasgupta
Girish Kumar Chethrapilly Purushothaman
author_sort P.R. Asish
collection DOAJ
description Dengue caused by the Dengue virus (DENV) is a vector-borne viral disease. It is a major public health issue in endemic regions such as India, where secondary infections pose a higher risk of severe illness due to antibody-dependent enhancement. Differentiating primary and secondary infections is crucial for disease management and surveillance. The aim of this study was to estimate the proportion of primary and secondary infections among Dengue cases using Capture IgM and IgG ELISAs and assess the performance of various ratio- and index-based classification methods. Archived serum samples from 784 hospitalized acute-phase Dengue cases in Thiruvallur district, Tamil Nadu, were analyzed, with diagnosis confirmed by non-structural protein (NS1) and/or IgM ELISAs. Capture IgG Enzyme-Linked Immunosorbent Assay (ELISA) classified 46.6% as primary and 53.4% as secondary infections. The IgM/IgG ratio of 2.6 showed the highest concordance (88.6%) with Capture IgG ELISA, while the Receiver Operating Curve (ROC) analysis identified an optimal Optical Density (OD) ratio of 3.08, yielding a sensitivity of 94.3% and specificity of 89.8%. The findings underscore the substantial burden of secondary infections, highlighting the need for continuous surveillance and preventive strategies to mitigate severe outcomes. Capture IgG ELISA remains a robust tool for distinguishing secondary Dengue cases and the IgM/IgG OD ratio of 2.6 serves as a reliable diagnostic alternative with minimal misclassification. These results support the integration of ratio-based methods in Dengue diagnostics to enhance classification accuracy and inform targeted public health interventions.
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spelling doaj-art-a30bd8564df74639a31ddfed83f088692025-08-20T03:21:30ZengJournal of Pure and Applied MicrobiologyJournal of Pure and Applied Microbiology0973-75102581-690X2025-06-0119214011409https://doi.org/10.22207/JPAM.19.2.43Differentiating Secondary Dengue Cases using Capture IgG and IgM-based ApproachesP.R. Asishhttps://orcid.org/0009-0003-5507-4146Gladys Rachelhttps://orcid.org/0000-0002-4891-0391V. Sindhujahttps://orcid.org/0009-0005-2038-2928Josephine Pradhanhttps://orcid.org/0009-0004-7116-1140Sauvik Dasguptahttps://orcid.org/0000-0002-5760-9621Girish Kumar Chethrapilly Purushothamanhttps://orcid.org/0000-0002-5464-1028Dengue caused by the Dengue virus (DENV) is a vector-borne viral disease. It is a major public health issue in endemic regions such as India, where secondary infections pose a higher risk of severe illness due to antibody-dependent enhancement. Differentiating primary and secondary infections is crucial for disease management and surveillance. The aim of this study was to estimate the proportion of primary and secondary infections among Dengue cases using Capture IgM and IgG ELISAs and assess the performance of various ratio- and index-based classification methods. Archived serum samples from 784 hospitalized acute-phase Dengue cases in Thiruvallur district, Tamil Nadu, were analyzed, with diagnosis confirmed by non-structural protein (NS1) and/or IgM ELISAs. Capture IgG Enzyme-Linked Immunosorbent Assay (ELISA) classified 46.6% as primary and 53.4% as secondary infections. The IgM/IgG ratio of 2.6 showed the highest concordance (88.6%) with Capture IgG ELISA, while the Receiver Operating Curve (ROC) analysis identified an optimal Optical Density (OD) ratio of 3.08, yielding a sensitivity of 94.3% and specificity of 89.8%. The findings underscore the substantial burden of secondary infections, highlighting the need for continuous surveillance and preventive strategies to mitigate severe outcomes. Capture IgG ELISA remains a robust tool for distinguishing secondary Dengue cases and the IgM/IgG OD ratio of 2.6 serves as a reliable diagnostic alternative with minimal misclassification. These results support the integration of ratio-based methods in Dengue diagnostics to enhance classification accuracy and inform targeted public health interventions.https://microbiologyjournal.org/differentiating-secondary-dengue-cases-using-capture-igg-and-igm-based-approaches/primary denguesecondary dengueelisacapture igmcapture iggdiagnosis
spellingShingle P.R. Asish
Gladys Rachel
V. Sindhuja
Josephine Pradhan
Sauvik Dasgupta
Girish Kumar Chethrapilly Purushothaman
Differentiating Secondary Dengue Cases using Capture IgG and IgM-based Approaches
Journal of Pure and Applied Microbiology
primary dengue
secondary dengue
elisa
capture igm
capture igg
diagnosis
title Differentiating Secondary Dengue Cases using Capture IgG and IgM-based Approaches
title_full Differentiating Secondary Dengue Cases using Capture IgG and IgM-based Approaches
title_fullStr Differentiating Secondary Dengue Cases using Capture IgG and IgM-based Approaches
title_full_unstemmed Differentiating Secondary Dengue Cases using Capture IgG and IgM-based Approaches
title_short Differentiating Secondary Dengue Cases using Capture IgG and IgM-based Approaches
title_sort differentiating secondary dengue cases using capture igg and igm based approaches
topic primary dengue
secondary dengue
elisa
capture igm
capture igg
diagnosis
url https://microbiologyjournal.org/differentiating-secondary-dengue-cases-using-capture-igg-and-igm-based-approaches/
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AT vsindhuja differentiatingsecondarydenguecasesusingcaptureiggandigmbasedapproaches
AT josephinepradhan differentiatingsecondarydenguecasesusingcaptureiggandigmbasedapproaches
AT sauvikdasgupta differentiatingsecondarydenguecasesusingcaptureiggandigmbasedapproaches
AT girishkumarchethrapillypurushothaman differentiatingsecondarydenguecasesusingcaptureiggandigmbasedapproaches