Top 5 Takeaways

1. High Specificity: The study found that the specificity of DENV and SARS-CoV-2 enzyme-linked immunosorbent assays (ELISAs) was ≥98%, indicating minimal cross-reactivity.
2. Minimal Cross-Reactivity: Results showed minimal levels of cross-reactivity between DENV, Zika virus, and SARS-CoV-2 antibodies.
3. Diagnosis Integrity: Diagnoses of dengue or Zika virus diseases using the serological assays are not affected by COVID-19, nor do these diseases interfere with the diagnosis of COVID-19.
4. Study Scope: The study included serum specimens from 97 patients in Puerto Rico and 12 U.S.-based patients with confirmed COVID-19, as well as 122 specimens each from patients with confirmed dengue and Zika virus diseases.
5. Public Health Implication: Routine testing algorithms for dengue and Zika diseases can proceed without concerns of misdiagnosis due to COVID-19 antibodies.

Original Article Author and Citation

Corresponding Author

Jorge Munoz-Jordan, ckq2@cdc.gov

Suggested Citation

Munoz-Jordan J, Cardona J, Beltrán M, et al. Evaluation of Serologic Cross-Reactivity Between Dengue Virus and SARS-CoV-2 in Patients with Acute Febrile Illness — United States and Puerto Rico, April 2020–March 2021. MMWR Morb Mortal Wkly Rep 2022;71:375–377. DOI: http://dx.doi.org/10.15585/mmwr.mm7110a3

Summary

This study evaluated the potential serologic cross-reactivity between dengue virus (DENV) and SARS-CoV-2 in patients with acute febrile illness in Puerto Rico and the United States. The findings indicated that the specificity of DENV and SARS-CoV-2 enzyme-linked immunosorbent assays (ELISAs) was ≥98%, demonstrating minimal cross-reactivity. The study included serum specimens from patients with confirmed COVID-19, dengue, and Zika virus infections. The results suggest that diagnoses of dengue or Zika virus diseases using these serological assays are not affected by COVID-19, nor do these diseases interfere with the diagnosis of COVID-19.

Methods

The study tested serum specimens from 97 patients in Puerto Rico and 12 U.S.-based patients with confirmed COVID-19 using the DENV Detect IgM Capture ELISA. Additionally, 122 serum specimens from patients with confirmed dengue and 121 from patients with confirmed Zika virus disease were tested using the SARS-CoV-2 pan-Ig Spike Protein ELISA. The specificity and cross-reactivity of these tests were assessed.

Discussion

The results indicated high specificity and minimal cross-reactivity between DENV, Zika virus, and SARS-CoV-2 antibodies. The study’s findings are consistent with previous reports of high specificity for these ELISA tests. The study’s limitations include the use of specific tests at CDC laboratories and the focus on acute and early convalescent phases of disease.

Conclusion

The study concludes that serologic diagnosis of dengue or Zika virus diseases using the described assays is not affected by COVID-19 antibodies, nor do these diseases interfere with the diagnosis of COVID-19. Routine testing algorithms for dengue and Zika diseases can proceed without concerns of misdiagnosis due to COVID-19 antibodies.

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