*2.4.1.11. Enzyme-linked immunosorbent assay (ELISA) for NS1*

The NS1 nonstructural protein is produced during dengue infection and accumulated in higher concentrations in the human serum (up to 50 μg/ml) being detected during the acute phase (day 0–6) after the symptoms in primary and secondary infection start. Some studies have reported a correlation between elevated NS1 protein levels with hemorrhagic dengue cases, and even this technique seems to be effective to detect DENV in the vector. When evaluating three of these commercial tests from different manufacturers with human serum samples, it is found sensitivity between 85.5 and 95.9% and specificity between 95.0 and 100% using the viral isolation as a reference test [28].
