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For patients presenting acute febrile illness:

  • Obtain a travel history in all patients presenting with acute febrile illness.  

  • Consider dengue (and other arbovirus infections) in any patient with a history of international travel and an acute febrile illness and other symptoms compatible with dengue.

  • Consider dengue in a patient without travel history if presenting with an acute febrile illness and strongly suggestive symptoms including eye pain, muscle paint, joint pain, bone pain, macular or maculopapular rash, nausea, and vomiting.  

  • Obtain diagnostic tests in suspect cases. The appropriate tests depend on time since illness onset (see Laboratory Testing below). 


For patients presenting in the first seven days following illness onset, diagnostic testing should include both a nucleic acid amplification test (NAAT) such as real-time reverse transcription PCR (RT-PCR) and an IgM antibody test. Dengue virus antigen testing with nonstructural protein 1 (NS1 tests) can also be used to confirm infection.  

For patients presenting more than seven days after illness onset, only IgM testing is recommended. If in doubt about the timing of symptom onset, both NAAT and IgM should be ordered.    

IgG antibody tests are not useful for acute diagnosis because IgG remains detectable for life indicating long-term immunity. A limitation of serological tests is that they can cross react with other arboviruses.  

Laboratory testing is available at both commercial and public health laboratories, although some specialized laboratory tests are not widely available. Providers can contact the Long Beach Health Department for guidance on laboratory testing.  

For patients suspected to have dengue, it is important to rule out infections with other arboviruses, such as West Nile virus and Chikungunya virus.  

Where can I get additional information?

Dengue Information for Healthcare Providers (CDC)