{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:54:16Z","timestamp":1790250856412,"version":"4.1.0"},"reference-count":39,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T00:00:00Z","timestamp":1577145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Dengue virus (DENV) and Zika virus (ZIKV) are flaviviruses of public health relevance. Both viruses circulate in the same endemic settings and acute infections generally manifest similar symptoms. This highlights the importance of accurate diagnosis for clinical management and outbreak control. One of the commonly used acute diagnostic markers for flaviviruses is nonstructural protein 1 (NS1). However, false positives due to antigenic cross-reactivity have been reported between DENV and ZIKV infections when using DENV NS1 antigen (NS1 Ag) detection assays in acute cases. Therefore, we investigated the lowest detectable virus titres and cross-reactivity of three commercial dengue NS1 Ag rapid assays and two ELISAs for different flaviviruses. Our results showed that substantially high viral titres of ZIKV, Kunjin virus (KUNV) and yellow fever virus (YFV) are required to give false-positive results when using DENV NS1 rapid detection assays. Commercial DENV NS1 ELISAs did not react with ZIKV and YFV. In comparison, tested assays detected DENV at a significantly low virus titre. Given the relatively low viral loads reported in clinical samples, our findings suggest that commercially available dengue NS1 Ag detection assays are less likely to generate false-positive results among clinical samples in areas where multiple flaviviruses cocirculate.<\/jats:p>","DOI":"10.3390\/diagnostics10010011","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T10:28:43Z","timestamp":1577183323000},"page":"11","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Flavivirus Cross-Reactivity to Dengue Nonstructural Protein 1 Antigen Detection Assays"],"prefix":"10.3390","volume":"10","author":[{"given":"Li Kiang","family":"Tan","sequence":"first","affiliation":[{"name":"Environmental Health Institute, National Environment Agency, Singapore 38667, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing Yan","family":"Wong","sequence":"additional","affiliation":[{"name":"Environmental Health Institute, National Environment Agency, Singapore 38667, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui Ting","family":"Yang","sequence":"additional","affiliation":[{"name":"Environmental Health Institute, National Environment Agency, Singapore 38667, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5093-5988","authenticated-orcid":false,"given":"Roland G.","family":"Huber","sequence":"additional","affiliation":[{"name":"Bioinformatics Institute, Agency for Science, Technology and Research, Singapore 138671, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Bond","sequence":"additional","affiliation":[{"name":"Bioinformatics Institute, Agency for Science, Technology and Research, Singapore 138671, Singapore"},{"name":"Department of Biological Sciences, National University of Singapore, Singapore 117558, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee Ching","family":"Ng","sequence":"additional","affiliation":[{"name":"Environmental Health Institute, National Environment Agency, Singapore 38667, Singapore"},{"name":"School of Biological Sciences, Nanyang Technological University, Singapore 639798, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0813-9640","authenticated-orcid":false,"given":"Sebastian","family":"Maurer-Stroh","sequence":"additional","affiliation":[{"name":"Bioinformatics Institute, Agency for Science, Technology and Research, Singapore 138671, Singapore"},{"name":"Department of Biological Sciences, National University of Singapore, Singapore 117558, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7079-8538","authenticated-orcid":false,"given":"Hapuarachchige Chanditha","family":"Hapuarachchi","sequence":"additional","affiliation":[{"name":"Environmental Health Institute, National Environment Agency, Singapore 38667, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S860","DOI":"10.1093\/infdis\/jix451","article-title":"History and Emergence of Zika Virus","volume":"216","author":"Gubler","year":"2017","journal-title":"J. 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