Isolation of Dengue Viruses from Peripheral Blood Leukocytes of Patients with Hemorrhagic Fever

Abstract
Dengue viruses were isolated by a plaque technique in LLC-MK2 [rhesus monkey kidney] cells from washed peripheral blood leukocytes of patients with hemorrhagic fever. In comparison with plasma, the use of peripheral blood leukocytes permitted greater than 3 times the recovery rate of viruses, allowed for the isolation of strains of virus from patients with high serum levels of antibody to dengue virus and extended the period of detectable viremia. The use of peripheral blood leukocytes was especially useful for isolation of viruses from patients with hemorrhagic fever, in whom antibody titers were generally quite high during the acute phase of the disease. This method is recommended for use by laboratories with access to the appropriate acute-phase specimens. Of the peripheral blood leukocytes, adherent monocytes appeared most likely affected; involvement of atypical lymphocytes, which are commonly found in patients with hemorrhagic fever, or polymorphonuclear leukocytes could not be excluded. Only a small number of infected centers could be identified by infectious-center assays, but the marked augmentation of recovery of virus with the use of peripheral blood leukocytes indicated the presence in patients of a subpopulation of cells that permit dengue virus infection.