<unk>  is most frequently a clinical diagnosis, based on symptomatology and travel history. Mild cases of the disease can only be confirmed virologically. Since mild cases of<unk>  can also contribute significantly to regional outbreaks, every suspected case of<unk>  (involving symptoms of fever, pain, nausea, and vomiting 6–10 days after leaving the affected area) is treated seriously. If<unk>  is suspected, the virus cannot be confirmed until 6–10 days following the illness. A direct confirmation can be obtained by reverse transcription polymerase chain reaction, where the genome of the virus is amplified. Another direct approach is the isolation of the virus and its growth in cell culture using blood plasma; this can take 1–4 weeks. Serologically, an enzyme-linked immunosorbent assay during the acute phase of the disease using specific IgM against<unk>  or an increase in specific IgG titer (compared to an earlier sample) can confirm<unk> . Together with clinical symptoms, the detection of IgM or a four-fold increase in IgG titer is considered sufficient indication for<unk> . As these tests can cross-react with other flaviviruses, such as dengue virus, these indirect methods cannot conclusively prove<unk>  infection. Liver biopsy can verify inflammation and necrosis of hepatocytes and detect viral antigens. Because of the bleeding tendency of<unk>  patients, a biopsy is only advisable post mortem to confirm the cause of death. In a differential diagnosis, infections with<unk>  must be distinguished from other feverish illnesses such as malaria. Other viral hemorrhagic fevers, such as Ebola virus, Lassa virus, Marburg virus, and Junin virus, must be excluded as the cause.
Yellow fever
Dengue fever
Tomato fever
Chikungunya
Ross River fever
Trench fever
Haverhill fever
Blackwater fever