Abstract
Background: Dengue is a highly endemic infectious disease of tropical countries and is rapidly becoming a global burden. It is clinically similar to many other acute febrile illnesses, in which serological test plays an important role in early diagnosis and management. The spectrum of illness is broad and ranges in severity from mild symptoms to death. Changes in dengue epidemiology and increase in incidence rates (with and without co-morbidities) have lead WHO to propose a new dengue classification system according to disease severity.
Objective: The study was aimed at determining the seropositivity in clinically suspected dengue cases and also to study the clinical profile of dengue positive patients.
Materials and Methods: In this study, 2968 patients with Pyrexia of unknown origin (PUO) were included .Rapid Card test and Enzyme Linked Immunosorbent Assay (ELISA) were used for testing serum of patients.
Results: Of 2968, 521 were clinically suspected cases of dengue. 228 were confirmed to have dengue. Based on the 228 serological positive test, 126 (55%) were with dengue with warning signs followed by 74 (33%) dengue without warning signs and severe dengue 28 (12%)
Conclusion: Dengue fever continues to be a major public health problem. The study showed that 521 were clinically suspected cases of dengue and 228 were confirmed to have dengue. The study highlights that in most dengue endemic countries, access to diagnostic laboratories is limited and dengue diagnosis may rely solely on clinical recognition. Moreover, even where diagnostic laboratory services are available, virological tests are requested only upon a clinical suspicion of dengue, based on the presenting symptoms and signs.
Keywords: Dengue fever, new dengue classification, Pyrexia of unknown origin (PUO),Seropositivity.
References
- Christie J: Remarks on “Ki dinga Pepo”: A peculiar form of exanthematous disease. BMJ 1872; 577.
- Gubler DJ and Sather GE. Laboratory diagnosis of dengue and dengue hemorrhagic fever.In A.Homma and J.F.Cunha (ed.), Proceedings of the International Symposium on Yellow Fever and Dengue 1988; 291–
- Halstead S.B., Mosquito borne haemorrhagic fever of South and South East Asia. Bull World Health Organanization 1966; 35:3-15.
- Gubler DJ. “Dengue/dengue hemorrhagic fever: History and current status” Novartis Foundation Symposium,vol.277,pp.3-16,2006.
- WHO (2009). Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control.
- Young PR, Hilditch PA, Bletchly C & Halloran W. An antigen capture enzyme-linked immunosorbent assay reveals high levels of the dengue virus protein NS1 in the sera of infected patients. J Clin Microbiol 2000;38: 1053–
- Aikat A, Sarkar A, Tudu N, Moitra S,Pal PP, Sarkar TK. Diagnostic dilemma of dengue fever:how much reliability are there in rapidity. J of Indian Medical Assoc 2011; 109: 8.
- Dutta AK, Biswas A, Baruah K, Dhariwal AC. National guidelines for diagnosis and management of dengue fever/ dengue hemorrhagic fever and dengue shock syndrome.J.Indian Medical Assoc 2011; 109:No 1.
- Guy,M.Saville,andJ.Lang”Development of Sanofi Pasteur tetravent vaccine” Human Vaccines,vol.6,no.9,pp.696-705,2010.
- Padbidri VS, Adhikari P, Thakare J, Hegde MB , “The 1993 epidemic of dengue fever in Mangalore,Karnataka state,India”, South East Asian Journal of Tropical Med and Public Health 1995; 26(4): 699-704.
- Neeraja M, Lakshmi V, Teja VD, Umabala P, Subbalakshmi MV. Serodiagnosis of dengue virus infection in patients presenting to a tertiary care hospital. Indian Journal of Medical Microbiology 2006; 24(4): 280-2 .
- Richards A, Bagus R, Samuel M Basu et al, “The reported outbreak of dengue haemorrhagic fever in Irian Jaya, Indonesia”,Am J Trop Med Hyg 1997;57(1): 49-55.
- Sharma S, Sharma SK, Mohan 1998; A et al. Clinical profile of dengue hemorrhagic fever in adults during 1996 – Outbreak in Delhi, India. Dengue Bull 1998; 22: 20-7.
- Narayanan M, Arvind MA, Thilothammal N, Prema R, Rex CS et al. Dengue fever epidemic in Chennai-A study of clinical profile and outcome. Indian Pediatr 2002; 39: 1027-33.
- Jain PK, Sharma AK, Agarwal N, Siddiqui MK, Pawal P, Gaba R and Srivastava A prospective clinical study of incidence of hepatorenal and hematological complica-tions in dengue fever and management of symptomatic bleed in bundelkhand region of Northern India with fresh whole blood. Journal of Infectious Diseases and Immunity 2011; 3(7): 124-33.
- Low JGH, Ong A, Tan LK, Chaterji S, Chow A.The Early Clinical Features of Dengue in Adults: Challenges for Early Clinical Diagnosis. PLoS Negl Trop Dis 2011; 5(5): e1191.
- Chandrakanta RK, Garima JA, Jain A, Nagar R.Changing clinical manifestations of dengue infection in North India. Dengue Bulletin 2008; 32.
- Agarwal R, Kapoor S, Nagar R, Misra A, Tandon R, Mathur A, Misra AK, Srivastava KL, Chaturvedi UC: A clinical study of the patients with dengue hemorrhagic fever during the epidemic of 1996 at Lucknow, India. Southeast Asian J Trop Med Public Health 1999;30:735-40.
- Dengue and Dengue Hemorrhagic Fever in the Americas: Guidelines for Prevention and Control. (Pan American Health Organization, Washington, DC, USA 1994).
Corresponding Author
Shilpi Hora
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