Immunological Diagnosis of Dengue Fever with Antigen and Antibody Detection Methods

Abstract

Introduction: Dengue fever or infection is a potentially fatal infection that can occur in people of all age groups. Dengue virus is distributed worldwide and represents a serious public health problem; it affects over 100 million people worldwide, annually. Detection of Non-structural Protein 1 (NS1) antigen helps in diagnosing dengue infection in the early stages and helps in prevention of Dengue Shock Syndrome (DSS) and Dengue Haemorrhagic Fever (DHF). Aim: To identify the dengue specific antigen (NS1) and antibody (Immunoglobulin M (IgM) and Immunoglobulin G (IgG)) and correlate them with the platelet and White Blood Cell or Total Leukocyte Count (WBC or TLC) and also to assess the effectiveness of platelet transfusion in these patients. Materials and Methods: This was a prospective study done for two consecutive years involving only second half of the year 2018 and 2019 i.e., June-December 2018 and June-December 2019. Dengue infection or fever incidence is more during second half of the year during monsoon and winter seasons. A total of 587 samples were included in this study (positives) out of 4477 samples received for dengue testing. Statistical analysis was done with the help of SPSS version 14.0 software. A p-value <0.05 was taken as significant for interpretation. Results: A total of 587 cases were included in this study, males were 349 (59.45%) and females 238 (40.55%). Out of the 587 positive tests, NS1 antigen was positive in 473 cases, IgM was positive in 188 cases and IgG was positive in all active and recovered cases. Out of the 587 cases, only 423 cases (72%) showed thrombocytopenia during the first three days of the clinical symptoms or NS1 positivity, total 561 (95.6%) cases showed thrombocytopenia during the first five days of positivity or symptoms. Conclusion: Association of thrombocytopenia in dengue positive cases was highly significant. NS1 antigen detection is the only means of diagnosis of dengue infection in the first few days of fever, which helps in minimising the complications and early management of complications.

Keywords

• dengue haemorrhagic fever
• dengue shock syndrome
• thrombocytopenia