Dengue fever is a viral infection caused by the dengue virus, which is transmitted to humans primarily through the bite of infected female mosquitoes, particularly Aedes aegypti and Aedes albopictus. [1] These mosquitoes are commonly found in tropical and subtropical regions of the world, including parts of Southeast Asia, the Pacific Islands, the Caribbean, Central and South America, and some regions of Africa. According to the WHO (World Health Organization), more than 1 billion people are at risk of dengue infection in over 100 countries. [2]
Dengue virus is a member of the Flaviviridae family and is the causative agent of dengue fever. It is a single-stranded RNA virus that exists in four distinct serotypes: DEN-1, DEN-2, DEN-3, and DEN-4. Each serotype can cause dengue fever, which is a systemic febrile illness lasting 3–7 days, and infection with one serotype does not provide immunity against the others. [1]
After the virus enters the human body through a mosquito bite, it replicates and multiplies in various tissues, including lymph nodes, skin, liver, and blood. This replication process results in symptoms such as high fever, severe headaches, joint and muscle pain, and a characteristic skin rash. Symptoms of dengue fever can range from mild to severe and usually appear 4 to 10 days after being bitten by an infected mosquito. Dengue is not contagious from person to person except through blood transfer and organ donation. However, it can be passed from a pregnant person to their child. [3]
Subsequent infections with different serotypes can increase the risk of severe dengue (also known as dengue hemorrhagic fever or dengue shock syndrome).
Severe dengue, also known as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), is a potentially life-threatening complication of dengue fever. It occurs when the infection progresses to a more severe form, and the body’s response to the virus leads to severe bleeding, plasma leakage, and organ failure. Severe dengue is more common in individuals who have had a previous dengue infection with a different serotype of the virus.[4]
There is no specific treatment for dengue fever itself, but supportive care and rest are essential. Patients are advised to stay well-hydrated and take medications such as acetaminophen to relieve fever and pain. However, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen should be avoided, as they can increase the risk of bleeding.[3]
Preventing dengue fever primarily involves controlling mosquito populations and protecting oneself from mosquito bites. Measures such as using mosquito repellents, wearing protective clothing, and using mosquito nets can significantly reduce the risk of infection.
If you suspect you have dengue fever, seek medical attention promptly, especially if you develop severe symptoms or if you live in or have recently traveled to an area with known dengue transmission. Early detection and medical care can help prevent complications and improve outcomes.
How to Diagnose the Dengue Fever?
Diagnosing dengue fever involves a combination of clinical evaluation, symptom assessment, and laboratory tests. Since dengue fever shares symptoms with other viral infections, a proper diagnosis is essential for appropriate management. Healthcare professionals use the following methods to diagnose dengue fever:
Clinical Evaluation: The doctor will review your medical history and conduct a physical examination. They will ask about your symptoms, recent travel history (as dengue is common in specific regions), and potential exposure to mosquitoes.
Blood Tests:
- Dengue Virus Nucleic Acid Detection (PCR): This test detects the presence of the dengue virus’s genetic material (RNA) in the blood. It is most effective during the first few days of symptom onset.
- Rapid Test Kits (Dengue Serology Test): This test checks for dengue-specific antibodies (such as IgG, IgM) and antigens (such as NS1) in the blood, which the body produces in response to the infection. It can be used in the later stages of the disease when the virus may no longer be detectable in the blood by PCR. The serology test can differentiate between current and past dengue infections.
- Platelet Count: Dengue fever often causes a drop in platelet levels (thrombocytopenia). A simple blood test can check your platelet count, and low platelet levels may indicate dengue fever.
How to Use the Dengue Virus Rapid Test Kit?
Dengue Virus Rapid Test Kits are designed to detect the presence of specific dengue virus antibodies or antigens in a person’s blood. It can help distinguish between primary and secondary dengue infections, is simple, safe, and accurate, and results are available in minutes. Here is how to use a Dengue Virus Rapid Test Kit, step by step:
- Read the Instructions: Before starting the test, carefully read the instructions provided with the test kit. Pay attention to the expiration date, storage conditions, and any special considerations mentioned in the instructions.
- Gather Materials: Ensure you have all the necessary materials provided in the test kit. This usually includes the test device, a sample collection device (such as a lancet or dropper), a buffer solution, etc.
- Wash Hands: Thoroughly wash your hands with soap and water before handling the test kit to avoid contamination.
- Prepare the Sample: Follow the instructions to collect the sample (whole blood, serum, plasma) using the provided sample collection device.
Figure 2: Display of Sample Collection
- Apply Sample to the Test Device: Place the collected sample onto the designated area of the test device, as instructed in the kit. This could involve adding a few drops of blood, serum, or plasma to a specific well or area on the device.
- Add Buffer Solution (if required): Some test kits may require the addition of a buffer solution to the test device after the sample has been applied. The buffer helps the test to work properly and provides accurate results. Follow the instructions regarding the amount and method of adding the buffer.
Figure 3: Test Procedure Illustrations
- Wait for Results: Allow the test device to develop for the specified amount of time as indicated in the instructions. This typically ranges from a few minutes to around 15 minutes, depending on the test.
- Interpret Results: After the development time, check the test device for the appearance of lines, symbols, or color changes. The presence or absence of these indicators will determine the test result. Most rapid test kits have a control line that should always appear, indicating that the test is working correctly.
- Seek Professional Advice: If you get a positive result on the rapid test or have any concerns about the test results, it’s essential to consult a healthcare professional for confirmation and further evaluation. A positive rapid test result should be followed up with additional testing and medical assessment.
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REFERENCES
[1] Kularatne, S. A. M. (2015). Dengue fever. BMJ, h4661. doi:10.1136/bmj.h4661
[2] World Health Organization, Regional Office for South-East Asia. Comprehensive guidelines for prevention and control of dengue and dengue hemorrhagic fever—revised and expanded edition. 2011. www.searo.who.int/entity/vector_borne_tropical_diseases/ documents/SEAROTPS60/en/.
[3] Guzman MG, Kouri G. Dengue and dengue hemorrhagic fever in America: lessons and challenges. J Clin Virol 2007;27:1-13.
[4] Gubler, D. J. (1998). Dengue and Dengue Hemorrhagic Fever. Clinical Microbiology Reviews, 11(3), 480–496. doi:10.1128/cmr.11.3.480