Investigation in dengue
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Transcript of Investigation in dengue
LABORATORY INVESTIGATION
IN DENGUE INFECTION
Dr Lai Jun YuanPegawai Perubatan Jabatan Patologi
Hospital Batu Pahat
LABORATORY INVESTIGATION
DISEASE MONITORING TESTS DIAGNOSTIC TESTS
DISEASE MONITORING TESTS(WBC, HCT, PLATELETS COUNT, LFT)
DIAGNOSTIC TESTS
DIAGNOSTIC TESTSC1. DENGUE SEROLOGY TESTS
• Haemagglutination Inhibition Test• Dengue IgM Test• Indirect IgG ELISA Test• Dengue Rapid Tests
2. VIRUS ISOLATION3. POLYMERASE CHAIN REACTION (PCR)4. NON STRUCTURAL PROTEIN – 1 (NS1 Antigen)
• Gold Standard for serological diagnosis
• Labour intensive & requires paired samples for interpretation
• Differentiate between 1° & 2 ° dengue infection
• Used mainly for research purpose
HAEMAGGLUTINATION INHIBITION TESTS
• Widely used serological test.
• Significantly higher in primary infections
DENGUE IgM TEST
• Detected after 7 days of onset of fever.
• Recommended if dengue IgM is still negative after day 7 in secondary dengue.
INDIRECT IgG ELISA TEST
• Qualitative detection of dengue IgM & IgG
• Possible of False Positive
• Need to confirm by dengue IgM ELISA tests
DENGUE RAPID TESTS
VIRUS ISOLATION
• Most definitive test for dengue infection• Performed in Lab equipped with tissue & virus
isolation facilities• Time consuming (2 weeks)• Expensive
POLYMERASE CHAIN REACTION (PCR)• Diagnosis of dengue infection in the early phase
(< 5 days of illness)
POLYMERASE CHAIN REACTION (PCR)
NON STRUCTURAL PROTEIN – 1(NS1 Antigen)• This antigen is present in high concentrations in
the sera of dengue infected patients during the early phase of the disease
AVAILABLE DENGUE INVESTIGATION IN JABATAN PATOLOGI HSNI
Dengue Rapid Test Possible of false positive Confirmation with ELISA Please call the lab prior to sending any samples TAT – 1hour
Dengue IgM ELISA method Done in batches TAT – 2 to 3 days
Dengue IgG (Special request) ELISA method TAT – 2 to 3 days
NS1 Antigen Rapid NS1Please call the lab prior to sending any
samplesTAT – 1hour
• NS1 Antigen (ELISA method) ELISA method Done in batches (twice a week) TAT – 2 to 3 days
REQUEST FORM FOR DENGUE SEROLOGY
Please write down the type of Tests:1) Dengue IgM2) Dengue IgG3) Rapid IgM/IgG4) NS1 Antigen5) Rapid NS1
DENGUE SEROTYPE SURVEILLANCE
• For NS1 Antigen Test only
• The form must be completely filled
Patient details Date of onset Clinical Finding
LASTLY
Dengue investigation is very costlyPlease plan carefully before you send
any investigation for dengue Investigation must base on clinical
presentation of the patient
REFERENCES
• Clinical Practice Guildlines “Management of Dengue Infection in Adults” 2nd Edition by MOH