Dengue Fever: At the hospital

Dear, Auntie:

I know that going to the hospital for your Dengue test can be very scary for two reasons: 1) You are unsure whether you have dengue or not, and 2) it is hard to tell what the doctors and nurses are looking for in your blood in order to diagnose you.

Unlike malaria, which is caused by a parasite that is visible in the blood cells under the microscope, dengue is caused by a virus which had to be detected by testing the blood or, more recently, saliva.

Since dengue infection can be very serious and life-threatening, it is important that the doctors can diagnose it early in order to begin treatment and offer better outcomes for the ill person. The World Health Organization has set a goal to reduce the number of dengue fever related deaths by 50% as early as 2020.

Recent research in Vietnam has focused on creating a faster and more sensitive tool for diagnosing Dengue Fever from small amounts of blood. Currently, a test that comprises antibody testing called an ELISA (similar to the test they use to screen for HIV in patients in Guyana) which tests the body's immune response after exposure to the dengue virus, realtime polymerase chain reaction (RT-PCR) testing used to detect specific genetic sequences of the dengue virus, and additional first-response antibody testing for something called IgM is used. I know this sounds complicated, Auntie. Essentially, when a person becomes infected with the dengue virus their body starts to build an army of soldiers called "antibodies" to fight off the infection. Unfortunately, the dengue virus is sneaky and smart and can spread faster that the body's army is able to destroy it which causes the illness [1].

Dengue infections can range in severity from mild to life threatening. Doctors use the following standards to classify dengue and how serious the infection is:

Figure 1. The criteria doctors use to diagnose dengue and how severe the infection is.[2]

The following video explains a test similar to the one described above (but using saliva) and how it may be used to diagnose Dengue more rapidly. That would be a great relief to Dengue Fever patients and their families. Early diagnosis and treatment will very likely reduce the number of deaths associated with this infection world wide.

References:
1. Nguyen MT, Ho TN, Nguyen VVC, et al. Sensitivity and Specificity of a Novel Classifier for Early Diagnosis of Dengue. PLOS. April 2, 2015. DOI: 10.1371/journal.pntd.0003638
2. Suggested Dengue Case Classification and Levels of Severity. Accessed from: http://new.medicine.com.my/2015/01/dengue-dont-just-blame-the-primary-care-doctors/