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Investigation in dengue

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  • Thank you .it's been very useful information.
    In your experience ;what is the probability of a false negative Ig M dengue test ?(primary infection)
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Investigation in dengue

  1. 1. LABORATORY INVESTIGATION IN DENGUE INFECTION Dr Lai Jun Yuan Pegawai Perubatan Jabatan Patologi Hospital Batu Pahat
  2. 2.  DISEASE MONITORING TESTS  DIAGNOSTIC TESTS
  3. 3. 1. DENGUE SEROLOGY TESTS • Haemagglutination Inhibition Test • Dengue IgM Test • Indirect IgG ELISA Test • Dengue Rapid Tests 2. VIRUS ISOLATION 3. POLYMERASE CHAIN REACTION (PCR) 4. NON STRUCTURAL PROTEIN – 1 (NS1 Antigen)
  4. 4. HAEMAGGLUTINATION INHIBITION TESTS • Gold Standard for serological diagnosis • Labour intensive & requires paired samples for interpretation • Differentiate between 1° & 2 ° dengue infection • Used mainly for research purpose
  5. 5. DENGUE IgM TEST • Widely used serological test. • Significantly higher in primary infections
  6. 6. INDIRECT IgG ELISA TEST • Detected after 7 days of onset of fever. • Recommended if dengue IgM is still negative after day 7 in secondary dengue.
  7. 7. DENGUE RAPID TESTS • Qualitative detection of dengue IgM & IgG • Possible of False Positive • Need to confirm by dengue IgM ELISA tests
  8. 8. VIRUS ISOLATION • Most definitive test for dengue infection • Performed in Lab equipped with tissue & virus isolation facilities • Time consuming (2 weeks) • Expensive
  9. 9. POLYMERASE CHAIN REACTION (PCR) • Diagnosis of dengue infection in the early phase (< 5 days of illness)
  10. 10. POLYMERASE CHAIN REACTION (PCR)
  11. 11. 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
  12. 12.  Dengue Rapid Test  Possible of false positive  Confirmation with ELISA  Please call the lab prior to sending any samples  TAT – 1hour
  13. 13.  Dengue IgM  ELISA method  Done in batches  TAT – 2 to 3 days
  14. 14.  Dengue IgG (Special request)  ELISA method  TAT – 2 to 3 days
  15. 15.  NS1 Antigen  Rapid NS1  Please call the lab prior to sending any samples  TAT – 1hour
  16. 16. • NS1 Antigen (ELISA method)  ELISA method  Done in batches (twice a week)  TAT – 2 to 3 days
  17. 17. Please write down the type of Tests: 1) Dengue IgM 2) Dengue IgG 3) Rapid IgM/IgG 4) NS1 Antigen 5) Rapid NS1
  18. 18. • For NS1 Antigen Test only • The form must be completely filled  Patient details  Date of onset  Clinical Finding
  19. 19. Dengue investigation is very costly Please plan carefully before you send any investigation for dengue Investigation must base on clinical presentation of the patient
  20. 20. • Clinical Practice Guildlines “Management of Dengue Infection in Adults” 2nd Edition by MOH

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