investigation in dengue
TRANSCRIPT
![Page 1: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/1.jpg)
LABORATORY INVESTIGATION
IN DENGUE INFECTION
Dr Lai Jun YuanPegawai Perubatan Jabatan Patologi
Hospital Batu Pahat
![Page 2: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/2.jpg)
LABORATORY INVESTIGATION
DISEASE MONITORING TESTS DIAGNOSTIC TESTS
![Page 3: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/3.jpg)
DISEASE MONITORING TESTS(WBC, HCT, PLATELETS COUNT, LFT)
![Page 4: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/4.jpg)
DIAGNOSTIC TESTS
![Page 5: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/5.jpg)
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)
![Page 6: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/6.jpg)
• 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
![Page 7: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/7.jpg)
• Widely used serological test.
• Significantly higher in primary infections
DENGUE IgM TEST
![Page 8: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/8.jpg)
![Page 9: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/9.jpg)
• 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
![Page 10: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/10.jpg)
• Qualitative detection of dengue IgM & IgG
• Possible of False Positive
• Need to confirm by dengue IgM ELISA tests
DENGUE RAPID TESTS
![Page 11: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/11.jpg)
VIRUS ISOLATION
• Most definitive test for dengue infection• Performed in Lab equipped with tissue & virus
isolation facilities• Time consuming (2 weeks)• Expensive
![Page 12: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/12.jpg)
POLYMERASE CHAIN REACTION (PCR)• Diagnosis of dengue infection in the early phase
(< 5 days of illness)
![Page 13: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/13.jpg)
POLYMERASE CHAIN REACTION (PCR)
![Page 14: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/14.jpg)
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
![Page 15: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/15.jpg)
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
![Page 16: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/16.jpg)
Dengue IgM ELISA method Done in batches TAT – 2 to 3 days
![Page 17: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/17.jpg)
Dengue IgG (Special request) ELISA method TAT – 2 to 3 days
![Page 18: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/18.jpg)
NS1 Antigen Rapid NS1Please call the lab prior to sending any
samplesTAT – 1hour
![Page 19: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/19.jpg)
• NS1 Antigen (ELISA method) ELISA method Done in batches (twice a week) TAT – 2 to 3 days
![Page 20: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/20.jpg)
REQUEST FORM FOR DENGUE SEROLOGY
![Page 21: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/21.jpg)
Please write down the type of Tests:1) Dengue IgM2) Dengue IgG3) Rapid IgM/IgG4) NS1 Antigen5) Rapid NS1
![Page 22: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/22.jpg)
DENGUE SEROTYPE SURVEILLANCE
![Page 23: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/23.jpg)
• For NS1 Antigen Test only
• The form must be completely filled
Patient details Date of onset Clinical Finding
![Page 24: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/24.jpg)
LASTLY
Dengue investigation is very costlyPlease plan carefully before you send
any investigation for dengue Investigation must base on clinical
presentation of the patient
![Page 25: Investigation in dengue](https://reader035.vdocument.in/reader035/viewer/2022062513/55501fa4b4c90535638b5424/html5/thumbnails/25.jpg)
REFERENCES
• Clinical Practice Guildlines “Management of Dengue Infection in Adults” 2nd Edition by MOH