scholarly journals Presentation, Management and Outcome of Dengue Fever – A Study of 200 Cases

2013 ◽  
Vol 14 (1) ◽  
pp. 18-22
Author(s):  
Md. Habibur Raman ◽  
Abu Yousuf Md. Shahidul Alam ◽  
AKM Mijanur Rahman ◽  
Md. Sarwar Khan ◽  
Nahid Reaz Shapla ◽  
...  
Keyword(s):  
Platelet Count ◽  
Dengue Fever ◽  
Skin Rash ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Blood Platelet ◽  
Viral Disease ◽  
Female Ratio ◽  
General Weakness

Background: Dengue is the most rapidly spreading mosquito-borne viral disease in the world1. The rapidly expanding global footprint of dengue is a public health challenge. The endemicity of dengue is also increasing in Bangladesh. This study highlights our current understanding of dengue, including its clinical manifestations, laboratory tests, management and outcome. Objectives: This study was designed to document the presenting features and outcome of Dengue infection in Border Guard personnel. Materials and Methods: It was a prospective observational study which was carried out among outpatient and indoor cases from February 2011 to November 2012 in Border Guard Hospital, Dhaka which is a 300 bedded hospital. Total 200 cases were enrolled. A detailed history, clinical examinations and relevant investigations were done. Data were collected in a predesigned structured questionnaire and analyzed with the help of SPSS-16.0 and Chisquare (X2) Test. Results: A total of 200 adult seropositive Dengue cases of various grade were studied. Among these 152(76%) were male and 48 (24%) were female. Male to female ratio was 3.17:1.The age range of the patients was 18 to 60 years and the mean age 39±12.56 years. Among 200 patients, 112(66%) were Dengue Fever (DF) and 88(44%) were Dengue Haemorrhagic Fever (DHF) including 3(1.5%) cases of DHF Grade lII but none (0%) had Grade-IV DHF. All the patients presented with fever 200(100%), general weakness 200(100%) followed by various skin rash 196(98%), headache 192(96%), myalgia/arthralgia 191(95.5%), retroorbital pain 84(42%). Bleeding manifestation showed in 94(47%) cases of which petechiae was most frequent 86(43%), Haematocrit was normal only in 13(6.5%) patients and 82(41%) had a rise of >20%; Leucopenia was found in 187(93.5%) patients.Only 2(1%) patients had normal platelet count and 03(1.5%) patients had platelet count of less than 10X109 /L. Raised serum alanine aminotransferase (ALT) was observed in 184(92%) of cases. All (200%) the patients recovered completely from the disease; however, one patient subsequently developed Guillein Barre Syndrome. Conclusion: High persistent fever, profound general weakness, myalgia, headache and itchy skin rash were the usual presenting features. Most of the patients recovered well with efficient symptomatic and supportive treatment. Very few cases required blood/platelet transfusion. There was no case fatality in this study group DOI: http://dx.doi.org/10.3329/jom.v14i1.14531 J MEDICINE 2013; 14 : 18-22

scholarly journals Recombinant Multiepitope Protein for Early Detection of Dengue Infections

2006 ◽  
Vol 13 (1) ◽  
pp. 59-67 ◽  
Author(s):  
Ravulapalli AnandaRao ◽  
Sathyamangalam Swaminathan ◽  
Sirimali Fernando ◽  
Asha M. Jana ◽  
Navin Khanna
Keyword(s):  
Dengue Fever ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Laboratory Diagnosis ◽  
Viral Disease ◽  
M Protein ◽  
Enzyme Linked Immunosorbent Assay ◽  
Protein Fusion ◽  
Promising Alternative ◽  
Strip Test

ABSTRACT Dengue fever is a mosquito-borne viral disease prevalent mainly in tropical countries. As the clinical manifestations of dengue are not very unique, laboratory diagnosis is crucial in identifying cases of dengue infection. Detection of dengue infection based on the identification of antidengue antibodies has emerged as a practical and reliable means of diagnosing dengue fever. We recently developed a customized recombinant dengue multiepitope protein (r-DME-G) that can specifically detect the immunoglobulin G (IgG) class of antidengue antibodies in patient sera. Using this strategy, we have now created another dengue multiepitope protein, r-DME-M, with specificity for the IgM class of antidengue antibodies. A synthetic gene encoding the r-DME-M protein was expressed as a maltose-binding protein fusion in Escherichia coli. The recombinant protein was purified in a single affinity chromatographic step to obtain yields of ∼15 mg purified protein/liter of culture. The purified protein was used to develop an in-house IgM enzyme-linked immunosorbent assay (ELISA) and tested using a panel of 172 patient sera characterized using the commercially available Dengue Duo rapid strip test from PanBio, Australia. The IgM ELISA results showed that the r-DME-M protein not only recognized all IgM+ samples identified by the PanBio test but also identified samples missed by the latter test. We also successfully adapted the r-DME-M protein to a rapid strip test format. This approach of creating customized antigens coupled to overexpression in E. coli and simple purification offers a promising alternative option to dengue diagnosis with the potential to circumvent the drawbacks of the whole virus antigen-based commercial kits.

scholarly journals The changing clinico-demographic profile of dengue infection in children: a hospital-based study from eastern India

2020 ◽  
Vol 7 (5) ◽  
pp. 1901
Author(s):  
Radheshyam Purkait ◽  
Rajarshi Basu
Keyword(s):  
Dengue Fever ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Severe Dengue ◽  
Eastern India ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Study Population

Background: Many parts of India, including the eastern regions, are now endemic for the dengue infection with increased recognition of atypical neurological manifestations apart from the classical clinical features.Methods: This prospective study was conducted in the department of paediatrics in a tertiary care teaching hospital in eastern India from July 2019 to November 2019 to determine the changing trends of the clinical features in the dengue patients of this region in the recent years among paediatric populations. All the serologically confirmed dengue patients admitted during this period satisfying the inclusion criteria were enrolled in the study population and classified as per new WHO-2009 classification into: dengue fever without warning signs (DF), dengue fever with warning signs (DFWS) and severe dengue (SD). Detailed history, clinical and laboratory parameters were recorded and analysed for all children.Results: Out of the total of 110 cases, 16 cases (14.55%) were DF, 80 cases (72.73%) were DFWS and 14 cases (12.73%) were SD. The commonest age group affected (63.64 %) was between 4-<10 years. The male: female ratio of cases was 1.68:1. Besides classical clinical manifestations, we observed CNS involvement in nine cases (8.18%). Among them, five patients had dengue encephalitis, two patients had dengue encephalopathy, one patient had hypokalemic paralysis and one patient had Guillain-Barré syndrome. All the patients were treated as per standard guidelines.Conclusions: Clinician must be aware of such association during dengue outbreak because early diagnosis and appropriate supportive care can reverse this potentially fatal disease.

scholarly journals Clinical profile and laboratory characteristics of dengue fever in children: analysis of 2019 outbreak from Bengaluru, Karnataka, India

2020 ◽  
Vol 7 (8) ◽  
pp. 1670
Author(s):  
Poornima Shankar ◽  
Shajna Mahamud
Keyword(s):  
Platelet Count ◽  
Abdominal Pain ◽  
Dengue Fever ◽  
Case Fatality ◽  
Warning Signs ◽  
Severe Dengue ◽  
P Value ◽  
High Morbidity ◽  
High Grade Fever ◽  
Female Ratio

Background: Dengue, an endemic disease in most subtropical and tropical regions of the world is causing severe epidemics in India. An alarming rise of dengue has also been seen in India during the recent years. Majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality. Present study was undertaken with an objective of describing various clinical presentations as noted in our cohort of dengue patients and to evaluate the outcome of dengue fever.Methods: This retrospective study included all confirmed dengue cases below 18 years age admitted to Paediatric department of KIMS, Bengaluru over a period of 1 year in 2019. Medical records were reviewed and analysed. Those diagnosed to be positive for dengue serology (NS1 or IgM) were included in our study. Dengue was classified according to the WHO guidelines into 2 groups, Dengue fever (without/with warning signs) and Severe Dengue. Clinical features, haematological, biochemical, radiological parameters, management and the outcome were assessed.Results: Out of 441 patients enrolled, 79% had non-severe dengue and 21% severe dengue. The commonest age of presentation was above 10 years with mean age of 8.68±5.25 years. Male to female ratio was 1.7:1. 60% presented within 4 to 7 days of illness (mean 4.26±1.72 days). Majority presented with fever (88%). 47% had vomiting and 31% abdominal pain. Bleeding manifestations were seen in 18%. Dengue serology was positive for NS1Ag (58%), IgM (21%), mixed (21%). Thrombocytopenia and leukopenia seen in 82% and 39.45% respectively. The association between dengue serology and platelet count was statistically significant (p value 0.001). 46% had raised SGPT. 31% had evidence of plasma leakage. The case fatality rate was 0.2%.Conclusions: High grade fever, vomiting, abdominal pain and bleeding manifestations with normal or low platelet count were the presenting features. Early diagnosis, monitoring and prompt supportive management can reduce mortality.

scholarly journals Dengue Fever and its Dermatological Changes

2020 ◽  
Vol 3 (1) ◽  
pp. 11-14
Author(s):  
Mohan Kumar R ◽  
Muddu Surendra Nehru
Keyword(s):  
Dengue Fever ◽  
Clinical Features ◽  
Skin Rash ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
General Medicine ◽  
Febrile Illness ◽  
Medical Sciences ◽  
Trial Analysis ◽  
Common Causes

Background: Around the world dengue incidence has dramatically grown with a large number of asymptomatic cases. Worldwide about 390 million dengue infections were occurring per year, among them 96 million people were developing clinical manifestations with varied severity. About 3.9 billion people residing in 128 countries, were at-risk of dengue virus infection. Dengue fever (DF) is one of the common causes of acute febrile illness. In half the patients with dengue fever skin involvement occurs. Aim & Objectives: To study the socio-demographic parameters, clinical features and laboratory parameters among the patients with and without skin rash in dengue infection. Also determine outcome among the patients with dengue fever and its association with skin rash. Subjects and Methods: A hospital-based, analytical prospective study was conducted in the Department of General Medicine, Sapthagiri Institute of Medical Sciences and Research Center, Bangalore. Patients older than 16 years of age with clinical features and laboratory reports suggestive of dengue infection were included. The study was conducted for a period of 12 months from 1st December 2014 to 30th November 2015. These patients were further divided based on the skin rash presence and absence. The data obtained was entered in Microsoft Excel and analyzed in SPSS version-22 trial. Analysis was done using unpaired students t-test, ANOVA. Results: In total 97 patients with dengue fever were enrolled into the study. About 14.4 p.c (14) patients were with skin rash. The patients with skin rash were found to have lower platelet levels during the disease course. Patients with skin rash had higher percentage of platelet transfusion which was statistically significant. Conclusion: A cutaneous involvement may facilitate clinical diagnosis but it may not be present among all the patients.

scholarly journals A study on the outbreak of dengue fever in a tertiary care children’s hospital in southern Tamil Nadu, India

2019 ◽  
Vol 6 (3) ◽  
pp. 1194
Author(s):  
Belgin Premkumar ◽  
Baburaj S. ◽  
Margaret Hepzibah N. ◽  
Misha K. P. ◽  
Binu Abraham
Keyword(s):  
Dengue Fever ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Case Fatality ◽  
Dengue Shock Syndrome ◽  
Viral Disease ◽  
Severe Dengue ◽  
Care Hospital ◽  
Clinical Criteria ◽  
Public Health Challenge

Background: Dengue fever is the most rapidly spreading mosquito-borne viral disease in the world.Incidence has increased 230-fold with increasing geographic expansion with potential for further spread. The rapidly expanding global footprint of dengue is a public health challenge with an economic burden. This study’s objective is to assess the outbreak of epidemic of dengue fever in a tertiary care children hospital and to describe their socio-demographic, clinical outcome and serological profile.Methods: It is an observational descriptive study conducted for a period of 1 year in less than 12 years old children in a tertiary care hospital at Southern Tamil Nadu.Results: Among the 360 children admitted with dengue fever, there were 198 boys (55%) and 162 (45%) were girls. Maximum incidence of dengue incidence was seen in infants less than 1 year (25%). The highest number of cases were admitted during September and October. The most common affected age group was less than 3 years with 179 (49%). Among the cases, 297 (82%) were of severe dengue which constitute dengue haemorrhagic fever-183(38%) and Dengue shock syndrome 114 (62%). Serological analysis showed NS1 Ag was positive in 144 children (40%), Dengue IgM was positive in 54 children (15%), both IgM and IgG positive in 126 children (35%) and IgG was positive in 36 children (10%). Out of the total children admitted with dengue fever, the case fatality was 0.5% (2 children).Conclusions: This study highlights the importance of WHO clinical criteria for early diagnosis of severe dengue. Moreover, the early and intensive management reduces the mortality significantly.

scholarly journals Dengue Fever : Study of 100 Cases in a Tertiary Care Hospital in Dhaka City

2015 ◽  
Vol 24 (Number 1) ◽  
pp. 3-7
Author(s):  
A H M Karnal ◽  
K H Mollah ◽  
A Begum ◽  
K Khoda ◽  
S Tanzeem ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Viral Disease ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Male To Female ◽  
Body Ache

Dengue is a rapidly spreading mosquito-borne viral disease worldwide. The endemicity in Bangladesh is also increasing gradually. The study was a prospective observational one, documented the presenting features and outcome of management. It was carried out in Department of Medicine in Holy Family Red Crescent Medical College Hospital, Dhaka from June 2013 to December 2013. Total 100 admitted cases of both sera positive and sera-negative were included in this study. Detailed history was taken, clinical examination and relevant investigations were done. Out of 100 patients 54 (54%) were male and 46 (46%) were female. So male to female ratio was 1.7:1. The age of the patients ranged from 12-75 years. Among them 20-40 years age group was highest 63%. Patients of higher socio-economic group were (69%) more affected. Out of 100 cases 54 had classical dengue fever (DF), 46 had dengue hemorrhagic fever (DHF). Antibody was positive in 81% cases. All patients presented with high fever, headache in 90%, retro-orbital pain in 45%, body ache in 56%, and backache in 48%. Leucopenia found in 60, platelet count <100x1091L was in 57, HCT- normal 17, <20% rise in 48%, ?20% rise in 28%. With proper management all patients were recovered.

scholarly journals Epidemiological and Clinical Features of Dengue Infection in Adults in the 2017 Outbreak in Vietnam

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bui Vu Huy ◽  
Le Nguyen Minh Hoa ◽  
Dang Thi Thuy ◽  
Nguyen Van Kinh ◽  
Ta Thi Dieu Ngan ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Dengue Fever ◽  
Clinical Features ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Severe Dengue ◽  
Severe Bleeding ◽  
Cross Sectional ◽  
Number Of Patients

Purpose. The clinical features and laboratory results of dengue-infected adult patients admitted to the hospital during the 2017 outbreak were analyzed in this study. Method. This is a cross-sectional study. 2922 patients aged 18 years or more with dengue fever in National Hospital for Tropical Diseases (NHTD) in the North and Hospital for Tropical Disease (HTD) in the South of Vietnam were recruited in this study. Result. Patients were admitted in the hospital around the year and concentrated from August to December, in 53/63 (84.0%) provinces in Vietnam, and patients in all ages were affected. The number of patients with dengue fever was 1675 (57.3%), dengue with warning signs 914 (31.3%), and severe dengue 333 (11.4%), respectively. Among patients with severe dengue, severe plasma leakage and dengue shock account for 238 (8.1%), severe organ impairment 73 (2.5%), and severe bleeding 22 (0.75%). The rate of mortality was 0.8%, and the outcome of dengue patients is worse in the elderly and people with underlying diseases. Conclusion. The 2017 dengue outbreak occurred in a larger scale than in the previous years in terms of time, location, and number of patients. More elderly patients were infected by dengue in this outbreak, and this may contribute to the mortality rate. Clinical manifestations of dengue patients in Southern Vietnam are more typical than the northern, but the rate of severe dengue is not different. The mortality risk and underlying conditions associated with dengue-infected elderly patients are worthy of further investigations in the future.

scholarly journals Clinical and laboratory profile of dengue fever: a retrospective study

2019 ◽  
Vol 6 (4) ◽  
pp. 1254
Author(s):  
Sachin N. Solanke ◽  
Abhay S. Pohekar ◽  
Jayshree A. Pohekar
Keyword(s):  
Platelet Count ◽  
Abdominal Pain ◽  
Dengue Fever ◽  
Dengue Infection ◽  
Recent Decade ◽  
High Morbidity ◽  
Normal Platelet ◽  
Bone Marrow Diseases ◽  
Number Of Patients ◽  
Low Platelet Count

Background: The global incidence of dengue has grown dramatically in recent decade. Half of world’s population is now at risk. India represents significantly a larger burden, accounting for nearly 34% of the global burden of dengue infection. Dengue infection needs to be addressed as a single disease with different clinical presentations ranging from asymptomatic conditions to severe clinical courses that may lead to high morbidity and mortality.Method: This was retrospective observational study carried out during period of July 2017 to April 2018, to study clinical profile and laboratory parameters in dengue fever patients. Confirmed dengue cases having NS1 positive or IgM positive or having both NS1 and IgM positive or dengue ELISA reactive, having minimum one CBC reports done and not having other confounding factor such as co-infection, bone marrow diseases etc. that may altered clinical and laboratory results are included in study. Statistical analysis was done by SPSS software version 18.0.Results: Out of 48 confirmed dengue cases maximum patients 58.33% was from young age group (21 to 40 years) with M:F ratio was 2.43:1. Fever was found in 100% patients, in order of frequency followed by headache, bodyache, abdominal pain, weakness, retro-orbital pain, anorexia, dry cough, back pain, nausea, diarrhoea, vomiting, rash, joint pain, itching and malena.NS1was positive in 41.67% cases, dengue ELISA in 31.25%, IgM was positive in 20.83% cases, and both NS1 and IgM positive were in 4.17% cases. TLC count was low 35.42%, high in 12.50% of cases and remaining had normal TLC count. Platelet count was ranged between normal platelet counts to thrombocytopenia. One case had platelet count less than 20000. Out of 48 patients, 2 (4.17%) had malena.Conclusion: In this study, fever was found in all patients, and headache, body ache and weakness were common symptoms, but significant number of patients also had gastroentstinal and respiratory symptoms like abdominal pain, nausea, diarrhea, vomiting and dry cough. TLC count ranging from normal TLC, leukopenia to leucocytosis. Large number of patients had low platelet count that shows dengue fever had varied clinical presentation. 

scholarly journals The seasonal reproduction number of dengue fever impacts of climate on transmission

2016 ◽  
Author(s):  
Sittisede Polwiang
Keyword(s):  
Low Temperature ◽  
Dengue Fever ◽  
Rainy Season ◽  
Reproduction Number ◽  
Dengue Infection ◽  
Viral Disease ◽  
Seasonal Reproduction ◽  
Epidemic Period ◽  
Very High ◽  
Very Low Temperature

Background: The dengue fever is a mosquito-borne viral disease and a regular epidemic in Thailand. The peak of the dengue epidemic period is around June to August during the rainy season. It is believed that the climate is an important factor for dengue transmission.Method: A mathematical model for vector-host infectious disease was used to calculate the impacts of climate to the transmission of dengue virus. In this study, the data of climate and dengue fever cases were derived from Chiang Mai during 2008-2015, Thailand. The value of seasonal reproduction number was calculated to evaluate the potential, severity and persistence of dengue infection.Results: The mosquito population was increasing exponentially from the start of the rainy season in early May and reached its the peak in late June. The simulations suggest that the greatest potential for the dengue transmission occurs when the temperature is 28.9ºC. The seasonal reproduction numbers were larger than one from late March to end of August and reaching the peak in June. The highest incidences occurred in August due to the delay of transmission humans-mosquito-humans. Increasing mean temperature by 1.2ºC, the number of incidences increases 43.7%. However, a very high or very low temperature reduces the number of infection.Discussion and Conclusion: The results show that the dengue infection depends on the seasonal variation of the climate. The rainfall provides places for the mosquitoes to lay eggs and develop to adult stage. The temperature plays an important role in the life cycle and behavior of the mosquitoes. A very high or very low temperature reduces the risk of the dengue infection.

scholarly journals Clinical Manifestations of Nipah Virus–Infected Patients Who Presented to the Emergency Department During an Outbreak in Kerala State in India, May 2018

2019 ◽  
Vol 71 (1) ◽  
pp. 152-157 ◽  
Author(s):  
Radhakrishnan Chandni ◽  
T P Renjith ◽  
Arshad Fazal ◽  
Noufel Yoosef ◽  
C Ashhar ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Nipah Virus ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Molecular Testing ◽  
X Rays ◽  
Female Ratio ◽  
The Difference ◽  
The Government ◽  
Kerala State

Abstract Background An outbreak of Nipah virus (NiV) disease occurred in the Kozhikode district of Kerala State in India in May 2018. Several cases were treated at the emergency medicine department (ED) of the Government Medical College, Kozhikode (GMCK). The clinical manifestations and outcome of these cases are described. Methods The study included 12 cases treated in the ED of GMCK. Detailed clinical examination, laboratory investigations, and molecular testing for etiological diagnosis were performed. Results The median age of the patients was 30 years and the male to female ratio was 1.4:1.0. All the cases except the index case contracted the infection from hospitals. The median incubation period was 10 days, and the case fatality ratio was 83.3%. Ten (83.3%) patients had encephalitis and 9 out of 11 patients whose chest X-rays were obtained had bilateral infiltrates. Three patients had bradycardia and intractable hypotension requiring inotropes. Encephalitis, acute respiratory distress syndrome, and myocarditis were the clinical prototypes, but there were large overlaps between these. Ribavirin therapy was given to a subset of the patients. Although there was a 20% reduction in NiV encephalitis cases treated with the drug, the difference was not statistically significant. The outbreak ended soon after the introduction of total isolation of patients and barrier nursing. Conclusion The outbreak of NiV disease in Kozhikode in May 2018 presented as encephalitis, acute respiratory distress and myocarditis or combinations of these. The CFR was high. Ribavirin therapy was tried but no evidence for its benefit could be obtained.

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