DENGUE FEVER OUTBREAK IN TWIN CITIES; A TERTIARY CARE CENTER EXPERIENCE

Objective: To characterize the clinical presentations and laboratory markers (as disease predictors and markers) and severity of disease in patients admitted with dengue fever. Study Design: Prospective observational study. Place and Duration of Study: Department of Infectious Diseases, Pak Emirates Military Hospital Rawalpindi, from May to Oct 2018 Methodology: In our study, we included the patients treated for dengue fever. Data were recorded on predesigned proforma and analyzed using Microsoft excel 365 and Social Package for Statistical Sciences version 23. Results: A total of 160 patients were included in this study, all were males. All cases were positive for Nonstructural Protein 1 Antigen. Symptoms seen in abundance were fever with rigors, chills, backache, retro-orbital pain, nausea and vomiting. Manual platelet count at admission ranged from 15-396 x 103 (mean 107.5 ± 6.8 x 103). Platelet count on discharge ranged from 102-577 x 103 (mean 207.9 ± 95.4 x 103). A total of 34 (21.25%) patients out of 160 confirmed and admitted dengue fever cases had Dengue Hemorrhagic Fever (Nonstructural Protein 1 Antigen positive, thrombocytopenia and leukopenia) and 2 patient went into dengue shock syndrome. The derangement in alanine aminotransferase and alkaline phosphatase levels were shown in 98 (61.2%) and 62 (31.2%) of patients. All these patients were immunoglobulin M and Nonstructural Protein 1Antigen positive. Conclusion: Raised serum alanine aminotransferase and alkaline phosphatase levels along with early positive Nonstructural Protein 1 Antigen is a marker of disease severity.

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Clinical and Laboratory Profile of Children with Dengue Fever and Predictors of Severe Dengue

International Journal of Research and Review ◽

10.52403/ijrr.20210801 ◽

2021 ◽

Vol 8 (8) ◽

pp. 1-7

Author(s):

Sahana M ◽

Devakumar VK ◽

Santhosh Kumar A

Keyword(s):

Platelet Count ◽

Dengue Fever ◽

Urine Output ◽

Care Center ◽

Univariate Analysis ◽

Tertiary Care ◽

Age Distribution ◽

Sampling Procedure ◽

Severe Dengue ◽

Laboratory Profile

Objectives: To study the Clinical and Laboratory profile of children upto 12 years of age with Dengue fever and to study the predictors of Severe Dengue among these children. Methods: Design: Descriptive study over 1 year 9 months. Setting: SAT hospital, Thiruvananthapuram, a tertiary care center. Study Population: 204 children aged 1month to 12 years admitted with serologically confirmed dengue fever without any co-infections; consecutive sampling. Procedure: Relevant history, detailed physical examination and investigations were noted. Patients were classified for their severity based on DENGUE guidelines-WHO 2009. Children were followed up till discharge during hospital stay. Categorical values were expressed as proportions and quantitative variables in mean and standard deviation. Association between various study variables and severe dengue were statistically analysed. Results: Mild dengue was seen in 96 children(47.1%), moderate dengue in 78 children(38.2%) and severe dengue in 30 children(14.7%). Mean age of presentation was 6.4 years. Age distribution- infants were 4.4%, 38.7% were between 1 year and 5 years; 56.9% were between 6 and 12 years.51% of children were males. Common clinical presentation was fever (100%), vomiting(46.6%), abdominal pain(32.4%), lethargy(24.5%), myalgia(22%), headache(16.7%) and reduced appetite(15.7%). Mean fever duration was 5 days. Hypotension was noted in 13.2%, Tender hepatomegaly in 44%, signs of plasma leakage in 6%, hypoalbuminemia in 7.8%. Total number of death was 2(1%). Variables with significant association with severe dengue on univariate analysis were Lethargy (p-<0.001, OR- 11.6), reduced appetite (p- <0.001,OR- 17.14), mucosal bleed (p<0.001, OR- 15.45), Fever spike >39◦C (p- 0.001, OR- 4.3), tender hepatomegaly (p- 0.001, OR- 4.2), decreased urine output (p <0.001, OR- 23.04), hypoalbuminemia (p <0.001, OR-43.5), platelet count below 80,000 (p <0.001, OR-4.43), SGOT above 85 (p <0.001, OR-4.9). According to the maximum area under ROC curve, a cutoff of platelet count 80,000 had 75% sensitivity and 60% specificity for predicting severe dengue. Conclusion: Proportion of children developed severe dengue was 14.7%. Independent predictors of severe dengue after multiple logistic regression were Lethargy, Reduced appetite, Reduced urine output and Hypoalbuminemia. Keywords: severe dengue; urine output; shock; hypoalbuminemia.

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Dengue Fever: Clinical, Laboratory Profile and Outcome in Pediatric Patient

International Journal of Medical Science and Diagnosis Research ◽

10.32553/ijmsdr.v6i1.892 ◽

2022 ◽

Vol 6 (1) ◽

Author(s):

Pooja Gandhi ◽

Pinkal Taral ◽

Krunal Patel ◽

Sanketsinh Rathod ◽

Bhavini Rathwa

Keyword(s):

Platelet Count ◽

Dengue Virus ◽

Dengue Fever ◽

Care Center ◽

Dengue Infection ◽

Tertiary Care ◽

Clinical Profile ◽

Severe Dengue ◽

Diverse Range ◽

Laboratory Profile

Introduction: Infection with any of the 4 dengue virus serotypes results in a diverse range of symptoms, from mild undifferentiated fever to life-threatening hemorrhagic fever and shock. Given that dengue virus infection elicits such a broad range of clinical symptoms, early and accurate laboratory diagnosis is essential for appropriate patient management. So a study was carried out to know its clinical profile, correlation between the laboratory profile and the severity of dengue fever and outcome in dengue patients. Aim: To study the clinical profile, correlation between the laboratory profile and the severity of dengue fever and outcome in dengue patients at tertiary care center. Method: Retrospective Observational study from 1st May 2019 to 31st April 2021. Result: Total 323 patients were studied during 1st May 2019 to 31st April 2021. Most common presentation was fever (100%), most common clinical finding is hepatomegaly (14.2%). All severe dengue infection has platelet count < 50000/cumm. In study of 323 patients 194(60%) of dengue fever,85(26.4%) of DHF GRADE 1,9(2.8%) of DHF GRADE 2 were discharged .13(4%) patients of DSS were expired.22 patients (6.8%) went DAMA. Conclusion: Reliable diagnosis of dengue fever in endemic areas can be done by clinical parameters like presence of nausea, vomiting, pain abdomen and hepatomegaly. Monitoring platelet count, hematocrit and WBC count is very useful for management of dengue cases. Keywords: dengue fever, platelet count, outcome

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Detection of Dengue Fever Nonstructural Protein 1 Antigen by Proteolytic Peptide Imprinting Technology and UHPLC–MS/MS

Analytical Chemistry ◽

10.1021/acs.analchem.1c01983 ◽

2021 ◽

Author(s):

Jinyi Wu ◽

Shuyi Huang ◽

Lei Tan ◽

Yuling Li ◽

Xiaotong Wu ◽

...

Keyword(s):

Dengue Fever ◽

Nonstructural Protein ◽

Nonstructural Protein 1

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Dengue fever. Clinical features of 567 consecutive patients admitted to a tertiary care center in Saudi Arabia

Saudi Medical Journal ◽

10.15537/smj.2017.10.20965 ◽

2017 ◽

Vol 38 (10) ◽

pp. 1025-1033 ◽

Cited By ~ 5

Author(s):

Samar Badreddine ◽

Fahmi Al-Dhaheri ◽

Ammar Al-Dabbagh ◽

Abdulrahman Al-Amoudi ◽

Maged Al-Ammari ◽

...

Keyword(s):

Saudi Arabia ◽

Dengue Fever ◽

Clinical Features ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center

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Rhabdomyolysis and Dengue Fever: A Case Report and Literature Review

Case Reports in Medicine ◽

10.1155/2013/101058 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 6

Author(s):

Tanya Sargeant ◽

Tricia Harris ◽

Rohan Wilks ◽

Sydney Barned ◽

Karen Galloway-Blake ◽

...

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Dengue Fever ◽

Private Hospital ◽

Nonstructural Protein ◽

Febrile Illness ◽

University Hospital ◽

Close Monitoring ◽

Nonstructural Protein 1 ◽

The University

The medical literature contains only a few reports of rhabdomyolysis occurring in patients with dengue fever. We report the case of a 25-year-old Jamaican man who was admitted to a private hospital four days after the onset of an acute febrile illness with fever, myalgia, and generalized weakness. Dengue fever was confirmed with a positive test for the dengue antigen, nonstructural protein 1. He remained well and was discharged on day 6 of his illness. On day 8, he started to pass red urine and was subsequently admitted to the University Hospital of the West Indies. On admission he was found to have myoglobinuria and an elevated creatine phosphokinase (CPK) of 325,600 U/L, leading to a diagnosis of rhabdomyolysis. Dengue IgM was positive. He was treated with aggressive hydration and had close monitoring of his urine output, creatinine, and CPK levels. His hospital course was uneventful without the development of acute renal failure and he was discharged after 14 days in hospital, with a CPK level of 2463 U/L. This case highlights that severe rhabdomyolysis may occur in patients with dengue fever and that early and aggressive treatment may prevent severe complications such as acute renal failure and death.

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Prevalence and epidemiological aspect of dengue fever in western Rajasthan in year 2018

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20194301 ◽

2019 ◽

Vol 7 (10) ◽

pp. 3735

Author(s):

Varun Kothari ◽

Laxmi Rathore ◽

P. K. Khatri ◽

Saroj Meena

Keyword(s):

Public Health ◽

Dengue Fever ◽

Tertiary Care ◽

Health Problems ◽

Immunoglobulin M ◽

Test Method ◽

Poor People ◽

Structural Protein ◽

Medical College ◽

Epidemiological Characteristics

Background: Dengue fever (DF) is a common mosquito borne disease caused by dengue virus and is transmitted by Aedes mosquito. It is one of the major public health problems in India which affects all levels of society, but the burden of disease is a higher in poor people who live together in communities. Aim of present study is aimed to assess the prevalence and epidemiological characteristics of cases of DF in Tertiary Care Hospitals in Jodhpur, Rajasthan.Methods: A cross-sectional study was conducted in all cases of DF registered in the associated group of Hospitals of Dr. S.N. Medical College, Jodhpur from 1st January 2018 to 31st December 2018. Rapid immune-chromatographic card test and MAC ELISA test method was used to detect dengue non-structural protein 1 (NS1) antigen and dengue immunoglobulin M (IgM) antibodies in the Viral Research Diagnostic Laboratory (VRDL) of Department of Microbiology, Dr. S.N. Medical College to confirm the diagnosis. Results: Out of 2701 patients, 541 patients were tested serologically positive for DF (NS1, IgM). The highest number of suspected cases (1061) was reported in the month of October, 2018 out of whom 228 were positive. Maximum number of dengue cases reported were males belonging to 31-40 years age group from urban area. Fever was the main complaint in all the cases followed by vomiting, headache, and abdominal pain.Conclusion: Dengue is one of the major public health problems in India. A large number of cases are reported in the monsoon and post-monsoon period in the months from September to December. Measures can be taken both at personal and government level to reduce morbidity and mortality from dengue.

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Co-circulation of all the Four Serotype of Dengue Virus in Endemic Region of Saurashtra, Gujarat during 2019-2020 Season

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49300.15065 ◽

2021 ◽

Author(s):

Binita Joseph Aring ◽

Dipali Magan Bhai Gavali ◽

Pushpa Ramjibhai Kateshiya ◽

Hiral Modbhai Gadhvi ◽

Summaiya Mullan ◽

...

Keyword(s):

Dengue Virus ◽

Nonstructural Protein ◽

Geographical Area ◽

Immunoglobulin M ◽

Enzyme Linked Immunosorbent Assay ◽

Endemic Region ◽

Male Population ◽

Monsoon Period ◽

Cross Sectional ◽

Nonstructural Protein 1

Introduction: Dengue has rapidly emerged as a vector - borne viral disease in recent years and also endemic in all continents. The agent of dengue, i.e., dengue viruses, are categorised under the genus Flavivirus, with the four dengue virus serotypes: designated as DENV-1, DENV-2, DENV-3 and DENV-4. These all four serotypes are in circulation either singly, or more than one at the same time. Aim: To study the epidemiological update of dengue with circulating serotype and co-infection in Saurashtra region, Gujarat, India. Materials and Methods: A cross-sectional study was conducted during January 2019 to December 2020 and total samples received were 12,563 which were clinically suspected dengue samples case. After receiving blood samples, serum was separated and proceeded for Dengue NS1Ag (nonstructural protein 1 antigen), and Dengue IgM Ab (Immunoglobulin M antibody). After serological confirmation, 151 samples from different geographical area were selected for Dengue specific Reverse Transcriptase- Polymerase Chain Reaction (RT-PCR) for serotyping. results: Total 4069 (32%) had confirmed dengue positive by Enzyme Linked Immunosorbent Assay (ELISA). The ratio of male cases was higher than female, and in age group 21-35 year (47%). Seasonal trend showed a gradual increase in positivity from June with high peak in October. Circulation of all the four serotypes in area, higher monotypic infection by DENV-1 serotype (41%), followed by DENV-4, DENV-2 and DENV-3. Co-infection of different serotypes were also found. conclusion: The present study concluded that all four serotypes circulate with predominant being DENV-1 type and co-infection of different serotypes in the saurashtra region. Dengue mainly affected adult male population, and seasonal peak during monsoon and post-monsoon period.

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Investigation of Dengue Fever Outbreak in a Rural Area of Islamabad, Pakistan: A Case Control Study

10.1101/2021.10.01.21264329 ◽

2021 ◽

Author(s):

Fawad Khalid Khan ◽

Khurram Shahzad Akram ◽

Ambreen Chaudhry ◽

Mir Muhammad Hassan Bullo ◽

zakir Hussain ◽

...

Keyword(s):

Dengue Fever ◽

Nonstructural Protein ◽

Health Department ◽

Control Measures ◽

Outbreak Investigation ◽

Blood Samples ◽

Breeding Sites ◽

Nonstructural Protein 1 ◽

Breeding Grounds ◽

Ns1 Antigen

Background: In the second week of October 2019, five suspected cases of dengue fever were reported from union council Sohan, Islamabad rural (population 45,747) to the health department, Islamabad Capital Territory (ICT). Outbreak investigation was conducted with the objectives to identify risk factors and to recommend control measures. Methods: Outbreak investigation was conducted from 17 th October to 25 th November 2019. A case was defined as, “fever and two or more of the following signs/symptoms; headache, retro-orbital pain, joint/bone pain, myalgia and petechial rash with NS1 test (Nonstructural Protein 1) positive during 8 th October to 25 th November 2019 among residents of Sohan”. Age and sex-matched controls were recruited from the same neighborhood. All cases were positive for NS1 antigen. Blood samples from five suspected cases were collected and tested for laboratory confirmation. Results: A total of 547 households were surveyed and 85 cases were identified. The mean age was 34.4 years + 16.05 (range 3-71 years). The attack rate was 0.19% whereas the most affected age group was the 45-54 years (AR 0.43%). Males were predominantly affected (n=48 56.5%). Among all cases, 32% (n=27)) had stagnant water inside or around their houses (aOR 2.65, CI 1.20-5.83, P= 0.005), 33% (n=28) were using mosquito repellent (aOR 0.35, CI 0.17-0.70, P <0.001), 31% (n=26) used indoor residual spray insecticide (aOR 0.48, CI 0.24-0.97, P =0.041), and 73% (n=62) used full protective clothing (aOR 0.17, CI 0.05-0.58, P <0.001). All five blood samples were tested positive for NS-1 antigen. Conclusion: The presence of accumulated rainwater in pools and empty receptacles around houses acted as breeding grounds for Aedes aegypti mosquitos and was the most probable cause of this outbreak. Following our recommendations, the health department-initiated mosquito breeding sites control activities through residual insecticide spray and advocacy on the use of protective measures against mosquito bites.

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