LABORATORY SCREENING AND CONFIRMATION :

LABORATORY SCREENING :

1) Full Blood Count (FBC)

People with dengue fever commonly have a low level of circulating white blood cells. The
clot forming elements in the blood, the platelets, are also characteristically low;
thrombocytopenia (platelet count < 100 x 109/L) and leukopenia also will occur. The
percentage of the blood comprised of red cells, the hematocrit, is increased due to fluid
leakage into the body tissues. The specimen requirement for this test is whole blood.

2) Biochemistry test’s

Blood sodium levels are often lower than normal, and liver enzyme levels such as aspartate
aminotransferase (AST) and alanine aminotransferase (ALT) may be increased due to
inflammation. The specimen requirement for this test is serum.

3) Dengue NS1 and IgG/IgM rapid test

The NS1 antigen is expected to be detected 1 day after the onset of fever and persist up to 9

days in both primary and secondary dengue infection. But if anti-NS1 antibodies produced,

the detection of NS1 is inhibited. Primary dengue is characterized by the presence of

detectable IgM 3-4 days after the onset of infection. Secondary dengue is characterized by

the elevation of specific IgG 1-2 days after the onset of infection and in the majority of cases

this is generally accompanied by an elevation of IgM. The specimen requirement for this test

is serum.

LABORATORY CONFIRMATION:

1) Molecular testing (polymerase chain reaction, PCR)

This type of test detects the genetic material of the dengue virus in blood within the first

week after symptoms appear (fever) and can be used to determine which of the 4 serotypes is
causing the infection. One type of Real Time RT-PCR test can detect dengue and the two other
mosquito-borne viruses, Zika and chikungunya, and distinguish between the three
 2) Cell cultures

An improved method for the isolation and identification of dengue viruses is described. Viruses were
isolated in mosquito cell cultures (C6/36 or AP-61), identified by indirect fluorescent antibody
technique, and typed by complement-fixation test, using the cell culture fluid as antigen. The
sensitivity of this method was compared with mosquito inoculation in comparative titrations of 16
low passage dengue virus strains. Although lower virus titers were obtained by the mosquito cell
culture technique, its decreased sensitivity was compensated for by the much larger volume (588X)
which could be assayed. By incubating the mosquito cells at 32 degrees C, dengue viruses can be
identified and typed within 6 days after inoculation.