NS1 Antigen Research Articles

Diagnostic accuracy of Dengue NS1 lateral flow immunoassay in comparison to reverse transcriptase polymerase chain reaction and enzyme linked Immunosorbent Assay

The most widely used invitro diagnostic qualitative screening method for dengue virus infection is the lateral flow immunoassay technique. Testing of dengue non-structural antigen NS1 offers specificity in determining the active infection while testing of IgM and IgG helps in differentiating the primary and secondary dengue infections. The ELISA functions as the golden standard for dengue testing and PCR credits for the most accurate determination tool at the genetic level. The RT-PCR endorsed NS1 gene and in ELISA or LFIA NS1 antigen is used as the marker owing to the specificity and lesser chances of mutation effects. This study evaluated the performance of AG-Q Dengue NS1 LFIA kit in comparison with RT-PCR quantification cycle (Cq) Values and ELISA NS1 quantitation. The study also focused on differentiating the samples among dengue serotypes using the RealStar Dengue Type RT-PCR Kit 1.0. Dengue serotype 2 is the prominent viral strain in Kerala region succeeded by serotype 3 and 1 with a prevalence rate of 64 %, 20 % and 6 % respectively. Dengue serotype 4 was not reported during this study period. 10 % co-infection with DENV 1 & DENV 2 was also reported. The AG-Q Dengue NS1 kit stood as efficient in screening by providing positive results with samples having RT-PCR Cq values up to 43 and ELISA NS1 quantification minimum of 14 Panbio units.

Case Report: acute pancreatitis in a patient with dengue fever

Dengue fever is caused by the dengue virus (DENV) and affects over 390 million people yearly. It is prevalent in tropical areas, and warning signs have been established to easily identify patients who need further medical attention. In this article, we report the case of an 18–year–old female patient in Lima, Peru, during a dengue outbreak, presenting with abdominal pain, fever, and gingival bleeding. She tested positive for the NS1 antigen and was also diagnosed with mild acute pancreatitis. It is important to note that DENV infection may lead to acute pancreatitis during outbreaks, which could be underdiagnosed due to symptoms similar to dengue fever.

CLINICAL PROFILE OF EXPANDED DENGUE SYNDROME IN CHILDREN.

The objective is to study the clinical profile and outcome of expanded dengue syndrome (EDS) in children. We conducted a retrospective cohort study and enrolled consecutive children (1 month to 18 years) who presented with dengue fever for over 1 year. The diagnosis of dengue fever was confirmed by the presence of dengue NS1 antigen and/or dengue IgM positivity. Subsequently, we identified children exhibiting EDS according to the revised World Health Organization guidelines (2011). We compared the clinical and laboratory profiles of children diagnosed with EDS and those without EDS. Of 178 children with dengue fever, 33 (18.5%) had EDS [95% confidence interval (CI): 13.1%-25.0%]. In these 33 children, neurological involvement was the most common manifestation [n = 16/33 (49%, 95% CI: 32%-65%)], namely encephalopathy, febrile seizures and encephalitis, respectively. Gastrointestinal involvement was the second most common [n = 10/33 (30%, 95% CI: 17%-47%)], which included fulminant hepatic failure, acalculous cholecystitis and acute pancreatitis. Renal presentation [n = 7 (21%, 95% CI: 10%-37%)] was limited to acute kidney injury. Children with EDS were significantly anemic and had leukocytosis, hyperkalemia, azotemia, hyperbilirubinemia, raised serum transaminases and fluid-refractory shock than their non-EDS counterparts. Children with EDS had a trend toward higher mortality (P = 0.07) and the survivors had a longer duration of hospital stay (5 days vs. 4 days in non-EDS, P = 0.001). In conclusion, we observed a high prevalence (18.5%) of EDS among children hospitalized for dengue fever. The common manifestations of EDS include neurological, renal and gastrointestinal involvement. Children with EDS showed a trend toward higher mortality and longer duration of hospital stay than children without EDS.

CLINICAL AND LABORATORY PROFILE OF ADMITTED PATIENTS PRESENTING WITH FEBRILE ILLNESS DUE TO DENGUE AND SCRUB TYPHUS COINFECTION FROM A TERTIARY CARE HOSPITAL IN SOUTH RAJASTHAN, INDIA

Objective: The present study aims at describing the clinical features, laboratory diagnosis, and complications in patients presenting with febrile illness due to scrub typhus and dengue coinfection from Southern Rajasthan, India. Method: This present prospective, observational, and hospital-based study conducted in the Department of Microbiology of AIMS & RC, Rajsamand, located in Southern Rajasthan, from January 2021 to December 2021. Scrub typhus was diagnosed in the microbiology laboratory by performing SD Bioline, one-step scrub typhus for the detection of IgM antibody, and dengue fever using J.mitra and Co. Pvt. Ltd., rapid card test for the detection of NS1 antigen and IgM antibody. Result: Out of 500 patients suspected of AUFI, 25 (5%) patients diagnosed of having dengue and scrub typhus coinfection. Fever was present in all 25 (100%) patients and 13 (52%) of patients had arthralgia, nausea, and vomiting. The most common sign noticed in our study was pallor and icterus in 10 (40%) patients each followed by shock/hypotension in 8 (32%) and hepatosplenomegaly in 5 (20%). The most predominant laboratory finding was thrombocytopenia (<1.0 × 106/cumm) in 23 (92%) patients, while elevated bilirubin (>2 mg/dl) in 22 (88%) and elevated transaminase and prolonged aPTT in 21 (84%) patients each. The majority of patients 23 (92%) had hepatic dysfunction, i.e., in followed by multi-organ dysfunction (MODS) in 15 (60%). Conclusion: In developing countries like India, particularly in tropical areas, dengue, and scrub typhus coinfection is under-recognized entity. Additional investigation should be carried out in cases of AUFI patients with features such as hypotension, leukocytosis, early drop in platelet counts, and hypoalbuminemia.

Dengue Virus Surveillance in Nepal Yields the First On-Site Whole Genome Sequences of Isolates from the 2022 Outbreak.

The 4 serotypes of dengue virus (DENV1-4) can each cause potentially deadly dengue disease, and are spreading globally from tropical and subtropical areas to more temperate ones. Nepal provides a microcosm of this global phenomenon, having met each of these grim benchmarks. To better understand DENV transmission dynamics and spread into new areas, we chose to study dengue in Nepal and, in so doing, to build the onsite infrastructure needed to manage future, larger studies. During the 2022 dengue season, we enrolled 384 patients presenting at a hospital in Kathmandu with dengue-like symptoms; 79% of the study participants had active or recent DENV infection (NS1 antigen and IgM). To identify circulating serotypes, we screened serum from 50 of the NS1 + participants by RT-PCR and identified DENV1, 2, and 3 - with DENV1 and 3 codominant. We also performed whole-genome sequencing of DENV, for the first time in Nepal, using our new on-site capacity. Sequencing analysis demonstrated the DENV1 and 3 genomes clustered with sequences reported from India in 2019, and the DENV2 genome clustered with a sequence reported from China in 2018. These findings highlight DENV's geographic expansion from neighboring countries, identify China and India as the likely origin of the 2022 DENV cases in Nepal, and demonstrate the feasibility of building onsite capacity for more rapid genomic surveillance of circulating DENV. These ongoing efforts promise to protect populations in Nepal and beyond by informing the development and deployment of DENV drugs and vaccines in real time.

An Observational Study to Find the Association of Viral Load, NS1 Antigen, IgG Antibody, and Other Laboratory Parameters With the Outcome of Dengue Patients in Eastern India.

Background Dengue, the mosquito-borne febrile disease caused by the dengue virus, has become one of the major concerns of public health. It may present with only fever, or there may be a hemorrhagic manifestation or septic shock. As there is no specific treatment for dengue, early detection of the disease, assessment of progression, and prediction of outcome by studying the laboratory markers will help guide the management of cases and lower morbidity and mortality. Methodology This clinico-observational study was conducted at the Department of Microbiology in a tertiary care hospital in Kolkata, India, from February 2020 to August 2022 to determine the outcome of dengue patients in correlation with viral load, NS1 antigen, IgM and IgG antibodies, ferritin level, platelet count, and other laboratory parameters. Results Out of 316 samples from fever patients, 103 (32.5%) were NS1 antigen reactive. We followed up the dengue patients (n = 103) for 15 days and divided them into three groups according to their duration of symptoms (group A suffered for ≤5 days, group B for 5 to 10 days, and group C for >10 days) and per the WHO classification of disease severity, namely dengue without warning signs (DOS), dengue with warning signs (DWS), and severe dengue (SD). Based on severity, 65 (63.1%) patients had DOS, whereas 31 (30.09%) patients had DWS, and seven (6.79%) patients had SD. Secondary infection was present in 83.33% of patients in group C, 71% of DWS cases, and 57% of SD cases, which positively correlates with liver enzymes, viral load (mean value 102195 in secondary infection vs. 1195 copies/10 µl in primary infection), and negatively correlates with platelet counts (mean value 60,213 in secondary infection vs. 1,25,516 in primary infection). Patients in group C had higher liver enzymes, a lower platelet count, and a higher initial viral load than groups A and B. Similarly, SD cases had a higher ferritin level (9215 ug/l), a lower platelet count (mean value 23,250), and a higher initial viral load (mean value 2,74,257 copies/10 µl). An increase in hematocrit value considering the peak value and its baseline value is an important marker for disease severity rather than its absolute value. Conclusion Poor outcome of dengue infection, i.e., an increase in the duration of symptoms and disease severity depends on concurrent associations between high serum ferritin, increased hematocrit level, thrombocytopenia, secondary infection, increasing liver enzymes, and increased initial viral load.

An Early Dengue Virus Fever Diagnostic Tool

The dengue virus is a persistent and very prevalent pathogenic threat in underdeveloped nations such as India. In order to create effective management and treatment plans, it is necessary to continuously monitor the spread and diagnosis of dengue infections due to their variable types and frequencies. The dengue virus is a very complicated illness that presents in many ways. Using standard laboratory techniques to define the dengue virus infection is challenging. NS1, however, might be a useful diagnosis in the initial several days of fever. In this study, the presence of the dengue-specific NS1 antigen was examined in 88 patients from the Raipur regions of Chattisgarh who had been ill for one to thirty days.A kit based on ELISA was used. The collected data was analyzed and the percentage frequency of both IgM positive and negative and NS1 positive and negative results were expressed for each dengue fever patient. Notably, 36.3% of the population had dengue infection. Early in the infection period, the NS1 antigen was effectively measured. In every participant who tested positive for NS1 on the second day of fever, IgM was negative. Nevertheless, when the temperature increased, this correlation became less strong. It was determined through analysis that leuckocytopenia and thrombocytopenia were random states unrelated to NS1 positive. It is clear that diagnosing dengue is extremely difficult and that the antigenic profile drastically shifts as the fever progresses over a period of days.By using a diagnostic approach based on a thorough examination of the subjects, clinicians can reduce the possibility that dengue shock syndrome would cause hemorrhage. Key Words: India's dengue outbreak, dengue virus fever, or virally transmitted diseases

Dengue NS1 interaction with lipids alters its pathogenic effects on monocyte derived macrophages.

While dengue NS1 antigen has been shown to be associated with disease pathogenesis in some studies, it has not been linked in other studies, with the reasons remaining unclear. NS1 antigen levels in acute dengue are often associated with increased disease severity, but there have been a wide variation in results based on past dengue infection and infecting dengue virus (DENV) serotype. As NS1 engages with many host lipids, we hypothesize that the type of NS1-lipid interactions alters its pathogenicity. Primary human monocyte derived macrophages (MDMs) were co-cultured with NS1 alone or with HDL, LDL, LPS and/or platelet activating factor (PAF) from individuals with a history of past dengue fever (DF=8) or dengue haemorrhagic fever (DHF=8). IL-1β levels were measured in culture supernatants, and gene expression analysis carried out in MDMs. Monocyte subpopulations were assessed by flow cytometry. Hierarchical cluster analysis with Euclidean distance calculations were used to differentiate clusters. Differentially expressed variables were extracted and a classifier model was developed to differentiate between past DF and DHF. Significantly higher levels of IL-1β were seen in culture supernatants when NS1 was co-cultured with LDL (p=0.01), but with lower levels with HDL (p=0.05). MDMs of those past DHF produced more IL-1β when NS1 with PAF (p=0.02). MDMs of individuals with past DHF, were significantly more likely to down-regulate RPLP2 gene expression when macrophages were co-cultured with either PAF alone, or NS1 combined with PAF, or NS1 combined with LDL. When NS1 was co-cultured with PAF, HDL or LDL two clusters were detected based on IL10 expression, but these did not differentiate those with past DF or DHF. As RPLP2 is important in DENV replication and in regulating cellular stress responses and immune responses and IL-10 is associated with severe disease, it would be important to further explore how differential expression of RPLP2 and IL-10 could lead to disease pathogenesis based on NS1 and lipid interactions.

Evaluation of NS1 Antigen Detection for Early Diagnosis of Dengue in a Tertiary Hospital in Warangal, Telangana, Southern India

Evaluation of NS1 Antigen Detection for Early Diagnosis of Dengue in a Tertiary Hospital in Warangal, Telangana, Southern India

Dengue: A review of laboratory diagnostics in the vaccine age

Background. Dengue is an important arboviral infection of considerable public health significance. It occurs in a wide global belt within a variety of tropical regions. The timely laboratory diagnosis of Dengue infection is critical to inform both clinical management and an appropriate public health response. Vaccination against Dengue virus is being introduced in some areas. Discussion. Appropriate diagnostic strategies will vary between laboratories depending on the available resources and skills. Diagnostic methods available include viral culture, the serological detection of Dengue-specific antibodies in using enzyme immunoassays (EIAs), microsphere immunoassays, haemagglutination inhibition or in lateral flow point of care tests. The results of antibody tests may be influenced by prior vaccination and exposure to other flaviviruses. The detection of non-structural protein 1 in serum (NS1) has improved the early diagnosis of Dengue and is available in point-of-care assays in addition to EIAs. Direct detection of viral RNA from blood by PCR is more sensitive than NS1 antigen detection but requires molecular skills and resources. An increasing variety of isothermal nucleic acid detection methods are in development. Timing of specimen collection and choice of test is critical to optimize diagnostic accuracy. Metagenomics and the direct detection by sequencing of viral RNA from blood offers the ability to rapidly type isolates for epidemiologic purposes. Conclusion. The impact of vaccination on immune response must be recognized as it will impact test interpretation and diagnostic algorithms.

SERO-PREVALENCE OF DENGUE INFECTION FROM GOVERNMENT HOSPITAL, RAJASTHAN DURING 2022

Background: Viral haemorrhagic fevers are becoming increasingly common in the tropics and subtropics. Dengue fever is currently the most important arthropod‑borne viral disease because of its widespread distribution in more than 100 countries and its potential for extensive outbreaks of life‑threatening disease. Material and Methods: This study was a hospital‑based cross‑sectional study conducted in LaboratoryShrr. R.K.J. Hopsital, Dausa, in Rajasthan, India, between January 2022 to December 2022. The present study included all serum specimens received at laboratory of R.K.J. Hopsital, Dausa, from clinically suspected cases of dengue infection, during this duration. Serum samples were received for serological testing from suspected cases of dengue as advised by consultants from various departments in hospital for laboratory confirmation of suspected cases. Laboratory-confirmed dengue cases were defined as suspected dengue cases with positive dengue serology. Result: The present study analyzed the samples of 1880 of suspected patients during year of 2022. and seropositivity rate of 15% (296/1880) was found out of which 10% (67/648) were seropositive for NS1 antigen and 18% (229/1232) were by IgM ELISA test. The present study revealed trend of cases from August to December 2022 peak of cases was reported in month of September and November. Discussion: The resurgence of dengue has been notable in India and dengue epidemics have been frequently reported in the country both from urban and rural regions. Recent analysis of the past two decades highlighted that, in India, transmission pattern of dengue has changed and widened with shift in peak post-monsoon shifting toward November from October in the recent decade from irregular peak of the previous decade. However, the present pattern in shift of transmission is clear that dengue cannot be considered as a seasonal disease. Conclusions: An alarming rate of increasing emerging and reemerging trends of these arboviral infections are noted in this part of Rajasthan. Hence, the need to focus on proper surveillance, and implementation of prevention and control measure in the country are of utmost priority. Presently, there are no licensed vaccines or antivirals available however, India has initiated several efforts in this direction including traditional medicines. The outcome of this study will help in focusing and improvement of existing surveillance systems and vector control tools, as well as on the development of suitable antiviral agents and formulating candidate vaccine.

Significance of Serological Markers in Diagnosis of Acute Dengue Infection: 2021 Outbreak

Objective: To highlight the significance of Dengue anti-IgM and Dengue NS1 antigen in diagnosing Acute Dengue infection. Study Design: Cross-sectional study. Place and Duration of Study: Virology Department, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Sep to Nov 2021. Methodology: One hundred and fifty Dengue NS1-positive patients of either gender with age≥5 years were included. ELISA tested patients for detection of Dengue anti-IgM antibody. A questionnaire was used to collect demographic and personal data of each patient. Results: Out of 150 dengue NS1 positive samples, 26(17%) were positive for dengue anti-IgM. In collected samples, Dengue serological markers (NS1 and anti-IgM) positivity was observed based on ‘the day of onset of symptoms. On days 1 and 2, 54 and 44 NS1 positive samples were collected, respectively, but no one was found positive for anti-IgM. Anti-IgM was detected on day-3 and onwards. 27% Dengue anti-IgM positivity was found on day-3, which increased gradually as the time of infection increased. On day four, it was 53%; on day 5, it was 55%; on day-6, it was 60%; on day 7, it was 75%; and on day 8, it was 100%. Conclusions: The findings of present study suggested that anti-Dengue IgM antibodies are less significant than the Dengue NS1 antigen in diagnosing acute dengue infection.

Hematological profile of pediatric patients with dengue in district hospital Samba

Background: Dengue is an acute viral illness spread by vector aedes mosquito and caused by RNA virus of the family Flaviviridae. Dengue presents with high fever, severe headache, vomiting, arthralgia, myalgia. Laboratory findings include thrombocytopenia and leukopenia. Dengue is self-limiting illness. Objectives were to study hematological profile of pediatric patients with dengue in district hospital samba from September to November 2022. Methods: Dengue patients aged 0-18 years detected by ELISA NS1 antigen assay in DH samba were included in the study. CBC of all these patients was analyzed on day of presentation to hospital and day of dengue positivity. Results: There were 50 participants in this study. Out of these 35 (70%) were males and 15 (30%) were females, 11 patients were 1-5-year-old (22%); 16 patients were 6-12-year-old (32%); 23 patients were 13-18-year-old (46%), 21 patients (42%) had thrombocytopenia at presentation. 29 out of 50 (58%) were anemic, 19 out of 50 (38%) patients had leukocytopenia. Statistically significant association were seen between age group and platelet counts; platelet and leukocyte count. Conclusions: Teenagers were most commonly affected. Males were affected 3× more than females. Although thrombocytopenia was not universal at presentation but it was observed in less than half (42%) of study participants. One third of study participants (38%) had leukocytopenia at presentations. Thrombocytopenia was most predominant in adolescent age group. Leukocytopenia and thrombocytopenia were associated with each other.

Epidemiological investigation of dengue fever outbreak and its socioeconomic determinants in Banadir region, Somalia

BackgroundDengue has become an alarming global problem and is endemic in many countries, particularly in tropical and subtropical countries. The aim of this study was to investigate dengue fever outbreak in Banadir Region, Somalia, to understand the risk factors (time, place, personal characteristics).MethodsA descriptive cross-sectional study was undertaken to determine the levels of circulating anti-dengue virus antibodies and DENV NS1 antigen among Banadir Region residents, while a questionnaire survey was conducted to understand the clinical and demographic characteristics of the patients.ResultsA total of 735 febrile patients were studied, with 55.6% men and 44.3% women. The majority of the participants were children aged 14 years and younger. Among them, 10.8% tested positive for IgM antibodies against dengue virus (DENV), while the prevalence of DENV NS1 antigen was 11.8%. Fever and myalgia were the most common symptoms observed in the DENV-positive patients.ConclusionsA dengue fever outbreak has been confirmed in Banadir region, Somalia. This study provides information on the most affected districts and identifies risk factors contributing to DF outbreaks. The study recommends improving outbreak readiness and response, particularly in surveillance and laboratory diagnostics, by fostering intersectoral collaboration and establishing regulatory frameworks for financial and operational participation.

Investigating the Clinico-Demographic Characteristics of Dengue Fever and Its Seroprevalence at a Tertiary Care Hospital in Northern India.

Background and objective Dengue virus (DENV) is a major global health threat, causing over 50,000 deaths annually. The state of Uttar Pradesh (UP) in India faces significant challenges due to the increasing number of dengue cases detected. This study aimed to assess DENV seropositivity in the Raebareli district of UP, to offer crucial insights into the region's effective control and management strategies. Materials and methods This study, after obtaining approval from the ethics committee, analyzed blood samples of individuals suspected of having dengue at a teaching hospitalin rural UP between January and December 2022. To determine the disease's seroprevalence, both dengue NS1 antigen ELISA and dengue IgM Microlisa were conducted. Furthermore, RT-PCR was performed on NS1-positive samples to confirm the serotypes. The collected data were analyzed using Epi Info 7.0. Results Of the 589 suspected dengue cases, 86 (14.60%) tested positive for dengue NS1 and/or IgM. Our findings showed that males (n=330, 56.03%)and adolescents and young adults (n=301, 51.1%)from rural areas (n=523, 88.4%) were predominantly affected. Cases peaked post-monsoon, and platelet levels were notably low in NS1-positive cases. Dengue serotype 2 (DEN-2) was found in all RT-PCR-positive samples. Our results revealed a dengue seroprevalence of 14.60% (n=86), which peaked in post-monsoon months. The higher incidence among males and young adults from rural areas attending the outpatient department highlights the importance of targeted interventions and community surveillance. RT-PCR confirmed the circulation of a single serotype in the region. Conclusions This study contributes crucial insights into dengue's epidemiology and clinical profile and its findings are all the more significant now as India prepares for phase 3 trials of a quadrivalent dengue-virus vaccine in 2024. Adolescent and young adult males have an increased likelihood of acquiring the virus, and this demographic can be prioritized for vaccine trials.

Retrospective Study of Various Factors In Pediatric To Severe Dengue Infection

Introduction: Dengue epidemics are known to have occurred over the last three centuries in tropical, subtropical and temperate areas of the world. Annually a 100 million cases of Dengue fever and half a million cases of dengue hemorrhagic fever (DHF) occur in the world with a case fatality in Asian countries of 0.5%–3.5%. Objective: To assess the various factors in pediatric to severe dengue infection. Methods: A hospital-based Retrospective study was conducted at Department Of Paediatric, Mugda Medical College Hospital, Dhaka, Bangladesh from October to December 2023. Number of patients included in the study was 50. In children with high degree clinical suspicion of Dengue infection NS 1 antigen (who came within first 48 hours of fever) and/or Dengue antibody IgM, IgG (who came after five days of fever) were performed. Positive Dengue cases were taken written informed consent & interviewed on the risk factors of Dengue infection. Data related to patients demography, risk factors, clinical presentation, pattern of Dengue infection and outcome were documented on the pre-structured questionnaire. Results: The study was enrolled 100 patients of suspected dengue fever of whom 50 (50.0%) were serologically confirmed to have dengue infection. 30 (60%) patients were males and 20 (40%) were females. 38 (76%) patients had classic dengue fever while 12 (24%) fulfilled the criteria of dengue hemorrhagic fever. Of those patients with dengue hemorrhagic fever, 6 patients had developed dengue shock syndrome. Among the study 44 (88%) from urban and 6 (12%) rural area patients. All cases and is the most common symptom followed by headache, myalgia, vomiting etc. Hemorrhagic manifestations were seen that included petechiae, ecchymosis, gum bleeding, hematuria, malena, hematemesis and epistaxis. Most common complicationswere hepatic dysfunction, renal failure, multi organ failure, encephalopathy and ARDS. Among 50 suspected dengue cases 38 (76.0%) cases were serologically dengue positive. Among the 38 serologically dengue positive patients 17 (44.7%) were NS1 antigen positive, 13 (34.2%) IgM antibodies and 8(21.0%) both IgM and IgG antibodies positive. The distribution of the serologically dengue positive patients out of 50 clinically suspected cases. Conclusion: Dengue is one amongst the key causes of dedifferentiated fever. It presents as an extremely broad wellness and is hardly recognized as a clinical entity by primary health care physicians. This study highlights the practician the importance of break bone fever to clinicians within the areas of medical specialty, manifestations, complications and outcome of the wellness

Detection of dengue in German tourists returning from Ibiza, Spain, related to an autochthonous outbreak, August to October 2022.

In February 2023, German public health authorities reported two dengue cases (one confirmed, one probable) and four possible cases who travelled to Ibiza, Spain, in late summer/autumn 2022; the infection was probably acquired through mosquito bites. Case 1 visited Ibiza over 1 week in late August with two familial companions; all three developed symptoms the day after returning home. Only Case 1 was tested; dengue virus (DENV) infection was confirmed by presence of NS1 antigen and IgM antibodies. Case 2 travelled to Ibiza with two familial companions for 1 week in early October, and stayed in the same town as Case 1. Case 2 showed symptoms on the day of return, and the familial companions 1 day before and 3 days after return; Case 2 tested positive for DENV IgM. The most probable source case had symptom onset in mid-August, and travelled to a dengue-endemic country prior to a stay in the same municipality of Ibiza for 20 days, until the end of August. Dengue diagnosis was probable based on positive DENV IgM. Aedes albopictus, a competent vector for dengue, has been present in Ibiza since 2014. This is the first report of a local dengue transmission event on Ibiza.

Hematological and Biochemical Profiles of Patients with Dengue Virus Infection in Lalitpur, Nepal

Dengue viral infection is a disease transmitted by mosquitoes of the Aedes genus, and it arises as a result of being bitten by mosquitoes that are carrying the virus. This infection induces a wide range of changes in the body’s immune system. Thus serological evaluation together with hematological and biochemical parameters in cases of dengue viral infection make an accurate clinical diagnosis. The main objective of this study was to study the serological, hematological, and biochemical parameters among patients infected with Dengue virus. A total of 102 blood samples were collected at Asrik Diagnostic Lab, Lalitpur during the period of August to October 2022. Samples were analyzed by following methods: hematological tests were done by coulter counter, Biochemical tests were done by fully automated analyzer and serological tests were done by ELISA. Of the 102 blood samples NS1 antigen was detected in 62 (60.9%) whereas anti-dengue IgM antibody was detected in 10 (9.8%). Leukopenia and thrombocytopenia were present in 33 (53.1%) and 32 (51.6%) of the 62 NS1 positive samples, respectively. Of the 62 cases, only 16 samples were tested for the alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Out of 16 samples, ALT and AST level were significantly higher in 11 (68.8%) and 14 (87.5%) positive cases, respectively. The statistical analysis showed that there was no significant association between NS1 and IgM. It can be concluded that the investigation of leukocytes, thrombocytes, ALT, and AST helps to diagnose the dengue efficiently.

Atypical Dengue Outbreak in Odisha: Insights from the Entomological Investigations.

An outbreak of dengue fever struck Tikarapada village, Rayagada district (April 2020). Among 117 fever cases, 49 tested positive for the dengue NS1 antigen. To identify mosquito-related factors in the outbreak, a survey of 101 houses found Aedes breeding sites in 11.6% of containers. Aedes aegypti (79%) and Aedes albopictus (21%) emerged from collected pupae. The village exhibited high (house index = 24.8), (container index = 11.6), (pupal index = 32.7), and (Breteau index = 40.6) indices. The findings confirmed the presence of Aedes and ample breeding sites, suggesting their role in the outbreak. A report recommending integrated vector control measures was submitted to district and state health authorities.

Dengue encephalopathy in an adult due to dengue virus type 1 infection

BackgroundDengue is an important public health problem, which caused by the dengue virus (DENV), a single-stranded RNA virus consisted of four serotypes. Central nervus system (CNS) impairment in dengue usually results from DENV-2 or DENV-3 infection, which lead to life-threatening outcomes. Furthermore, neurological complications due to DENV-1 was rare especially in adult patients.Case presentationA 44-year-old man without comorbidities had lethargy after hyperpyrexia and a positive DENV NS1 antigen was detected for confirming the diagnosis of dengue on day 8 of onset. Then logagnosia, decreased muscle strength, delirium and irritability were occurred even radiographic examination were normal. He was treated with low-dose hormone, sedatives and gamma goblin with a short duration of 6 days. The cerebrospinal fluid (CSF) tests were persistent normal. However, presence of DENV-1 RNA was confirmed both in CSF and serum. Furthermore, the complete sequence of the DENV isolated from the patient’s serum was performed (GenBank No.: MW261838). The cytokines as IL-6, IL-10 and sVCAM-1 were increased in critical phase of disease. Finally, the patient was discharged on day 24 of onset without any neurological sequelae.ConclusionEncephalopathy caused by a direct CNS invasion due to DENV-1 during viremia was described in an adult patient. Treatment with low-dose hormone and gamma goblin was helpful for admission.