Increasing number of secondary dengue cases: a concern
DOI:
https://doi.org/10.18203/2320-6012.ijrms20191635Keywords:
ELISA, Flaviviridae, IgG avidity, IgM ELISA, NS-1, Severe dengueAbstract
ackground: Dengue fever is caused by mosquito borne arbovirus of family Flaviviridae, Aedes agypti as the principle vector. In the recent past Delhi has witnessed several outbreaks affecting thousands of individuals and many of them get re-infected during subsequent years forming a bulk of secondary dengue cases putting them at risk of developing severe dengue.
Methods: A total of 150 serum samples from suspected dengue cases were tested for dengue fever by NS-1 antigen and IgM antibody enzyme-linked immunosorbent assay (ELISA) followed by categorization into primary and secondary dengue using IgG avidity ELISA.
Results: Out of total 150 clinically suspected dengue cases, 56 were positive either by Dengue NS-1 antigen or dengue IgM antibody or both. On the basis of dengue IgG avidity ELISA among 56 diagnosed dengue cases, 30 (53.57%) were found to be of secondary dengue.
Conclusions: There is increasing trend of dengue cases in Delhi since past one decade. Being hyper-endemic area for dengue, more than 25% population have been reported to have past infection of dengue. Due to increased prevalence and simultaneous circulation of more than one serotypes, number of secondary dengue cases is also increasing. Since majority of severe dengue cases are associated with secondary dengue, early diagnosis and treatment can significantly reduce the fatal outcome. Thus, avidity testing for IgG antibody becomes an important tool.
References
Gubler DJ. Dengue and dengue haemorrhagic fever. Clin Microbiol Rev. 1998; 11:480-96.
Guzman MG, Kourf G. Dengue: An update. Lancet Infect Dis. 2002;2:33-42.
Mustafa MS, Rasotgi V, Jain S, Gupta V. Discovery of fifth serotype of dengue virus (DENV-5): A new public health dilemma in dengue control. Med J Armed Forces India. 2015;71(1):67-0.
National vector borne disease control programme, 2018. Available at: http://www.nvbdcp.gov.in/index4.php?lang=1&level=0&linkid=431&lid=3715. Accessed on 15 December 2018.
Halstead SB. Observations related to pathogenesis of dengue haemorrhagic fever. VI. Hypotheses and discussion. Yale J Biol Med. 1970;42:350-62.
Sharma P, Mittal V, Chhabra M, Singh P, Bhattacharya D, Venkatesh S. Dominance shift of DENV-1 towards reemergence and co-dominant circulation of DENV-2 & DENV-3 during post-monsoon period of 2012 in Delhi, India. J Virol Retrovirol. 2014;1(1):104.
Islam A, Abdullah M, Tazeen A, Afreen N, Deeba F, Naqvi IH, et al. Detection of all the four serotypes of dengue virus in New Delhi, India during post monsoon season of 2015. Indian J Health Sci Care. 2016;3(3):24-9.
Vikram K, Nagpal BN, Pande V, Srivastava A, Saxena R, Anvikar A, et al. An epidemiological study of dengue in Delhi, India Acta Trop. 2016;153:21-7.
Souza SD, Bonon SH, Costa SC, Rossi CL. Evaluation of an in-house specific immunoglobulin G (IgG) avidity ELISA for distinguishing recent primary from long-term human cytomegalovirus (HCMV) infection. Rev Inst Med Trop Sao Paulo. 2003;45(6):323-6.
Parveen N, Broor S, Abdullah M, Hisamuddin M, Tazeen A, Asif N, et al. Resurgence of dengue-like and chikungunya-like illness in New Delhi, India during 2016. Indian J Health Sci Care. 2016;3(2):61-5.
Anita C, Suresh K, Neha S, Sonia M. Dengue outbreak in Delhi in 2009: study of laboratory and clinical parameters. J Commun Dis. 2012;44(3):163-8.
Abhishek KS, Chakravarti A. Laboratory evaluation of the SD Bioline- Dengue Duo rapid immunodiagnostic test kit for detection of NS-1 antigen and IgM antibody during dengue outbreak in Delhi. Int J Curr Res. 2018;10(05):69567-9.
Dar L, Gupta E, Narang P, Broor S. Cocirculation of dengue serotypes, Delhi, India, 2003. Emerg Infect Dis. 2006;12(2):352.
Fiorentino DF, Bond MW, Mosmann TR. Two types of mouse T helper cell. IV. Th2 clones secrete a factor that inhibits cytokine production by Th1 clones. J Exp Med. 1989;170(6):2081-95.
Abhishek KS, Chakravarti A, Baveja CP, Kumar N, Siddiqui O, Kumar S. Association of interleukin-2,-4 and-10 with dengue severity. Indian J Pathol Microbio. 2017;60(1):66.
de Souza VA, Fernandes S, Araújo ES, Tateno AF, Oliveira OM, Oliveira RR, et al. Use of an immunoglobulin G avidity test to discriminate between primary and secondary dengue virus infections. J Clin Microbiol. 2004;42(4):1782-4.
