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Clinical Review

Diagnosis and management of dengue

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4338 (Published 18 November 2009) Cite this as: BMJ 2009;339:b4338

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Plaque reduction neutralization test for dengue virus is more sensitive test but expensive

Dengue hemorrhagic fever is characterized by systemic vascular
leakage, disordered haemostasis and may develop after infection with any
of four dengue viral subtypes. Between 2,50,000-5,00,000 cases of DHF, mainly in children, are reported by WHO annually with mortality rate 1-5%
among patients with Dengue hemorrhagic fever shock. In West Bengal
provinces of India, on average around 1064 cases of dengue occurs each
years with maximum infections are detected in kolkata district around 600
cases followed by in N-24 parganas , S-24 parganas and ,Howrah districts
and total death from DHF is 10-12. Usually the diagnosis of dengue
infection is made with use of Dengue DUO IgM capture and IgG capture
enzyme linked immunosorbant essays in paired sample. Coagulation profile
is also done for PT, APTT, fibriongen level by serum quantitative assay
besides quantitative platelet count. The serotype of dengue virus is
distinguishable by Plaque reduction neutralization test.

The plaque
reduction neutralization test is one of the most specific and sensitive
tests for dengue virus and can be used to identify the virus serotype in
primary dengue infection. The secondary and tertiary infection however the
infecting viral serotype can not be reliably done because of long
neutralizing antibodies. This test can also be linked for sero
epidemiology. The disadvantages of this test are it is highly expensive,
technical difficulty and need live virus in the lab.

Authors_:

Professor Pranab kumar Bhattacharya MD(cal), FIC path(Ind.) ,
Professor of Pathology, In charge of Histopathology Unit, in charge Blood
Bank &VCCTC, Cytogenetics. Institute of Post Graduate Medical Education
& Research, 244a AJC Bose Road, Kolkta-20, West Bengal, India; **Mr.
Ritwik Bhattacharya, B.Com(cal); ***Mr. Rupak Bhattacharya BSc(Cal)MSc(JU)
of 7/51 Purbapalli, Sodepur, Dist 24 parganas(North) ,Kol- 110, West
Bengal, India; ****Mrs Dahlia Mukherjee BA(hons) Cal, Swamiji Road, Habra
N-24 parganas, W.B, India, *****Miss Upasana Bhattacharya of Mahamyatala,
Garia kol-86,Daughter of Prof. Bhattacharya Dr. Hriday Ranjan Das MD,
DTM&H( Cal) Medical officer, Nephrology, IPGMER, KOl-20, Dr. Sumit
Chaudhury MD(cal)Asst.Prof.Dept of Medicine IPGMER Dr. Tarun Biswas
MaBBS(cal), Dept. Of Pathology, Institute of Post Graduate Medical
Education & Research, 244a AJC Bose Road, Kolkta-20, West Bengal,
India

Competing interests:
None declared

Competing interests: No competing interests

13 December 2009
Professor Pranab Kumar Bhattacharya ,MD(cal),FIcPath(ind)
Professor of Pathology, In charge of Histopathology Unit, in charge Blood Bank &VCCTC, Cytogenetics.
Ritwik Bhattacharya,B.Com(cal);Rupak BhattacharyaBSc(Cal)MSc(JU)7/5Purbapalli, Sodepur, 24 parganas(N) ,Kol- 110, Mrs. Dahlia Mukherjee BA(hons)Cal,MissUpasanaBhattacharya-student, Dr.HridayRanjanDas MD,DTM&H( Cal)Dr.Sumit Chaudhury MD IPGMER Kol-20
Institute of Post Graduate Medical Education & Research, 244a AJC Bose Road, Kolkta-20, W.B India