Prevalence of Dengue Fever and Comparative Analysis of Primary and Secondary dengue cases in a Tertiary care hospital, Amritsar, Punjab.

Dr. Nishtha Malik; Dr. Bimla Devi; Dr. Loveena Oberoi

Volume : VIII, Issue : I, January - 2019

Prevalence of Dengue Fever and Comparative Analysis of Primary and Secondary dengue cases in a Tertiary care hospital, Amritsar, Punjab.

Dr. Nishtha Malik, Dr. Bimla Devi, Dr. Loveena Oberoi

Abstract :

Background: The most challenging problem associated with patient management in Dengue infection is early diagnosis. Secondary infection with dengue virus is the most accepted risk factor for the development of dengue haemorrhagic fever. Confirmation of Dengue infection, this, is the most essential prerequisite in the management of its complications, hence reducing morbidity and mortality associated with it Aim: To determine the prevalence of Dengue Fever cases in a tertiary care hospital, Amritsar, Punjab, by serological tests IgM ELISA and IgG ELISA, to differentiate between the primary and secondary dengue cases. Methods: A cross sectional comparative study in patients with fever, testing positive for NS1 antigen and IgM ELISA designated as confirmed Dengue fever were included in the study. Detailed history was obtained and complete clinical examination was done. To distinguish between primary and secondary infections, IgG ELISA was performed in all the samples, which was markedly raised in patients with secondary infection. Results: Out of 282 patients presenting with fever and associated constitutional symptoms, 100 Confirmed Dengue Fever cases, testing positive with NS1 Ag by ELISA, were included in the study. It was found that 50% had primary Dengue and other 50% had secondary Dengue infection after testing them with IgM and IgG ELISA. Amongst the 100 positive cases 41 had hemorrhagic manifestations, of which 33were secondary dengue infected patients. Conclusion: As this study was conducted in an endemic area, a higher prevalence of secondary infection was seen with higher morbidity. All infected cases must be monitored for all parameters i.e NS1Ag, IgM, IgG to differentiate between primary and secondary infection as the possibility of patient landing into DHF/DSS is more in secondary infection, which is attributable to prevalence of all DEN virus serotypes in Indian subcontinent