Dengue

Positive: The presence of dengue nonstructural protein 1 (NS1) antigen is

consistent with acute-phase infection with dengue virus. The NS1antigen is typically
detectable within 1 to 2 days following infection and up to 9 days following symptom
onset.
NS1 positive but Igg and Igm are negative for dengue test. Is this a dengue
infection?
Answer
NS1 antigen becomes positive at a very early stage of dengue infection.

But,it is mainly used as a rough guide because most of the laboratories use the
rapid test method for this test ,and this lowers it's specificity.NS1 antigen can be
positive in certain other infections.So,if it is positive,it could be an early stage of
dengue. To confirm,IgM antibodies for dengue are tested by the ELISA method
after a few days.If IgM is positive,then a recent infection with dengue virus can be
confirmed.

IgG indicates a past infection with dengue.

Therefore,in this case ,it should be correlated with the clinical symptoms to arrive at
a diagnosis.Until IgM is positive,the case cannot be confirmed as dengue.

It should be remembered that treatment of dengue is purely supportive.

Dengue fever caused by Dengue virus usually follows the symptoms of headache,
fever, prostration, severe joint and muscle pain, swollen glands and Rash.
Diagnosis is made by doing blood tests in patient having these symptoms. Most
commonly asked blood tests are Dengue NS1 Antigen test, Dengue IGM and IGG
antibodies.
Dengue NS1 is a protein molecule that is present at high concentration in blood of
Dengue infected patients during the early clinical phase of the disease, & is usually
positive from day 1 of fever till upto day 9.
IgM, is the antibody response by the body against the virus, and it typically takes 3
to 5 days to appear in the body and hence, the test done for IgM would be positive
only after a period of 3 to 5 days of onset of fever. This persists for 2 to 3 months,
and then disappears from blood.
IgG, typically appears in body after a delay of 14 days from onset of fever, and
persists for life.
Hence, in a patient with Dengue NS1 positive, in early phase for 3 to 4 days, IgM
and IgG may appear negative.
Dengue NS1 antigen test is the first one to become positive in a patient with
dengue fever. IgM and IgG take time (3 to 4 days) before they become positive. In
case of typical symptoms with high grade fever, low platelet count, raised
hematocrit and a low white cell count positivity of IgM and IgG antibodies is not a
requirement to diagnose a case of dengue fever. NS1 antigen positivity alone with
this constellation of symptoms can be used to diagnose a patient with dengue fever
NS1 antigen becomes positive since the 1st day of Dengue Fever.. but that is not
specific of Dengue only. Patients are advised to go through Dengue IgM ELISA
after 4–5 days of fever, not at the same time of NS1.
A positive Dengue IgM after 4–5 days of fever confirms the diagnosis.
Ideally, get an IgM done on day 3–5 of the illness if your platelet counts show a
dropping trend. IgG is not required at present
IgG positive Dengue with IgM / NS 1 positive suggests second attack of dengue ,
which is more serious & dangerous . The second attack causes complications such
as 1 ) low platelets , which can cause bleeding disorder & 2 ) plasma leakage which
can lead to low BP & shock . IgG positive at onset of fever helps the doctor to
predict a severe type of dengue
The NS1 antigen becomes positive first. The IGM shows acute infection and IGG
positivity shows previous infection.
NS1 antigen test (nonstructural protein 1), is a test for dengue, introduced in 2006.
It allows rapid detection on the first day of fever, before antibodies appear some 5
or more days later. It has been adopted for use in some 40 nations