DENGUE

Rolando Jr. Villamar

Jazelle Tabarangao
 Table of contents

01 Characteristic 02 Mode of
of Etiologic Transmission
Agent

03 Pathophysiology 04 Laboratory
Diagnosis
01
Characteristics of
Etiologic Agent
Dengue is a mosquito-borne viral disease.. Dengue virus is
transmitted by female mosquitoes mainly of the species Aedes
aegypti and, to a lesser extent, Ae. albopictus. These mosquitoes
are also vectors of chikungunya, yellow fever and Zika viruses.
Dengue is widespread throughout the tropics, with local
variations in risk influenced by climate parameters as well as
social and environmental factors.

Living in endemic areas of the tropics where the vector

mosquito thrives is an important risk factor for infection.
Poorly planned urbanization combined with explosive
global population growth brings the mosquito and the
human host into close proximity. Increased air travel
easily transports infectious diseases between
populations.
Dengue is caused by a virus of the Flaviviridae
family and there are four distinct, but closely
related, serotypes of the virus that cause
dengue (DENV-1, DENV-2, DENV-3 and DENV-
4). Recovery from infection is believed to
provide lifelong immunity against that
serotype. However, cross-immunity to the
other serotypes after recovery is only partial,
and temporary. Subsequent infections
(secondary infection) by other serotypes
increase the risk of developing severe dengue.
Severe dengue was first recognized in the
1950s during dengue epidemics in the
Philippines and Thailand. Today, severe
dengue affects most Asian and Latin
American countries and has become a
leading cause of hospitalization and death
among children and adults in these
regions.
 02
Mode of
Transmission
The dengue virus is spread through a human-
to-mosquito-to-human cycle of
transmission.

1. Four days after being bit by an infected

Aedes aegypti mosquito, a person will
develop viremia. Viremia lasts for
approximately five days, but can last as
long as twelve days. On the first day of
viremia, the person generally shows no
symptoms of dengue. Five days after
being bit by the infected mosquito, the
person develops symptoms of dengue
fever, which can last for a week or longer.
2. After a mosquito feeds on the blood of
someone infected with the dengue virus, that
mosquito becomes a dengue vector. The
mosquito must take its blood meal during the
period of viremia, when the infected person
has high levels of the dengue virus in the
blood. Once the virus enters the mosquito's
system in the blood meal, the virus spreads
through the mosquito's body over a period of
eight to twelve day.

3. After this period, the infected mosquito can

transmit the dengue virus to another person
while feeding.
03
Pathophysiology
 o4
Laboratory
Diagnosis
• To detect the presence of the
dengue virus in the blood, you
need to undergo definitive tests
which include non-structural
protein 1 (NS1) test,
Immunoglobulin G/
Immunoglobulin M test or a real
time polymerase chain reaction
(RT-PCR) test.
Dengue NS1 Antigen
• This is a blood test to detect the dengue virus early in the course of an
infection.
• The test results can be obtained within a day. The NS1 Antigen test is
comparatively cheaper than other lab tests for dengue.
• 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.  
• The rapid test membrane is pre-coated with a NS1 specific antibody on the
test line region and utilizes a separate control to assure assay flow and
performance. During testing, the test sample is added directly to the sample
region and the test is placed into a well containing 3 drops of buffer.
Immunoglobulin G/ Immunoglobulin M test
The test is used to detect infection in the later course of the disease
because the level of IgG in the blood tends to increase slowly and IgM
levels are detectable in 50% of patients by day 3 after the onset of
illness, which increases to 80% by day 5 and 99% by day 10. Usually,
the level increases six to ten days after the infection and the antibodies
can remain in the blood for around 90 days or for the rest of your life.
Enzyme-linked immunosorbent assay is also used to detect IgG and
IgM. ELISA is based on capturing human IgM and IgG antibodies on a
microtiter plate using anti-human-IgM and anti-human-IgM antibodies. 
Dengue RNA PCR test
Nucleic acid amplification tests (NAATs)
• For patients with suspected dengue virus disease, NAATs are the preferred method of
laboratory diagnosis. It should be performed on serum specimens collected 7 days or
less after symptom onset.

The first step is to extract nucleic acid sample and its purification. Second stage
involves amplification of that nucleic acid and then detection along followed by
characterization of the amplified product. Extraction and purification are carried out on the
silica-based kits for faster results. Laboratories use nested RT-PCR assay along with
universal dengue primers which target the C/prM region of the genome. Electrophoresis is
used to separate the products on agarose gel. The resulting amplified products are obtained
on the agarose gel with the help of ethidium bromide dye. Bands with different molecular
weights separate accordingly.
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QUIZ
 QUIZ

Q1&Q2 Q3 Q4 Q5

Name the 2 How many

species of serotypes of the
It is a condition
in which there is Viremia lasts for
mosquito that is virus that cause
dengue a high level of approximately
possible to carry five days, but
the dengue the dengue virus
in the blood can last as long
virus. as ____ days
 QUIZ

Q6 Q7 Q8 Q9

.This is a blood During the

test to detect the testing, How The virus infects
A type of water
dengue virus many drops of and replicate where the main
early in the buffer are inside the _____ breeding centers
course of an needed in the cells for the female
infection kit? Aedes mosquitoes
 QUIZ

Q10

How many
needles are
found on the
mosquito’s
suckers
QUIZ
answers
 QUIZ

Q1&Q2 Q3 Q4 Q5

Aedes aegypti,
Aedes 4 Viremia 12
albopictus
 QUIZ

Q6 Q7 Q8 Q9

Dengue NS1
Antigen 3 Langerhans Stagnant waters
 QUIZ

Q10

6 NEEDLES