Obstacles in Dengue Diagnosis and Severity Prediction

Abstract Background: Dengue emerges as a perennial public health menace. Identification of patients at risk of developing dengue hemorrhagic fever (DHF)/dengue shock syndrome is still a huge challenge. Objective: In this background, this study was done to predict the severity of dengue by measuring the interleukin (IL) 6 and IL8 by enzyme-linked immunosorbent assay (ELISA). Materials and Methods: A total of 88 samples were collected from patients with clinical signs suggestive of dengue were tested for NS1 and immunoglobulin (Ig) M (NIV Pune), and proinflammatory markers IL-6 and IL-8 (Diaclone SAS Pvt Ltd., France) by ELISA. Results: All the 88 patients were positive for dengue IgM. Dengue NS1 was positive in 36 patients. IL-6 and IL-8 were raised in 56 cases and 46 cases, respectively. Out of 32 severe dengue cases, 24 had raised IL-6 and IL-8. Conclusion: The dynamic nature of dengue requires close monitoring and frequent clinical and laboratory evaluations. Early prediction requires prompt testing of all the markers (IgM, IgG, and NS1) irrespective of the day of illness. Although cytokine estimation aids in assessing the severity, other cost-effective alternatives (hematocrit and platelet count) are copacetic.