Dengue dissertation

Early clinical findings are nonspecific but require a high index of suspicion because recognizing early signs of shock and promptly initiating intensive supportive therapy can reduce risk of death among patients with severe dengue to <0.5%. See Box 3-01 for information regarding the World Health Organization (WHO) guidelines for classifying dengue.

In November 2009, WHO issued a new guideline that classifies symptomatic cases as dengue or severe dengue. Dengue is defined by a combination of ≥2 clinical findings in a febrile person who traveled to or lives in a dengue-endemic area. Clinical findings include nausea, vomiting, rash, aches and pains, a positive tourniquet test, leukopenia, ...

Indonesia does not conduct nationally-representative dengue serotype surveillance. Genotypic and serological surveillance has been undertaken by some Indonesian institutions, on a project basis which confirmed the dengue serotypes in symptomatic individuals [ 12 – 14 ].

Positive IgM and IgG tests for dengue antibodies detected in an initial blood sample mean that it is likely that the patient got infected with the dengue virus in the past few weeks. If the IgG is positive but the IgM is low or negative, then it is likely that the patient had an infection sometime in the past.