Outbreak of Dengue Fever in Bundelkhand Region: A Tertiary Care Hospital Study Report

• Main Authors: Parveen Kumar, Namita Srivastava, Anil Kumar, Kumari Poonam, Manju Choudhri
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2019-07-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: aedes mosquito; imunoglobulin m enzyme-linked immunosorbent assay; nonstructural protein 1 enzyme-linked immunosorbent assay; vector-borne disease
• Online Access: https://jcdr.net/articles/PDF/12999/41343_CE[Ra1]_F(SL)_PF1(AG_SHU)_PFA(KM)_PB(AG_OM)_PN(SL).pdf

Introduction: Dengue is most widely spread mosquito-borne viral disease which is a major public health threat globally. The incidence of dengue fever is increasing year after year with morbidity and mortality in urban and suburban areas of tropical and subtropical regions of the world. However, data related to its exact incidence in many parts of India is still lacking. The present study reports the dengue fever outbreak in 2018 in Bundelkhand region. Aim: To know the incidence of laboratory-confirmed dengue cases among clinically suspected patients in Bundelkhand region and to examine the diagnostic efficacy of two commercially available dengue NS1 and IgM ELISA tests. Materials and Methods: A total of 1794 blood samples of suspected dengue patients over the year 2018 (January to December) from Medical College and nearby hospitals of Bundelkhand region sent to Microbiology department for routine dengue diagnosis were included in this study. For the laboratory diagnosis of dengue cases, NS1 and IgM ELISA tests were performed by using the commercially available “RecombiLISA Dengue Ag ELISA kit (CTK Biotech, Inc., San Diego, CA)” and “National Institute of Virology (NIV) dengue IgM capture ELISA kit (NIV, Pune, India)” as per the manufacturer’s protocol respectively. Results: Out of 1794 suspected dengue cases, 1014 (56.52%) were males and 780 (43.47%) were females. Majority {1344 (74.9%)} of patients were adults with mean age of 29.2±12.8 years, while 25.1% were paediatric cases with mean age of 9.1±3.72 years. Out of 1794 cases, 625 (34.8%) patients were found to be dengue positive by NS1 and/or IgM dengue ELISA. In the present study, the first dengue ELISA positive case of 2018 was detected in the last week of June. The highest positivity rate was observed in October (42.3%), followed by November (38.9%). Maximum number of dengue cases were detected from Jhansi (38.8%), followed by Lalitpur (37.6%), Banda (26.3%) and Jalaun (20.2%), etc. Conclusion: The author’s experience of dengue fever outbreak in the year 2018 in Bundelkhand region has been demonstrated in this study. Both NS1 and IgM ELISA tests were useful for the laboratory confirmation of dengue cases. NS1 in combination with IgM ELISA offers most sensitive diagnosis for dengue as few cases which were missed by IgM were picked by NS1 ELISA test (and vice versa). Hence, continuous monitoring for dengue infection is important during the post-monsoon season when the peak of dengue virus infection was observed.