dengue fever could be here to stay

[pahoated]

quote:

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Originally posted by kalakoa
In other words: we can't run this test locally. This seems ... dumb.

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Let's see, we are living in a place where more and more people are absolutely convinced that heading back to a more primitive lifestyle will lead to better quality of life. Any attempt to improve technology is fought tooth and nail, especially if biology is mentioned. Another example of global situations becoming Hawaii problems, despite being ruled "non-regional".
http://www.nytimes.com/2015/10/10/world/....html?_r=0
Desperate Families in Delhi as Dengue Overwhelms Hospitals

You are such a smart guy. Why not just do the test yourself, regardless there is more than just "a test". You know how to do all this, right? The simple answer are the fast tests are only just now starting to show up.

"In 2011, the U.S. Food and Drug Administration (FDA) approved a blood test called the DENV Detect IgM Capture ELISA to diagnose people with dengue fever."

"Laboratory criteria for diagnosis include one or more of the following:

Isolation of the dengue virus from serum, plasma, leukocytes, or autopsy samples
Demonstration of a fourfold or greater change in reciprocal immunoglobulin G (IgG) or immunoglobulin M (IgM) antibody titers to one or more dengue virus antigens in paired serum samples
Demonstration of dengue virus antigen in autopsy tissue via immunohistochemistry or immunofluorescence or in serum samples via enzyme immunoassay (EIA)
Detection of viral genomic sequences in autopsy tissue, serum, or cerebral spinal fluid (CSF) samples via polymerase chain reaction (PCR)
A reverse-transcriptase PCR test has demonstrated promise, yielding a serotype-specific diagnosis very rapidly.[51, 52] However, this test is currently available only in research laboratories.

The following laboratory tests should also be performed:

Complete blood count (CBC)
Metabolic panel
Serum protein and albumin levels
Liver panel
Disseminated intravascular coagulation (DIC) panel
Characteristic findings in dengue fever are thrombocytopenia (platelet count < 100 x 109/L), leukopenia, and mild-to-moderate elevation of aspartate aminotransferase and alanine aminotransferase values. Jaundice and acute liver failure are uncommon. Peak liver enzyme levels occur later than other complications in adults studied prospectively in Vietnam. Enzyme levels begin to rise during the early stage and peak during the second week. Clinically severe involvement was found to be idiosyncratic and infrequent but did contribute to severe bleeding.[53]

A hematocrit level increase greater than 20% is a sign of hemoconcentration and precedes shock. The hematocrit level should be monitored at least every 24 hours to facilitate early recognition of dengue hemorrhagic fever and every 3-4 hours in severe cases of dengue hemorrhagic fever or dengue shock syndrome.

In patients with dengue hemorrhagic fever, the following may be present:

Increased hematocrit level secondary to plasma extravasation and/or third-space fluid loss
Hypoproteinemia
Prolonged prothrombin time
Prolonged activated partial thromboplastin time
Decreased fibrinogen
Increased amount of fibrin split products
Signs of early coagulopathy may be as subtle as a guaiac test that is positive for occult blood in the stool. Guaiac testing should be performed on all patients in whom dengue virus infection is suspected.

Typing and crossmatching of blood should be performed in cases of severe dengue hemorrhagic fever or dengue shock syndrome because blood products may be required.

Urinalysis identifies hematuria. Cultures of blood, urine, CSF, and other body fluids should be performed as necessary to exclude or confirm other potential causes of the patient's condition.

Arterial blood gas should be assessed in patients with severe cases to assess pH, oxygenation, and ventilation.

Electrocardiography may demonstrate nonspecific changes as a result of fever, electrolyte disturbances, tachycardia, or medications. The usefulness of these changes as a marker of cardiac involvement is unclear.

Biopsy of the skin lesions in patients with nonfatal, uncomplicated dengue fever reveals an abnormality of the small blood vessels. Endothelial swelling, perivascular edema, and mononuclear cell infiltration are the primary histologic findings.

Perform chest radiography to look for pleural effusions and bronchopneumonia. Right-sided pleural effusion is typical. Bilateral pleural effusions are common in patients with dengue shock syndrome. Head computed tomography without contrast may be indicated in patients with altered level of consciousness, to detect intracranial bleeding or cerebral edema from dengue hemorrhagic fever.

Since January 2010, dengue has been a reportable illness in the United States. Report known or suspected cases of dengue fever, dengue hemorrhagic fever, or dengue shock syndrome to public health authorities. Such reports should include the following:

Patient demographics and recent travel history
Case classification
Date of onset of illness
Whether hospitalization was necessary
Outcome
When multiple patients are involved, reports should include the number of cases of dengue fever and dengue hemorrhagic fever/dengue shock syndrome stratified by age, number of confirmed cases and serotypes, and number of hospitalizations and deaths."

"Aloha also means goodbye. Aloha!"