CHENNAI: Early identification of symptoms will help in getting quick treatment before it’s too late. Symptoms, which usually begin four to six days after infection and last for up to 10 days. Dengue can be with without warning signs and there can be severe dengue.

Dengue with or without warning signs can appear as sudden, high fever, severe headaches, pain behind the eyes, severe joint and muscle pain, fatigue, nausea and vomiting.

The other symptoms can also appear as skin rash, which appears two to five days after the onset of fever. There can be warning signs like pain abdomen, tenderness, persistent vomiting, mucosal bleeding such a nose bleed, bleeding gums, or easy bruising.

Other symptoms can be lethargy, restlessness, liver enlargement of more than 2cm, clinical fluid accumulation.

The laboratory diagnosis that indicates increased hematocrit with rapid decrease in platelet count can be risky. Laboratory diagnosis plays a crucial role in identifying dengue. This is because it can be difficult to distinguish it from other diseases with similar symptoms.

Early diagnosis of shock syndrome is particularly important, as it may be fatal if appropriate treatment is not administrated within 18-24 hrs.

Important blood tests:

1. Blood count: leukopenia, increase in HCT, decrease in platelet count.

2. Peripheral smear

3. Antigen detection: NS1 Antigen: Early detection of the infection. Can be detected by ICT, ELISA, ELFA formats. May be detected from day 1of fever to18 days of infection.

4. Antibody detection: ICT, ELISA, ELFA formats are available.

Dengue Ig M: detectable after 5days of fever and disappears within 90days.

Dengue Ig G: detectable at 14-21 days, later increases.

5. Virus detection: Real time RT PCR: detects serotypes, quantifies viral load.

6. Aspartate aminotransferase and alanine aminotransferase are elevated.