DIAGNOSIS
Dengue should be suspected in a traveler when they present with fever along with other symptoms such as severe headache, pain behind the eyes, muscle and joint pain, rash, nausea, vomiting, or bleeding from the nose or gums. If a traveler has recently visited an area where dengue is endemic or epidemic, particularly tropical or subtropical regions, and exhibits these symptoms, dengue should be considered as a potential diagnosis. Additionally, if the traveler has been exposed to mosquito bites during their trip, the likelihood of dengue should also be heightened. Early recognition and diagnosis are crucial for appropriate management and prevention of complications.
Symptoms
The disease should be suspected based on clinical presentation and epidemiological history. The classic manifestation in the body includes “fever, severe headache, and pain behind the eyes,” which can appear 4 to 10 days after the mosquito bite. Other common symptoms are muscle and joint pain, skin rash, nausea, vomiting, and mild bleeding, such as from the nose or gums.
SEROLOGY
Serology for dengue involves the detection of specific antibodies against the dengue virus in the patient’s blood. This method is fundamental for diagnosis, especially in non-endemic areas. In endemic regions, it is widely used to confirm recent or past infections. Serology can detect both IgM antibodies, which indicate a recent infection, and IgG antibodies, which signal previous exposure to the virus. It is a crucial tool for differential diagnosis and epidemiological monitoring of the disease.
Rapid Diagnostic Test (RDT)
Rapid Diagnostic Tests (RDTs) for dengue are tools for detecting specific antigens of the dengue virus. These tests are used to complement traditional serological methods in Europe and are implemented on a large scale in endemic areas. They are effective even if the patient has received pharmacological treatment, providing quick results and facilitating early diagnosis and appropriate management of the disease.
Molecular Diagnostic Tests using Polymerase Chain Reaction (PCR)
Molecular diagnostic tests using polymerase chain reaction (PCR) are advanced techniques used to detect the genetic material of the dengue virus. These tests are highly sensitive and specific, allowing for the identification of the virus in the early stages of infection. They are used both in clinical settings and epidemiological studies to confirm suspected cases and monitor outbreaks. PCR is an essential tool for the accurate diagnosis of dengue, especially in patients with initial symptoms, and it is valuable for guiding appropriate clinical management and public health interventions.
Self-Diagnosis of Dengue
Self-diagnosis of dengue involves the use of commercially available kits that allow individuals to perform tests at home to detect the presence of the dengue virus. These kits are typically easy to use and provide quick results, usually within minutes. Although they can be useful for preliminary detection, it is crucial to confirm positive results with more precise laboratory tests conducted by healthcare professionals. Self-diagnosis can help individuals seek early medical attention and take preventive measures to avoid spreading the virus, but it does not replace full clinical evaluation and diagnosis.