Definitive tests for dengue fever: when and which should I use?

WHAT IS DENGUE FEVER?Dengue fever is an acute illness caused by an infection from one or more of the four serotypes of dengue viruses (DENV 1 to 4).The viruses are transmitted through the female mosquito species Aedes aegypti and, less commonly, Aedes albopictus.It is a dynamic, systemic disease with a wide clinical spectrum that includes both severe and non-severe clinical manifestations.Although the illness is usually self-limiting, for a minority of patients, dengue can cause life-threatening complications.In 2009, the World Health Organization (WHO) introduced a revised scheme, which resulted in a paradigm shift in the approach to dengue fever.(1,2) The proposed scheme emphasised the early recognition of warning signs, resulting in the optimisation of triage and management decisions.The following classifications were revised: dengue without warning signs; dengue with warning signs (abdominal pain, persistent vomiting, fluid accumulation, mucosal bleeding, lethargy, liver enlargement, increasing haematocrit with decreasing platelets); and severe dengue (dengue with severe plasma leakage, severe bleeding or organ failure).(3)