Laboratory monitoring results of 463 cases of suspected dengue fever
CAI Liang1, ZHANG Heng-jiao1, HE Fang-ling1, WANG Juan1, HU Shi-xiong1, LI Liang2, YUE Wen-fang1, ZHAN Zhi-fei1, GAO Li-dong1, MA Hai-ling1
1. Key Laboratory of Microbial Molecular Biology of Hunan Province, Hunan Provincial Center for Disease Control and Prevention/Hunan Workstationfor Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Changsha, Hunan 410005, China; 2. Xiangnan University, Chenzhou, Hunan 423000, China
Abstract：Objective To perform a serological and etiological surveillance in 463 cases of suspected dengue fever, and to understand the production of NS1 antigen, IgM/IgG antibody and viral nucleic acid in different courses of the disease. Methods Gold immunochromatographic assay (GICA) and fluorescence immunochromatography assay (FICA) were used to detect NS1 antigen in sera from the cases of suspected dengue fever, and the specificity and consistency of the two Methods were compared. GICA was applied to detecting IgM/IgG antibody so as to analyze the law of antibody production in different course of the disease. Real-time RT PCR was employed to detect viral nucleic acid so as to know about the temporal distribution of positive Results in different course of the disease. Results Among the 463 cases of suspected dengue fever, 353 cases were confirmed by laboratory test. The positive rate of nucleic acid detection within 0-3 days of disease onset was found to be the highest in 353 confirmed cases, reaching 97.08%(133/137), followed by the positive rate of NS1 antigen, with the detection rate of 91.97%(126/137). The positive rates of NS1 antigen and IgM detection within 8-14 days of disease onset were the highest, and both reached 78.94% (45/57). The positive rates of NS1 antigen, IgM antibody, IgG antibody and viral nucleic acid detection in the course of the disease ≥15 days were 58.06% (18/31), 61.29%(19/31), 54.84% (17/31) and 87.10% (27/31), respectively. The positive, negative and overall coincidence rates of GICA and FICA to detect NS1 antigen were 94.88%(278/293), 85.00%(51/60) and 93.20%(329/353), respectively, and the kappa value was 0.768, showing high consistency. Conclusion The Results of NS1 antigen and nucleic acid detection showed high positive rate and consistency at the early stage of infection. Thedetection rates of IgM and IgG antibodies increased with the prolonged course of the disease, and reached the highest in the second week from disease onset. Both GICA and FICA are suitable for early diagnosis and screening in primary laboratories.
[1] Costa RL,Voloch CM,Schrago CG. Comparative evolutionary epidemiology of dengue virus serotypes[J]. Infect Genet Evol, 2012,12(2):309-314. [2] San Martin JL, Brathwaite O, Zambrano B, et al. The epidemiology of dengue in the Americas over the last three decades: a worrisome reality[J]. Am J Trop Med Hyg,2010, 82(1):128-135. [3] Gubler DJ. Epidemic dengue/dengue hemorrhagic as a public health,social and economic problem in the 21st. century[J]. Trends Microbiol, 2002,10:100-103. [4] Bhatt S, Gething PW, Brady OJ, et al. The global distribution and burden of dengue[J]. Nature,2013,496(7446):504-507. [5] 蔡亚男,刘世友,魏亚梅,等.河北省2011—2018年输入性登革热流行特征及防控策略[J].实用预防医学,2020,27(7):798-801. [6] Halstead SB. Dengue[J]. Lancet 2007,370(9599):1644-1652. [7] 蔡亮,张恒娇,何方玲,等.湖南省2018年登革热本地暴发流行病学和分子特征研究[J].中华流行病学杂志,2020,41(11):169-174. [8] Chien LJ, Liao TL, Shu PY, et al.Development of real-time reverse transcriptase PCR assays to detect and serotype dengue viruses[J]. J Clin Microbiol,2006,44(4):1295-1304. [9] Nawa M, Yamada KI, Takasaki T,et al. Serotype-cross-reactive immunoglobulin M responses in dengue virus infections determined by enzyme-linked immunosorbent assay[J]. Clin Diagn Lab Immunol. 2000,7(5):774-777. [10] 李建东,张全福,张硕,等.比较评价三种实验室检测方法在登革热早期诊断中的应用[J].中华实验和临床病毒学杂志, 2015,29(2):154-156.
2021, Vol. 28 
