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(usually 4 to 7 days)
Petechiae, purpura
Gum bleeding, epistaxis, menorrhagia, gastrointestinal bleedings (rare) Thrombocytopenia, leukopenia with lymphopenia Mild elevation of hepatic transaminases & LDH
Physiopathology: capillary leakage & hemorrhagic manifestations. 4 to 7 days after the onset (at approximately the
date of defervescence)
Abdominal pain, vomiting, consciousness troubles, hypothermia Marked decrease in platelet count. Mortality: up to 10 or 20%
Rapid weak pulse & low blood pressure (BP < 90mmHg)
Serology (IgM capture ELISA) Problem: negativity of the test early in the course of the disease > should be performed only 4 to 5 days after the onset of fever. IgM: remain positive for 3 to 6 month IgG: remain positive for life
Detection of all 4 types of dengue serotypes Result available in 15 min. (BioRad chromatographic
strip test)
Although in some reports, the same efficiency of detection for virus of the 4 serotypes has been described for the Dengue Early ELISA and Strip tests (Dussart et al., 2008), A recent analysis of the performance of these tests in Vietnam suggests a lower sensitivity for DENV-2 compared with DENV-1 and DENV-3.
These tests in Vietnam suggests a lower sensitivity for DENV-2 compared with DENV-1 and DENV-3. Also, a decreased sensitivity for DENV-4 with the Dengue Early ELISA has been reported in studies from South America (Bessoff et al., 2008; Dussart et al., 2008). A lower sensitivity for DENV-2 has been described in samples from Vietnam (Hang et al., 2009) tested by the PLATELIA systems (ELISA and Strip) and belonging to the Asian genotype 1 (according to the classification of Twiddy et al., 2002).