Role of IgM/ IgG Ratio in Distinguishing Primary and Secondary Dengue Viral Infections: A Cross-Sectional Study
Objectives In recent years, Uttarakhand, a state in North India has become one of the prime spots for tourism all over the world. Thereby, a tremendous increase in the epidemics of dengue infection has been observed recently. Secondary dengue causes more severe disease in comparison with primary, th...
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| description | Objectives In recent years, Uttarakhand, a state in North India has become one of the prime spots for tourism all over the world. Thereby, a tremendous increase in the epidemics of dengue infection has been observed recently. Secondary dengue causes more severe disease in comparison with primary, thus to differentiate the two is very crucial. We aim to find out the cut-off values of the IgM:IgG ratio for early detection of secondary dengue which could further help clinicians to prevent the complications. Methods A cross-sectional study was conducted over one year involving around 936 suspected cases of dengue. Samples were tested using the commercially available capture enzyme linked Immunosorbent assay (ELISA) method for IgM and IgG. Real-time and nested polymerase chain reaction (PCR) tests were also done to find out the prevalent serotype. IgM:IgG ratio was evaluated by using receiver operating characteristic curve analysis for the differentiation of primary and secondary dengue. Results Among the total 91 serologically confirmed dengue patients, forty-seven (51.6%) were found to be primary, and forty-four (48.4%) were secondary dengue infections with male preponderance. Using the WHO diagnostic criteria, patients with dengue fever (DF) without warning signs added up to 51.6%, with warning signs 42.9% and severe dengue 5.5% of the total cases. The cut-off ratio of IgM:IgG ratio = 1.59 found the best discrimination between primary and secondary infection. Forty out of ninety-one (44%) patients exhibited ratios of > 1.59 whereas the rest fifty-one (56%) exhibited ratios of < 1.59. Dengue virus - 2 (DENV- 2) was found to be the most prevalent serotype. Conclusion Our study recommends the cut-off values for IgM:IgG ratio as 1.59. Therefore it is hoped that this will guide the clinicians to early distinguish between primary and secondary dengue. Furthermore, it can reduce morbidity and mortality because of dengue infections in the future. |
| doi_str_mv | 10.7759/cureus.66714 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11390035</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3111420452</sourcerecordid><originalsourceid>FETCH-LOGICAL-c300t-f9d64910fde51f1c080a7c069063fd4f0ef3353362b1c879a2926a22a2813c6c3</originalsourceid><addsrcrecordid>eNpdkcFP2zAUxi00tKKO286TpV12WNpnO3HiXSZURqkE2tQCV8s4djFKbRYnk_jvcQirgIuf7ffzp_f5Q-gzgVlZFmKu-9b0ccZ5SfIDdEQJr7KKVPmHV_sJOo7xHgAIlBRK-IgmTFBOi0IcobAOjcHB4tX2cp6WJV6rzgXsPD51sXN-27t4lwr-07qdah-x8jXeGB18PZxOTSIMvnGtavDKW6PTax9_4BO8aEOM2Wa8Sd1N19ePn9ChVU00xy91iq7Pfl0tzrOL38vV4uQi0wygy6yoeS4I2NoUxBINFahSAxfAma1zC8YyVjDG6S3RVSkUTY4UpYpWhGmu2RT9HHUf-tudqbXxXZpQPowmZFBOvu14dye34Z8khAmApD1F314U2vC3N7GTOxe1aRrlTeijZARYnleiGNCv79D70LfJ80ARklPIC5qo7yOlh49pjd1PQ0AOacoxTfmcZsK_vHawh_9nx54A7AqbOg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3111420452</pqid></control><display><type>article</type><title>Role of IgM/ IgG Ratio in Distinguishing Primary and Secondary Dengue Viral Infections: A Cross-Sectional Study</title><source>PMC (PubMed Central)</source><source>PubMed Central Open Access</source><creator>Kalra, Charu ; Mittal, Garima ; Gupta, Priyanka ; Agarwal, Rajiv Kumar ; Ahmad, Sohaib</creator><creatorcontrib>Kalra, Charu ; Mittal, Garima ; Gupta, Priyanka ; Agarwal, Rajiv Kumar ; Ahmad, Sohaib</creatorcontrib><description>Objectives In recent years, Uttarakhand, a state in North India has become one of the prime spots for tourism all over the world. Thereby, a tremendous increase in the epidemics of dengue infection has been observed recently. Secondary dengue causes more severe disease in comparison with primary, thus to differentiate the two is very crucial. We aim to find out the cut-off values of the IgM:IgG ratio for early detection of secondary dengue which could further help clinicians to prevent the complications. Methods A cross-sectional study was conducted over one year involving around 936 suspected cases of dengue. Samples were tested using the commercially available capture enzyme linked Immunosorbent assay (ELISA) method for IgM and IgG. Real-time and nested polymerase chain reaction (PCR) tests were also done to find out the prevalent serotype. IgM:IgG ratio was evaluated by using receiver operating characteristic curve analysis for the differentiation of primary and secondary dengue. Results Among the total 91 serologically confirmed dengue patients, forty-seven (51.6%) were found to be primary, and forty-four (48.4%) were secondary dengue infections with male preponderance. Using the WHO diagnostic criteria, patients with dengue fever (DF) without warning signs added up to 51.6%, with warning signs 42.9% and severe dengue 5.5% of the total cases. The cut-off ratio of IgM:IgG ratio = 1.59 found the best discrimination between primary and secondary infection. Forty out of ninety-one (44%) patients exhibited ratios of > 1.59 whereas the rest fifty-one (56%) exhibited ratios of < 1.59. Dengue virus - 2 (DENV- 2) was found to be the most prevalent serotype. Conclusion Our study recommends the cut-off values for IgM:IgG ratio as 1.59. Therefore it is hoped that this will guide the clinicians to early distinguish between primary and secondary dengue. Furthermore, it can reduce morbidity and mortality because of dengue infections in the future.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.66714</identifier><identifier>PMID: 39262559</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Cross-sectional studies ; Dengue fever ; Emergency Medicine ; Hospitals ; Illnesses ; Infections ; Infectious diseases ; Internal Medicine ; Polymerase chain reaction ; Public Health ; Viral infections</subject><ispartof>Curēus (Palo Alto, CA), 2024-08, Vol.16 (8), p.e66714</ispartof><rights>Copyright © 2024, Kalra et al.</rights><rights>Copyright © 2024, Kalra et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2024, Kalra et al. 2024 Kalra et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c300t-f9d64910fde51f1c080a7c069063fd4f0ef3353362b1c879a2926a22a2813c6c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390035/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390035/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39262559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kalra, Charu</creatorcontrib><creatorcontrib>Mittal, Garima</creatorcontrib><creatorcontrib>Gupta, Priyanka</creatorcontrib><creatorcontrib>Agarwal, Rajiv Kumar</creatorcontrib><creatorcontrib>Ahmad, Sohaib</creatorcontrib><title>Role of IgM/ IgG Ratio in Distinguishing Primary and Secondary Dengue Viral Infections: A Cross-Sectional Study</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>Objectives In recent years, Uttarakhand, a state in North India has become one of the prime spots for tourism all over the world. Thereby, a tremendous increase in the epidemics of dengue infection has been observed recently. Secondary dengue causes more severe disease in comparison with primary, thus to differentiate the two is very crucial. We aim to find out the cut-off values of the IgM:IgG ratio for early detection of secondary dengue which could further help clinicians to prevent the complications. Methods A cross-sectional study was conducted over one year involving around 936 suspected cases of dengue. Samples were tested using the commercially available capture enzyme linked Immunosorbent assay (ELISA) method for IgM and IgG. Real-time and nested polymerase chain reaction (PCR) tests were also done to find out the prevalent serotype. IgM:IgG ratio was evaluated by using receiver operating characteristic curve analysis for the differentiation of primary and secondary dengue. Results Among the total 91 serologically confirmed dengue patients, forty-seven (51.6%) were found to be primary, and forty-four (48.4%) were secondary dengue infections with male preponderance. Using the WHO diagnostic criteria, patients with dengue fever (DF) without warning signs added up to 51.6%, with warning signs 42.9% and severe dengue 5.5% of the total cases. The cut-off ratio of IgM:IgG ratio = 1.59 found the best discrimination between primary and secondary infection. Forty out of ninety-one (44%) patients exhibited ratios of > 1.59 whereas the rest fifty-one (56%) exhibited ratios of < 1.59. Dengue virus - 2 (DENV- 2) was found to be the most prevalent serotype. Conclusion Our study recommends the cut-off values for IgM:IgG ratio as 1.59. Therefore it is hoped that this will guide the clinicians to early distinguish between primary and secondary dengue. Furthermore, it can reduce morbidity and mortality because of dengue infections in the future.</description><subject>Cross-sectional studies</subject><subject>Dengue fever</subject><subject>Emergency Medicine</subject><subject>Hospitals</subject><subject>Illnesses</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Internal Medicine</subject><subject>Polymerase chain reaction</subject><subject>Public Health</subject><subject>Viral infections</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkcFP2zAUxi00tKKO286TpV12WNpnO3HiXSZURqkE2tQCV8s4djFKbRYnk_jvcQirgIuf7ffzp_f5Q-gzgVlZFmKu-9b0ccZ5SfIDdEQJr7KKVPmHV_sJOo7xHgAIlBRK-IgmTFBOi0IcobAOjcHB4tX2cp6WJV6rzgXsPD51sXN-27t4lwr-07qdah-x8jXeGB18PZxOTSIMvnGtavDKW6PTax9_4BO8aEOM2Wa8Sd1N19ePn9ChVU00xy91iq7Pfl0tzrOL38vV4uQi0wygy6yoeS4I2NoUxBINFahSAxfAma1zC8YyVjDG6S3RVSkUTY4UpYpWhGmu2RT9HHUf-tudqbXxXZpQPowmZFBOvu14dye34Z8khAmApD1F314U2vC3N7GTOxe1aRrlTeijZARYnleiGNCv79D70LfJ80ARklPIC5qo7yOlh49pjd1PQ0AOacoxTfmcZsK_vHawh_9nx54A7AqbOg</recordid><startdate>20240812</startdate><enddate>20240812</enddate><creator>Kalra, Charu</creator><creator>Mittal, Garima</creator><creator>Gupta, Priyanka</creator><creator>Agarwal, Rajiv Kumar</creator><creator>Ahmad, Sohaib</creator><general>Cureus Inc</general><general>Cureus</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240812</creationdate><title>Role of IgM/ IgG Ratio in Distinguishing Primary and Secondary Dengue Viral Infections: A Cross-Sectional Study</title><author>Kalra, Charu ; Mittal, Garima ; Gupta, Priyanka ; Agarwal, Rajiv Kumar ; Ahmad, Sohaib</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c300t-f9d64910fde51f1c080a7c069063fd4f0ef3353362b1c879a2926a22a2813c6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Cross-sectional studies</topic><topic>Dengue fever</topic><topic>Emergency Medicine</topic><topic>Hospitals</topic><topic>Illnesses</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Internal Medicine</topic><topic>Polymerase chain reaction</topic><topic>Public Health</topic><topic>Viral infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kalra, Charu</creatorcontrib><creatorcontrib>Mittal, Garima</creatorcontrib><creatorcontrib>Gupta, Priyanka</creatorcontrib><creatorcontrib>Agarwal, Rajiv Kumar</creatorcontrib><creatorcontrib>Ahmad, Sohaib</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kalra, Charu</au><au>Mittal, Garima</au><au>Gupta, Priyanka</au><au>Agarwal, Rajiv Kumar</au><au>Ahmad, Sohaib</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of IgM/ IgG Ratio in Distinguishing Primary and Secondary Dengue Viral Infections: A Cross-Sectional Study</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><addtitle>Cureus</addtitle><date>2024-08-12</date><risdate>2024</risdate><volume>16</volume><issue>8</issue><spage>e66714</spage><pages>e66714-</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>Objectives In recent years, Uttarakhand, a state in North India has become one of the prime spots for tourism all over the world. Thereby, a tremendous increase in the epidemics of dengue infection has been observed recently. Secondary dengue causes more severe disease in comparison with primary, thus to differentiate the two is very crucial. We aim to find out the cut-off values of the IgM:IgG ratio for early detection of secondary dengue which could further help clinicians to prevent the complications. Methods A cross-sectional study was conducted over one year involving around 936 suspected cases of dengue. Samples were tested using the commercially available capture enzyme linked Immunosorbent assay (ELISA) method for IgM and IgG. Real-time and nested polymerase chain reaction (PCR) tests were also done to find out the prevalent serotype. IgM:IgG ratio was evaluated by using receiver operating characteristic curve analysis for the differentiation of primary and secondary dengue. Results Among the total 91 serologically confirmed dengue patients, forty-seven (51.6%) were found to be primary, and forty-four (48.4%) were secondary dengue infections with male preponderance. Using the WHO diagnostic criteria, patients with dengue fever (DF) without warning signs added up to 51.6%, with warning signs 42.9% and severe dengue 5.5% of the total cases. The cut-off ratio of IgM:IgG ratio = 1.59 found the best discrimination between primary and secondary infection. Forty out of ninety-one (44%) patients exhibited ratios of > 1.59 whereas the rest fifty-one (56%) exhibited ratios of < 1.59. Dengue virus - 2 (DENV- 2) was found to be the most prevalent serotype. Conclusion Our study recommends the cut-off values for IgM:IgG ratio as 1.59. Therefore it is hoped that this will guide the clinicians to early distinguish between primary and secondary dengue. Furthermore, it can reduce morbidity and mortality because of dengue infections in the future.</abstract><cop>United States</cop><pub>Cureus Inc</pub><pmid>39262559</pmid><doi>10.7759/cureus.66714</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Cross-sectional studies Dengue fever Emergency Medicine Hospitals Illnesses Infections Infectious diseases Internal Medicine Polymerase chain reaction Public Health Viral infections |
| title | Role of IgM/ IgG Ratio in Distinguishing Primary and Secondary Dengue Viral Infections: A Cross-Sectional Study |
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