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Paper I — 2025 March (Supplementary (SAY)) (2019 Scheme) — Q7

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Paper I
2025 March (Supplementary (SAY)) (2019 Scheme) · 100 marks · 180 min

Question

Enumerate four common etiological agents for viral hemorrhagic fever. Describe the laboratory diagnosis for any one of them.

Q76 marksShort Essays

Answer

Four common etiological agents for viral haemorrhagic fever: Dengue virus, Kyasanur Forest Disease (KFD) virus, Crimean-Congo Haemorrhagic Fever (CCHF) virus, and Ebola virus (other valid examples: Chikungunya-associated haemorrhagic manifestations, Yellow fever virus, Hantavirus).

Laboratory diagnosis of Dengue haemorrhagic fever:

  • NS1 antigen detection (ELISA/rapid test) — detects the dengue non-structural protein 1, positive from day 1 of illness up to about day 9, useful for early diagnosis before antibody appears.
  • IgM antibody ELISA (MAC-ELISA) — IgM becomes detectable from around day 5 of illness onward, indicating recent/current infection; the standard confirmatory serological test.
  • IgG antibody ELISA — useful for distinguishing primary from secondary dengue infection (a high IgG titre early in illness suggests secondary infection, which carries a higher risk of severe/haemorrhagic disease).
  • RT-PCR — detects and can serotype viral RNA directly, most useful in the first few days of illness (viraemic phase); the most sensitive and specific test in early illness.
  • Complete blood count — supportive findings of thrombocytopenia and a rising haematocrit (haemoconcentration, reflecting plasma leakage), important for monitoring severity/progression to dengue haemorrhagic fever/shock syndrome, though not organism-specific.
  • Virus isolation in cell culture — the gold standard for confirmation but not used routinely due to time and technical demands.
  1. 1General Properties of Viruses and Virus Host Interaction

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