Fever Advanced Panel (Including COVID & Influenza)

Dengue virus is a flavivirus with four distinct serotypes (Dengue virus 1, 2, 3, and 4). It is primarily transmitted by the Aedes aegypti mosquito, found in the tropical and subtropical regions.

Dengue nonstructural protein 1 (NS1) is an antigen produced by the replicating dengue virus. These antigens can be detected as early as the first day of symptoms and as late as day 18 of symptoms.

Clinically, in the beginning, there is sudden onset of fever combined with headache, muscle and joint pains (severe pain that gives it the nickname break-bone fever or bone crusher disease), distinctive pain from behind the eyes (retro-orbital pain) and rash (a generalized maculopapular rash with islands of sparing). After that, a hemorrhagic rash of characteristically bright red pinpoint spots (known as petechiae) can occur during the illness which is associated with thrombocytopenia. It usually appears first on the lower limbs and the chest, however, in some patients, it spreads to most of the body. Along with that, there can also be gastritis (inflammation in the stomach lining) with associated stomach pain, nausea (feeling sick), vomiting coffee-grounds-like congealed blood or diarrhea.

Dengue Hemorrhagic fever (DHF):

In DHF, the fever can go to a higher grade, it might also include variable bleeding manifestations like bleeding from the eyes, nose, mouth, ear and oozing blood from skin pores. Other bleeding manifestations include thrombocytopenia, and hemoconcentration (thickening of the blood).

Dengue hemorrhagic fever is a leading cause of serious illness and death among children. There is no specific treatment for dengue, but appropriate medical care can save the lives of patients with the more serious dengue hemorrhagic fever.

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Blood Stag is composed of blood cells suspended in blood plasma (yellowish-colored liquid). The blood cells include red blood cells (also called RBCs or erythrocytes), white blood cells (also called WBCs or leukocytes), and platelets (also called thrombocytes).

Red blood cells (RBCs) are the most abundant blood cells. RBCs contain hemoglobin which helps in the transportation of oxygen to the tissues. RBC count is the measurement of the number of RBCs in a given volume of blood.

Packed Cell Volume (PCV) or Hematocrit (Hct) is the measurement of the blood volume occupied by RBCs. It is expressed in percentage.

White blood cells (WBCs) are key components of the immune system and thus protect the body from various infections and cancers. Total Leucocyte count (TLC) is the measurement of the total number of leukocytes (WBCs) in a given volume of blood.

There are five types of WBCs:

1. Neutrophils

2. Basophils

3. Eosinophils

4. Lymphocytes

5. Monocytes

Differential Leucocyte Count (DLC) determines the percentage of different types of WBCs.

Neutrophils, Basophils, and Eosinophils are called Granulocytes because of the presence of granules inside these cells.

Absolute count of different types of WBCs is the measurement of their absolute numbers in the given volume of blood.

Platelet count - Platelets (also called thrombocytes) are disc-shaped cell fragments without a nucleus that help in blood clotting. Platelet count is the measurement of the number of platelets in a given volume of blood.

Mean Platelet Volume (MPV) is a measurement of the average size of platelets.

PDW or platelet distribution width refers to the variation of platelet size distribution

Hemoglobin (Hb) -  Hemoglobin (Hb) is a protein found in red blood cells (RBCs) that carries oxygen from the lungs to the body tissues, exchanges the oxygen for carbon dioxide, and then carries the carbon dioxide back to the lungs where it is exchanged for oxygen.

Mean Corpuscular Volume (MCV) is the average volume of a red blood cell.

Mean Corpuscular Hemoglobin (MCH) is the average amount of hemoglobin in the average red blood cell.

Mean Corpuscular Hemoglobin Concentration (MCHC) is the average concentration of hemoglobin in a given volume of red cells.

Red Cell Distribution Width Coefficient of variation (RDW CV)is a measurement of the variability of the red blood distribution curve and their mean size. 

CRP Test measures the levels of CRP in blood to detect the presence of an inflammation or to monitor the treatment and progress of an inflammatory condition. C-reactive Protein or CRP is an acute phase reactant protein which is produced and secreted by the liver in response to an inflammation in the body, which may be caused by tissue injury, infection, or autoimmune diseases. CRP levels increase in patients with trauma, heart attack, autoimmune diseases, bacterial infections, sepsis, post surgery, cancer, etc. CRP levels are often increased before the onset of other symptoms of inflammation such as pain, fever, etc. CRP levels in blood fall as the inflammation subsides.

It is a non-specific test. It can neither diagnose a condition by itself nor can it determine the location of a particular inflammation or disease. Other tests along with physical examination are performed to diagnose a particular condition and determine the location.

A variant of the CRP test is the High Sensitivity C-reactive Protein Test (hs-CRP) which is more sensitive for CRP levels and can detect blood CRP levels at a lower concentration than the standard CRP Test. The hs-CRP Test is performed usually to determine the risk of development of cardiovascular diseases in otherwise healthy individuals.

The Malarial Falciparum and Vivax antigen test is a rapid diagnostic test which detects the presence of malarial antigen in the blood sample. Malaria is an infectious disease which is caused by a species of Plasmodium parasite. It is transmitted by the bite of an infected mosquito (female anopheles). The species which cause infections in humans include Plasmodium Vivax, Plasmodium malariae, Plasmodium ovale, and Plasmodium falciparum. 

This malarial infection may rarely pass from a woman to her baby during pregnancy, labor, or delivery. Also, the chances of the spread of infection are very low through blood transfusion, sharing of contaminated needles or syringes, and organ transplant. 

When an infected mosquito bites a person, the parasites enter into the blood and travel to the liver. After a person is infected it takes about 7-30 days for the eggs to mature. The parasites enter the red blood cells of a person where they multiply inside these cells. These cells burst within 48 to 72 hours which leads to the occurrence of symptoms of malaria. 

The disease can relapse in case the infection is caused by P. vivax and P. ovale species. This is because these parasites can remain inoperative in the liver before they enter again into the blood and may take up to months and even years for the symptoms to appear.

If the malarial infection is not treated, it can cause severe illness and even death. The species likely to cause life-threatening disease is P. falciparum.

Urine Routine and Microscopy test involve the three-part evaluation of the urine sample.

1. Gross Examination - It involves the visual examination of the urine sample for color and appearance.

2. Chemical Examination - It is done by urine dip-stick method which involves the use of reagent test strips. These test strips are dipped into the urine sample and the colors that develop are matched with the control for analysis. It is done to examine the urine sample for glucose, protein, pH, specific gravity, blood, nitrites, ketones, leukocyte esterase, bilirubin, and urobilinogen.

3. Microscopic Examination - It involves the examination of the urine sample under the microscope for casts, crystals, cells, bacteria, and yeast. 

A positive test result means the presence of an active COVID-19 infection. Most people have a mild illness and can get better safely at home without the need of hospitalization. Connect with your doctor if symptoms worsen or if you have questions or concerns.

A negative test result means the absence of an active infection at the time of sample collection. However, it doesn't mean you are safe for any length of time. You can get infected with COVID-19 and spread the virus to others any time after testing. 

If you test positive, stay home, separate yourself from others and keep in touch with your doctor.  If you test negative, continue to take measures to protect yourself and others from getting COVID-19.