What are the World Health Organization's (WHO) minimum criteria for diagnosing dengue fever?

From the Guidelines

The World Health Organization (WHO) minimum criteria for diagnosing dengue fever include fever and any two of the following: thrombocytopenia (platelet count ≤100,000 cells/mm³), hemorrhagic manifestations, or hepatomegaly 1.

Key Criteria

• Fever is a required criterion
• Any two of the following are also required:
  • Thrombocytopenia (platelet count ≤100,000 cells/mm³)
  • Hemorrhagic manifestations
  • Hepatomegaly Specifically, the presence of fever and thrombocytopenia are essential components of the WHO minimum criteria for diagnosing dengue fever, as they are commonly observed in patients with dengue fever 1.

Laboratory Diagnosis

Laboratory diagnosis of dengue fever can be performed using various methods, including:

• Serology: Serum samples can be tested for the presence of dengue virus-specific antibodies 1
• NS1 antigen: Serum samples can be tested for the presence of the dengue virus NS1 antigen, which is secreted from infected host cells as early as 1 day after symptom onset and up to 10 days thereafter 1
• NAAT: Nucleic acid amplification tests (NAAT) can be used to detect dengue virus RNA in serum or plasma samples, and is preferred for acutely ill patients 1 It is worth noting that while these laboratory tests can aid in the diagnosis of dengue fever, they should be used in conjunction with clinical findings to confirm the diagnosis 1.

From the Research

Minimum Criteria for Diagnosing Dengue Fever

The World Health Organization (WHO) has established criteria for diagnosing dengue fever. According to the studies 2, 3, 4, 5, 6, the minimum criteria for diagnosing dengue fever are not explicitly stated. However, the WHO classification schemes are described in the studies.

WHO Classification Schemes

The WHO has two classification schemes for dengue:

• The 1997 scheme, which classifies dengue into dengue fever (DF) and dengue hemorrhagic fever (DHF) 2, 5, 6
• The 2009 scheme, which classifies dengue into three categories: dengue without warning signs, dengue with warning signs, and severe dengue 3, 4, 5, 6

Key Features of Dengue Fever

Some key features of dengue fever include:

• Leukopenia and thrombocytopenia 4
• Joint pain, higher temperatures, and absence of crackles on examination in adults 4
• Sore throat, fatigue, oliguria, and elevated hematocrit and transaminases in children 4
• Plasma leakage and bleeding 2, 3

Limitations of the WHO Classification Schemes

The studies highlight some limitations of the WHO classification schemes, including:

• Low specificity of the 2009 scheme 4, 5
• Poor diagnostic accuracy of the clinical criteria 5
• Need for modification of the classification schemes to improve accuracy 3, 5