Every dengue season the same thing happens: a patient tests on day one, the result says negative, and everyone relaxes — until day five. The test was not wrong. It was simply too early or too late for what was ordered.
The rule: which test, which day
- Day 1 to day 5 of fever — NS1 antigen. The virus itself is detectable in this window.
- Day 5 onwards — IgM and IgG antibodies. The body has had time to make them by now.
- Every visit — a complete blood count. Falling platelets and a rising haematocrit are what actually guide treatment.
Count the days from when the fever started, not from when you decided to see a doctor.
Warning signs — come in immediately
The dangerous phase of dengue usually begins as the fever falls, around day four to six. That is exactly when families relax. Come in at once if there is:
- severe or continuous abdominal pain
- persistent vomiting, or inability to keep fluids down
- bleeding from the gums or nose, black stools, or heavy menstrual bleeding
- restlessness, drowsiness or confusion
- cold, clammy hands and feet, or passing very little urine
What helps at home
- Fluids, steadily. Oral saline, coconut water, rice water, soups. Small amounts often beats a large glass occasionally.
- Paracetamol only for fever and pain.
- Never ibuprofen, diclofenac, aspirin or any other painkiller in a suspected dengue case — they add to the bleeding risk.
- Rest and a mosquito net — a patient with dengue who is bitten spreads it to the household.
Platelet transfusion is needed far less often than people expect; the decision is clinical, not a number on a page. Let the treating doctor make it.
Our laboratory runs NS1, dengue antibodies and blood counts with same-day reporting, and our Fever Panel groups dengue, typhoid, malaria and infection markers into one collection so an answer does not wait.
