Viral Hemorrhagic Fever: Test and Diagnosis

Laboratory parameters 1st order – obligatory laboratory tests – examination in a special laboratory (protection level 4)!

  • Chikungunya virus – pathogen detection from blood:
    • PCR, virus culture (in the first 3-5 days).
    • IgM, IgG detection from day 8-10.
  • Dengue virus:
    • DENV RNA – virus detection by PCR (polymerase chain reaction (PCR)* – between day 3-7 of illness.
    • Virus cultivation* – between the 3rd – 7th day of illness.
    • DENV NS-1 antigen (the NS1 protein is highly conserved within the four serotypes).
    • Antibody detection* DENV-specific IgG, IgM – from the 8th day of illness.
  • Ebola/Marburg virus – pathogen detection from blood:
    • PCR, virus culture in the acute phase.
    • IgM, IgG detection from week 4.
  • Corpus luteum virus – pathogen detection from blood:
    • PCR, virus culture in the acute phase.
    • IgM, IgG detection only after five to ten days.
  • Crimean Congo virus – pathogen detection from blood:
    • PCR, virus culture or electron microscopy in the acute phase.
    • IgM, IgG detection from the 10th day.
  • Lassa virus – pathogen detection from blood:
    • PCR, antigen EIA, virus culturing, electron microscopy in the acute phase.
    • IgM, IgG detection from the 10th day.
  • Rift Valley virus – pathogen detection from blood/tissue.
    • PCR, virus culture in the acute phase.
    • IgM, IgG detection
  • West Nile virus – pathogen detection from serum/liquor.
    • Direct virus detection by PCR (only 20-50% of samples PCR positive).
    • IgM and IgG at the earliest from the 7th day of illnessCaution: cross-reactive antibodies (TBE, dengue) titer rise (acute – convalescent).
  • Small blood count
  • Differential blood count
  • Inflammatory parameter – CRP (C-reactive protein)
  • Fasting glucose (fasting blood sugar)
  • Alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin [fever and transaminase elevation:
    • Brucellosis
    • Dengue fever
    • Hepatitides
    • Leptospirosis
    • Lymphotropic viral infections
    • Rickettsial infections
    • Syphilis (lues; typical: high alkaline phosphatase, AP).
    • Q fever
    • Rift Valley Fever
    • Viral hemorrhagic fever
    • Visceral leishmaniasis (when splenomegaly and pancytopenia (synonym: tricytopenia; reduction of all three cell series in the blood) are also present)]
  • Renal parameters – urea, creatinine, possibly cystatin C or creatinine clearance [VHF: renal involvement].
  • Coagulation parameters – PTT, Quick
  • Blood cultures