Diagnostic challenge
Nosocomial transmission of dengue fever via needlestick. An occupational risk

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Background

Dengue fever is currently considered to be the most important arboviral cause of disease in humans, with a dramatic increase in incidence over the last 30 years. The dengue virus is a flavivirus with four antigenically distinct serotypes and is endemic in over 100 different countries in the Americas, Africa, Eastern Mediterranean, Western Pacific and Southeast Asia. This is a case report of the first documented case of dengue transmission via needlestick in the United Kingdom. Our case is of a

Investigations

A blood sample underwent urgent testing at the Virology laboratory at ICHNT using a rapid solid phase diagnostic test for dengue that was under evaluation (Dengue SD DUO), which was positive for dengue NS1 antigen but negative for dengue IgG and IgM, confirming the clinical diagnosis of acute dengue infection (Fig. 1).

The patient was treated with intravenous fluids and paracetamol in the Emergency Department and discharged with follow up arranged with the Infectious Diseases Team. Six weeks

Learning points

  • 1.

    Needlestick injury should be recognised as a potential mode of transmission of dengue fever.

  • 2.

    Serological assays for dengue fever performed in-house can be of value in providing a rapid diagnosis.

  • 3.

    Items of potential relevance elicited from the clinical history must be carefully considered, and if necessary discussed with the relevant specialists, even though they may present unusual scenarios.

Patient's perspective

The patient described in this case study consented to documentation of his occupation. He felt it was important to raise awareness of the risk of transmission of dengue via needlestick injury. Although it is rare, he felt that increasing awareness of the possibility of transmission via this mode would be beneficial to the healthcare community.

Conflict of interest

None.

Funding source

None.

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