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Concern: NON-REACTIVE results on suspected Dengue Patients

Requested by: Dr. Emy Sangalang

All request were subjected to proper procedure by the MTOD as required and stated by the inserts of SD
Dengue NS1 + Ab Combo and Bio Tracer Dengue IgG/IgM Rapid Card.

Bio Tracer Dengue IgG/IgM Rapid Card Exp Date: 12-2017

1. Add 5ul of specimen (serum, plasma or whole blood) to sample well
2. Add 4 drops of sample diluent to diluent well
3. Read after 15 – 20 minutes
SD DENGUE NS1 + Ab Combo Exp Date: 01-2018
1. Add 100ul of serum, plasma or whole blood into sample well
Ab Combo
1. Add 10ul of serum, plasma or whole blood into sample well marked “S”
2. Put 4 drops of assay diluent into the round-shaped assay diluent well
READ after 15-20minutes

All of this procedure was done properly and accurately by MTODs.

With regards to the concern of NON-REACTIVE results with marked platelet drops, we can correlate it to the
indications and principle of the procedures:

Bio Tracer Dengue IgG/IgM Rapid Card

Principle: Immunochromatography
In-vitro test for the qualitative determination of dengue virus specific IgG or IgM
***If antibodies against dengue are present enough in the sample, a colored band of dengue IgG/IgM in
the test zone will appear. If there are no antibodies or not sufficient in the sample, the area will remain colourless.
The sample continues to move to the control reaction zone and forms a red or purple colour, indicating the test is
working and result is valid

SD DENGUE NS1 + Ab Combo

Principle: Immunochromatography
In-vitro test designed to detect both Dengue NS1 Dengue virus and differential IgG/IgM
antibodies for detection in acute dengue infection.
Limitation of the Test:
1. A negative result can occur if the quantity of Dengue virus NS1 antigen is present in the
specimen is below the detection limits of the assay, or the antigens that are detected by the
test are not present during the stage of disease in which sample is collected
2. A negative result cannot exclude a recent infection
3. In early infections and some secondary infections, detectable levels of IgM antibodies may be
low. Some patients may not produce detectable levels of IgM antibodies within the first seven
to 10 days after infection. Where symptoms persist, patients should be re-tested 3 – 4 days
after the first specimen.

Factors to consider:
1. Date of examination after disease / antigen exposure
2. Quantity of antigen and antibodies in the specimen
3. Other diseases to consider : Chikungunya