Dengue count mounts,hospitals locked in tussle with MCD over diagnostic tests

Hospitals say the MCD is ignoring positive results of NS-1 antigen tests,and only considering cases confirmed by IgM antibody tests. While the antigen tests give a faster diagnosis,showing results on the second or third day of the fever,the IgM antibody tests confirm the issue only by the sixth day.

However,MCD authorities maintain that hospitals are not carrying out correct antigen tests. According to Dr V K Monga,chairperson of MCD health committee,“Hospitals are employing the NS1 rapid antigen tests,when the National Programme and the Delhi government have only sanctioned the ELISA test. The rapid test cannot be considered to be confirmatory.”

However,hospital authorities denied Monga’s contention. Dr S P Byotra,senior consultant in medicine from Sir Ganga Ram Hospital,said,“As per the directive,we have been doing NS-1 antigen tests. After the dengue outbreak last year,the mandate was clear. We needed faster diagnosis.”

Dr R K Singhal,head of internal medicine at BL Kapur Hospital,said no hospital was conducting the NS-1 rapid tests on patients. “All established hospitals use the NS-1 ELISA test because the rapid test is absolutely unreliable. We report cases daily,but the MCD either wants to do its own confirmatory tests,or asks for results of serological tests. Now,not many patients want to go for double-testing,” he said.

From this year,the NS-1 antigen test has been introduced in the national programme,and government hospitals have also started using it. According to a consultant in medicine at AIIMS,“The main symptom of dengue is fever. We tell patients that if they want a confirmatory test in the first four days,we can go for an NS-1 test. But if they would rather wait for five days,we go for antibody tests. An early diagnosis is good but,in terms of treatment,there is nothing extra we do in the first few days.”

Dr Khushali Ratra,medical superintendent of the Jaipur Golden Hospital,said MCD authorities had visited the hospital last month,and confirmed that NS-1 tests could be used. “There was a lot of confusion a few months ago,when MCD started asking for serological tests. But now we have been specifically told that NS-1 tests can be used. This makes no sense.”

AIIMS Microbiology department has begun testing the strains of the dengue virus,to identify which of the four strains is prevalent this year.