Role of Goat Milk and Milk Products in Dengue Fever

Abstract

Dengue has become a major health problem in India. It is mainly transmitted to humans by Aedes aegypti
Introduction Dengue fever is the major introducing public health problem in India and worldwide, which infect several people annually and for which there is no effective therapy currently exist [1]. Dengue fever is a viral which is transmitted by Aedes mosquitoes to humans, normally 50 to 100 million cases occurring annually. The growing urbanization of populations is fail in controlling the spread of this disease by the mosquito vector. Now days, about two and half billion peoples are live in area where transmission of viral of one of the four serotypes of dengue virus can occur [2]. The disease is mostly found in South or Central America, also in some island of the Mexico, Caribbean and as well as tropical and sutropical areas [3, 4]. The infected mosquito that containing the virus, bite to a healthy person then the virus from the infected mosquito will enter through the body’s glands. After entering in the glands, these viruses will multiplies and can enter in to the bloodstream. Dengue virus have four serotypes, DEN 1, 2, 3 and 4; each virus is responsible for causing severe dengue and haemorrhagic syndrome [5-7]. Dengue fever affects the people of all age group, but especially in case of children under the age of 15 years. The infection which is caused by one dengue serotype will provides lifelong immunity but other remaining serotypes can eventually infect, several serotypes may be in circulation during epidemic [8- 10]. Dengue and dengue hemorrhagic fever may be an endemic in the sub-continent of Asian, it is declared by WHO. Now a day, dengue is endemic in 112 countries of the world [11]. Dengue is an effective mosquito-borne disease related to mosquito, which constitutes the etiological agents of the disease. So, for treating this disease goat milk and milk products are mostly preferred. Selenium (Se) is the main component of goat milk. Deficiency of Selenium and decrease in platelet count are the main complications of dengue fever. Goat milk as well as milk products are richest source of Selenium (Se) as comparison to cow and sheep milk. Goat milk also found to help with the digestive and metabolic utilization of various minerals.

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Mahendru Gunjan et . al. / JPBMS, 2011, 8 (06)
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JOURNAL OF PHARMACEUTICAL AND BIOMEDICAL SCIENCES
Role of Goat Milk and Milk Products in Dengue Fever
*Gunjan Mahendru1, P. K. Sharma1, V. K. Garg1, A. K. Singh1, S. C. Mondal1
Department of Pharmaceutical Technology, Meerut Institute of Engineering and Technology, Baghpat Bypass, NH-58, Meerut-
250005, Uttar Pradesh, India.
Abstract Dengue has become a major health problem in India. It is mainly transmitted to humans by Aedes aegypti
Introduction
Dengue fever is the major introducing public health
problem in India and worldwide, which infect several
people annually and for which there is no effective therapy
currently exist [1]. Dengue fever is a viral which is
transmitted by Aedes mosquitoes to humans, normally 50
to 100 million cases occurring annually. The growing
urbanization of populations is fail in controlling the spread
of this disease by the mosquito vector. Now days, about
two and half billion peoples are live in area where
transmission of viral of one of the four serotypes of
dengue virus can occur [2]. The disease is mostly found in
South or Central America, also in some island of the
Mexico, Caribbean and as well as tropical and sutropical
areas [3, 4]. The infected mosquito that containing the virus,
bite to a healthy person then the virus from the infected
mosquito will enter through the body’s glands. After
entering in the glands, these viruses will multiplies and
can enter in to the bloodstream. Dengue virus have four
serotypes, DEN 1, 2, 3 and 4; each virus is responsible for
causing severe dengue and haemorrhagic syndrome [5-7].
Dengue fever affects the people of all age group, but
especially in case of children under the age of 15 years.
The infection which is caused by one dengue serotype will
provides lifelong immunity but other remaining serotypes
can eventually infect, several serotypes may be in
circulation during epidemic [8- 10]. Dengue and dengue
hemorrhagic fever may be an endemic in the sub-
continent of Asian, it is declared by WHO. Now a day,
dengue is endemic in 112 countries of the world [11].
Dengue is an effective mosquito-borne disease related to
mosquito, which constitutes the etiological agents of the disease. So, for treating this disease goat milk and milk products
are mostly preferred. Selenium (Se) is the main component of goat milk. Deficiency of Selenium and decrease in platelet
count are the main complications of dengue fever. Goat milk as well as milk products are richest source of Selenium (Se) as
comparison to cow and sheep milk. Goat milk also found to help with the digestive and metabolic utilization of various
minerals.
Keywords: Dengue fever, Goat Milk, Milk Products, Selenium, Platelet Count.
*Corresponding Author
Gunjan Mahendru
Meerut Institute of Engineering and Technology, Baghpat
Bypass, NH-58, Meerut-250005, Uttar Pradesh, India.
Email: msgunjan.gunjan@gmail.com
Mobile No.: +91-7599050724
morbidity, mortality in the world [12]. Monocytes,
macrophages and mouse neural cells are the cellular
receptors, which are the main targets for the viral
infection [13]. The virus E-protein plays an important role
in attachment of virus to target cells and its interaction
with cellular receptors. In dengue fever, mainly decrease
in platelet counts takes place [14]. The several preventive
measures which can be taken by the person are use of
mosquito coils, discarding wastage, or by covering the
body when go outside [15]. The main symptoms which are
observed in the patients are high body temperature,
reddened eye, cold clammy skin and restlessness will feel
[16]. If platelet level drops (below 20,000) and there is
significant bleeding then platelet transfusion should be
provided. To prevent from dehydration high oral fluid is
prescribed [17]. Goat’s milk ranks fourth after cows,
buffaloes and sheep’s milk in terms of world milk
production. Although goat’s milk production was accounts
2.16% of the total world milk production. Goat-keeping
has a significant economic importance in countries where
climatic conditions are not favourable for cattle keeping.
Countries around the Mediterranean region have the most
developed dairy goat industries, with France, Greece,
Spain and Italy among the main goats' milk-producing
countries. There has been an increased interest for goats'
milk production and conversion to value-added products
was found in the last decade. Changes in social attitudes
and increased frequency of travel have resulted in greater
consumer awareness and demand for gourmet foods. Goat
milk is an alternative milk source for those people who
have cow’s intolerance found in recent years [18]. Goat milk
and milk products helps in the digestive and metabolic
utilization of many types of minerals which are iron,
calcium, phosphorous and magnesium [19]. Goat milk is
mainly prescribing to dengue patients to maintain body
fluid balance because transfusion of platelets is not
possible from outside in all cases [20]. Biliary secretion of
cholesterol increased by goat milk diet and it decrease the
ISSN NO- 2230 - 7885
Review Article

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2 Journal of Pharmaceutical and Biomedical Sciences (JPBMS), Vol. 08, Issue 08
plasma cholesterol levels, but phospholipids, biliary acid
and lithogenic level remain same [19]. On comparison of
goat and cow milk it was observed that goat milk have
more than 2.5 times the Se powdered infant formula
(19.98 mg/l vs. 7.47 mg/l) and nearly 35% greater than
pasteurized cow milk (19.98 mg/l vs 14.85 mg/l) present
[21]. Dietary goat milk increases the iron bioavailability
which helps in recovery from haematological parameter
after ferropenic nutritional anaemia by increasing the Fe
deposition in the target organs [22]. Better recovery with
goat milk was seen in case of ferropenic anaemia and bone
demineralisation. Positive effect on metabolism of
minerals shows by goat milk [23]. Se deficiency also causes
an irreversible cardiomyopathy [24]. In case of auto-
immune disease Se control the human immune system by
upgrading it when necessary and degrading it when it is
overactive. Se also prevents the replication of virus. T cell
and interleukin both are the important component of
immune system and Se help by increasing the function of T
cell or by modulating the production of interleukin [25].
Composition of goats' milk
There are many factors like parity, season, breed, stages of
lactation, nutritional and environmental which affect the
composition of goat milk [26]. In goat milk more than 27%
selenium is present as compared to cow milk [27]. Large
difference in composition was seen in the single animals of
the same breed which is related to an extensive and
complex genetic polymorphism of the goats' milk casein
[28]. Five principal proteins are present in goat milk α-
lactalbumin, β-lactoglobulin, κ-casein, β-casein, and αs2-
casein [29].
Difference between Goat mIlk over Cow Milk
Goat milk in reality is very safe product in many important
ways and naturally homogenized. Goat milk is very easy to
digest than cow milk and in goat milk, lesser amount of
proteins molecules are present than cow milk and fat
molecules in goat milk have thinner, more fragile
membrane or half of the size of those in cow milk [30].
Difference in composition between cow and goat milk are
given in (Table 1).
Table 1: Difference in composition between goat and cow milk [31, 32, 33,
27].
Biochemistry and Processing of Goat Milk and
Other Milk Products
When goat milk is used single or mixed with other animal
milk such as cow or buffalo, then it give various valuable
products such as dried milk product, ghee (clarified butter
fat), dahi (curd), yogurt, khoa (heat-desiccated milk
product), channa (acid and heat coagulated milk product),
and cheese (paneer, cheddar, mozzarella and gouda) [34].
Beneficial Effects of Goats Milk to Health than
Cow’s Milk in Case of Dengue
On comparison of goat’s milk with cow’s milk it was
observed that goat milk help in the digestive and
metabolic utilization of several minerals such as Fe,
calcium, phosphorous and magnesium and it also help in
prevention of various diseases like anaemia and bone
demineralization. In case of ferropenic anaemia and bone
demineralisation better recovery with goat milk was seen.
Goat milk also has positive effect on metabolism of
minerals [23]. It is also used as a substitute for the patients
who are allergic to cow milk [35].
Role of Selenium (Se) in Dengue Fever
Selenium(Se) is also called by the name selenoprotein, it is
the one of the most essential micronutrient which is
incorporated in to about 25 proteins. Mostly
selenoproteins are act as enzymes, they protect from
cellular damages which is caused due to the formation of
by-product of oxygen metabolism because of its
antioxidant property [36, 24]. Se-enriched product, milk
product, plant food that are grown in Se rich soils and
animals that graze on this soils are the main dietary
sources of this micronutrient [37].
Selenium(Se) shows its effect on the thromboxane /
prostacycline ratio, because of this nature it shows role in
the regulation of blood clotting and it also shows its effects
on the complement system. Se has an anticlotting effect
where as, thrombotic or proclotting effects are mainly
observed due to the Se deficiency. Haemorrhagic effects in
animals are mainly associated with the extreme dietary Se
deficiency which is never seen in humans [38]. The
replication of virus is prevent by Se, T cell and interleukin
both are the important component of immune system and
Se help by modulating the production of interleukin or by
increasing the T cell function [25]. The main mechanism of
causing severity in host pathology and viral mutations
mainly remains unknown. Oxidative stress and host
immune response are the causes of Se deficiency [39, 40]. By
incorporation of Se as selenocysteine in GPx, helps
significantly help immune responses of host and
antioxidant protection [41]. Increased of harmful effect and
development of viral quasispecies are also leads to the
deficiency of Se [42, 43]. Se containing food pills and animal
product may prevent human being from Se deficiency [37].
Structure of Dengue Virus
The structure of dengue virus has been developed by the
help of using combination of cryoelectron microscopy and
by setting the structure of glycoprotein E into the electron
density map which permit the visualization of various
component of several proteins [44, 45]. For the specific
encapsidation of the RNA genome C protein is most
essential of the dengue virus [46]. On the entering of
envelope glycoprotein E of the dengue virus will binds to
the receptor and by rearrangement or reducing the pH of
an endosome it show its action. Fusion between viral and
host cell membrane will produce by conformational
changes [47]. E protein of dengue virus is glycosilated and it
favours the fusion with cell membrane by showing its
attachment to the cellular receptors [14].
Symptoms and Diagnosis of Dengue Fever
Dengue is an infection of short duration; it shows several
symptoms like rashes, headache, fever and severe pain in
the muscles and joints during an incubation period of 5-8
Constituents
Goat
Cow
Protein (%)
3.4
3.2
Lactose (%)
4.1
4.7
Fat (%)
3.8
3.6
Ash (%)
0.77
0.71
Vitamin A (I.U)
120
158
Vitamin B1 (mg)
0.05

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days, recovery is commonly seen although convalescence
may be long. In case of more severe form, internal
bleeding and severe dengue shock syndrome are produced
mostly in infants and young children [48, 49]. On high fever,
temperature as high as 104°F, reddened eyes, weak rapid
pulse, cold clammy skin and restlessness will feel. Renal
impairment, meningo-encephalities and change in the
function of many organs will occur due to the dengue
infection [16]. Primary infection of this result is a self-
limiting disease which is ranges from mild to high fever
lasting up to 3 to 7 days, severe headache with pain behind
the eyes, muscle, joint pain and rash also observed [50, 51].
Secondary infection is the common form of dengue virus
serotype; the main clinical symptoms are high fever,
hemorrhagic events, circulatory failure and fatality rate, if
proper treatment is not given to the patient than may die
within 12 to 24 hr [52]. After the onset of symptoms,
increase in specific IgM was seen with in 3 to 5 days which
generally persists for 30 to 60 days [53]. After 10 to 14 days
of infection increase in IgG level observed, and it can be
detectable for life, through at a haemaglutination
inhibition assay, during secondary infection IgG levels
generally increase more slowly and then come at lower
level in primary infection, but IgG level increased rapidly
from 1 to 2 days after the onset of symptoms [52].
Diagnosis of dengue fever can be done by various methods
for the detection of level of immunoglobulin IgG and IgM
like: Haemagglutination Inhibition Assays (HAI):
Traditionally acetone or kaolin treated method was used
for diagnosing sera which requires collection of sera 7
days apart variance in terms of haemagglutinin potency,
but this method resulted in several doubts as assessed in
terms of general applicability [52, 54].
ELISA: Serial dilution is not required in case of pre-
treatment; diagnosis can be performed from a single
serum specimen [54]. For each test sample the number of
antibody unit was calculated by this formula [55].
OD (Test) – OD (NC)*
OD (Weak PC) **- OD (NC)
X 100
*NC: Negative control, **Weak PC: Weak positive control
Treatments
To get prevention from this disease no accurate vaccine
treatment is available. By taking some rest, increasing oral
fluid intake and by using acetaminophen in about 2 weeks
to a month people may recover from this infection, but
never recommend an aspirin to the patients because it
may increases the risk for severe bleeding. If patient is not
able to take oral fluid then supplementation can be done
with intravenous fluids which help in prevent from
dehydration and maintain concentration of blood. If the
level of platelet drops (below 20,000) or if significant
bleeding occurs then platelet transfusion should be given.
Goat milk and milk products are also recommended for
those severe cases. Platelet or red blood cell transfusion is
given in the presence of melena; indicate gastrointestinal
bleeding [56, 17].
Preventive Measures to Control Dengue Fever
1.Use mosquito coils and electric vapors mats during the
day to prevent from dengue.
2.Discard all wasted items getting gathered around the
living area to avoid the breeding of mosquitoes.
3.Patients suffering from dengue-fever must be isolated
for at least 5 days.
4.Keep the water stores clean and closed.
5.Keep yourself well covered when outside.
6.Take prompt medical advice once fevers starts [15, 57].
Conclusion
For treating dengue fever goat milk and milk products are
very helpful because they directly modulate the human
immune system. In this review it can be concluded that the
dengue fever is managed with goat milk and its products.
Conflict of interest
There is no conflict of interest among authors.
References
1.Xu T, Sampath A, Chao A, Wen D, Nanao M, Chene P,
Vasudevan SG and Lescar J. Structure of the Dengue Virus
Helicase/Nucleoside Triphosphatase Catalytic Domain at a
Resolution of 2.4 Å. J. Virol. 2005; 79(16): 10278-88.
2.Phillips ML. Dengue Reborn: Widespread Resurgence of
a Resilient Vector. Environ Health Perspect. 2008; 116(9):
A382-A88.
3.Gubler DJ and Trent DW. Emergence of epidemic
dengue/dengue haemorrhagic fever as a public health
problem in the Americas. Infect Agents Dis. 1994; 2(6):
383-93.
4.Uzcategui NY, Comach G, Camacho D, Saludo M, Quintana
MCD, Jimenez M, et al. Molecular epidemiology of dengue
virus type 3 in Venezuela. J Gen Virol. 2003; 84(6): 1569-
75
5.Gubler DJ. Dengue Viruses. Encyclopedia of Virology.
2008: 5-14.
6.Stephen H W MPH and Gubler D J. Dengue Fever. Clin.
Dermatol. 1989; 7(1): 117-22.
7.Henchal E A and Putnak J R. The dengue viruses. Clin
Microbiol Rev. 1990; 3(4): 376-96.
8.Chaturvedi UC and Shrivastava R. Dengue haemorrhagic
fever: global challenge. Indian J Med Microbiol. 2004;
22(1): 5-6.
9.Franchini G, Ambinder RF and Barry M. Viral disease in
hematology. Hematol. 2000; 1: 409.
10.Bharaj P, Chahar H S, Pandey A, Diddi K, Dar L, Guleria
R et al.,Concurrent infection by all four dengue virus
serotypes during an outbreak of dengue in 2006 in Delhi,
India. Virol J. 2008; 5: 1.
11.Guzman MG and Kouri G. Dengue. Lancet Infect Dis.
2002; 2(1): 33–42.
12.Hemingway J, Beaty BJ, Rowland M, Scott TW and Sharp
BL. The innovative vector control consortium: improved
control of mosquito borne disease. Trends Parasitol. 2006;
22(7): 308-12.
13.Jorge RDV, Salvador CS, Fernando M and Rosa MDA.
Heat Shock Protein 90 and Heat Shock Protein 70 Are
Components of Dengue Virus Receptor Complex in Human
Cells. J. Virol. 2005; 79(8): 4557-67.
14.Kurane I. Dengue hemorrhagic fever with special
emphasis on immunopathogenesis. Comp. Immun.
Microbiol. Infect. Dis. 2007; 30: 329-40.
15.Fradin MS and Day JF. Comparative efficacy of insect
repellents against mosquito bites. N Engl J Med. 2002;
347(1): 13–18.

Mahendru Gunjan et. al. / JPBMS, 2011, 8 (06)
4 Journal of Pharmaceutical and Biomedical Sciences (JPBMS), Vol. 08, Issue 08
16.Anthony SY, Wong KT, Trishe YML, Puay HT, Pong SW.
The pathology of dengue hemorrhagic fever. Semin Diagn
Pathol. 2007; 24(4): 227-36.
17.Dengue Fever. The Bali Weekly Posted on 4 march
2010.
18.Goat milk a tziboula-clarke. Encyclopedia of dairy
sciences. 1270-79.
19.Aliaga IL, Castro JD, Alferez MM, Barrionuevo M,
Campos MS. A review of the nutritional and health aspects
of goat milk in cases of intestinal resection. Dairy Sci.
Technol. 2010; 90(6): 611-12.
20.Dengue cure rumour spikes goat milk price. India
Today. Available from:
http://indiatoday.intoday.in/site/story/delhi-clinics-
sting-dengue-patients/1/115926.html.
21.Rodriguez EM, Alaezos S, Romero DC. Chemometris
studies of several minerals in milks. J. Agric. Food Chem.
1999; 47(4): 1520–24.
22.Maria JMA, Inmaculoda LA, Teresa N, Javier DC,
Mercedes B, Patricia BR and Margarita SC. Dietary goat
milk improves iron bioavailability in rats with induced
ferropenic anemia in comparison with cow milk. Int Dairy
J. 2006; 16(7): 813-21.
23.Science Daily. Available from:
http://www.sciencedaily.com/releases/2007/07/070730
100229.htm. 2007.
24.Morgan KC, Esteveg AO, Muller CL, Valadez BC, Vizuete
AM, Szewczyk NJ et al. The glutaredoxin GLRX-21
functions to prevent selenium-induced oxidative stress in
caenorhabditids elegans. Toxicol. Sci. 2010; 118(2): 530-
43.
25.Goldenberg RL. The Plausibility of Micronutrient
Deficiency in Relationship to Perinatal Infection. J. Nutr.
2003; 133(5): 1645S-1648S.
26.Ozrenk E, Inci SS. The effect of seasonal variation on the
composition of cow milk in van province. Pakistan J
Nutrition. 2008; 7(1): 161-64.
27.Belewu MA and Adewole AM. Goat milk: A feasible
dietary based approach to improve the nutrition of orphan
and vulnerable children. Pakistan J Nutrition. 2009; 8 (10):
1711-14.
28.Jenness R. Composition and Characteristics of Goat
Milk. J Dairy Sci. 1980; 63(10): 1605-63.
29.Wal JM. Structure and function of milk allergens. Eur. J.
Allergy Clin. Immunol. 2001; 56(67): 35–38.
30.Attaie (2000) and Jensen. Goat milk magic: one of life’s
greatest healing foods. J. Dairy Sci. 1994; 83: 940-44.
31.Haenlein GFW and Caccese R. Difference between cow
and goat milk. United Caprine News available from:
http://HealthNews- NZ.Com. 1989.
32.Eddleman H. Composition of human, cow and goat milk.
Draft 1 available from: http://GoatWorld.com. 1999.
33.Maree HP. Goat milk and its use as a hypo-allergenic
infant food. Dairy Goat Journal. Available from:
http://goatconnection.com/articles/publish/article_152.s
html. 1978.
34.Agnihotri MK and Prasada VSS. Biochemistry and
processing of goat milk and milk products. Small Ruminant
Res. 1993; 12(2): 151-70.
35.Park YW. Hypo-allergenic and therapeutic significance
of goat milk. Small Ruminant Res.1994; 14: 151-59.
36.Moghadaszadeh B and Beggs AH. Selenoproteins and
their impact on human health through diverse
physiological pathways. Physiol. 2006; 21(5): 307-15.
37.Gupta C, Gupta UC and Subhas. Selenium deficiency in
soils and crops and its impact on animal and human
health. Curr Nutr Food Sci. 2010; 6(4): 268-80.
38.Ramnathan CS and Taylor EW. Computational genomic
analysis of hemorrhagic fever virus viral selenoproteins as
a potential factor in pathogenesis. Biol Trace Elem Res.
1997; 56(1): 93-106.
39.Saito Y, Yoshida Y, Akazawa T, Takahashi K and Niki E.
Cell death caused by selenium deficiency and protective
effect of antioxidants. J. Biol. Chem. 2003; 278(41): 39428-
34.
40.Prabhu KS, Zamamiri DF, Stewart JB, Thompson JT,
Sodillo LM and Reddy C. Selenium deficiency increase the
expression of inducible nitric oxide synthase in RAW 264-
7 Macrophage: role of nuclear factor- kappa B in up
regulation. Biochem J. 2002; 366: 203-09.
41.Verma S, Molina Y, Lo YY, Cropp B, Nakano C,
Yanagihara R et al. In vitro effect of selenium deficiency on
west nile virus replication any cytopathogenicity. Virol. J.
2008; 5: 66.
42.Akaike T, Fujii S, Kato A, Yoshitake J, Miyamoto Y, Sawa
T, et al. Viral mutation accelerated by nitric oxide
production during infection in vivo. FASEB J. 2000; 14(10):
1447-54.
43.Beck MA and Levander OA. Host nutritional status and
its effect on viral pathogen. J Infect Dis. 2000; 182(1): S93-
6.
44.Christopher TJ, Lixin M, John WB, Teresa DG, Carol BP
and Richard JK. Flavivirus capsid is a dimeric alpha- helical
protein. J Virol. 2003; 77(12): 7143-49.
45.Kuhn JR, Zehang W, Rossmann MG, Pletnev SV, Corver
J, Lenches E, et al. Structure of dengue virus: implications
for flavivirus organization, maturation, and fusion. Cell.
2002; 108(5): 717-25.
46.Lixin M, Christopher T J, Teresa D G, Richard K T and
Carol B P. Solution structures of dengue virus capsid
protein reveals another fold. Proc Natl Acad Sci U S A.
2004; 101(10): 3414–19.
47.Yorgo M, Steven O, David C and Stephen CH. Structure
of the dengue virus envelope protein after membrane
fusion.Nature. 2004; 427: 313-19.
48.Halstead SB. Selective primary health care: strategies
for control of disease in the developing world. XI. Dengue.
Clin Infect Dis. 1984; 6(2): 251-64.
49.Siler JF, Milton WH and Hitchens AP. Dengue in Its
History, Epidemiology, Mechanism of Transmission,
Etiology, Clinical Manifestations, Immunity, and
Prevention. Philippine J Sci. 1926; 29: 1-302.
50.Monath TP and Heinz FX. Flaviviruses. In B. N. Fields, D.
M. Knipe, and P. M. Howley (ed.), Virol. 1996; 1016-21.
51.Nimmannitya S. Clinical management of dengue
fever/dengue haemorrhagic fever/dengue shock
syndrome. Dengue Bull. 1996; 20: 13-19.
52.Sang CT, Hoon LS, Cozzubbu A and Peter D. Clinical
Evaluation of a Rapid Immunochromatographic Test for
the Diagnosis of Dengue Virus Infection. Clin. Diagn. Lab.
Immunol. 1998; 5(3): 407-09.
53.Lam SK. Rapid dengue diagnosis and interpretation.
Malays J Pathol. 1993; 15(1): 9-12.
54.Vaughn WD, Nisalak A, Kalyanarooj S, Solomon T, Dung
NM, Cuzzubbo A, et al. Evaluation of a rapid
Immunochromatographic Test for diagnosis of dengue
virus infection. J Clin Microbiol. 1998; 36(1): 234-38.

Mahendru Gunjan et. al. / JPBMS, 2011, 8 (06)
5 Journal of Pharmaceutical and Biomedical Sciences (JPBMS), Vol. 08, Issue 08
55.Sathish N, Vijayakumar TS, Abraham P and Sridharan G.
Dengue Fever: Its laboratory diagnosis, with special
emphasis on IgM detection. Dengue Bull. 2003; 27: 116-25.
56.Perez JGR, Clark GG, Gubler DJ, Reiter P, Sander EJ and
Vorndam AV. Dengue and dengue haemorrhagic fever. The
Lancet. 1998; 352: 971-77.
57.Ibrahim NK, Abalkhail B, Rady M, Al- Bar H. An
Educational Programme on dengue fever prevention and
control for females in jeedah high schools. East. Mediterr.
Health J. 2009; 15(5): 1058-67.
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