Biomarkers that could foretell dengue severity under study in Kerala

When a patient with dengue seems to be on the mend, doctors are often left waiting‑for‑the‑storm – a sudden bleed, a drop in blood pressure, or outright shock. Those dreaded turns happen without any obvious alarm, making it painfully hard to decide who needs close monitoring and who can safely go home.

That’s why a group of virologists and clinicians at the Institute of Advanced Virology in Thiruvananthapuram have rolled up their sleeves for a massive, prospective study. Their goal? To pin down a handful of biomarkers – measurable clues in the blood – that can shout “watch out!” long before the patient’s condition spirals.

So far, they’ve screened samples from 150 volunteers, and the findings are enough to keep the project moving. The next phase will involve around 2,000 confirmed dengue cases from three partner hospitals – Believers’ Church Medical College, Pushpagiri Institute of Medical Sciences, and the Government Medical College, Thiruvananthapuram. With each participant, the team will collect blood during the early febrile stage, then follow clinical outcomes for weeks.

Why does this matter so much in Kerala? The state battles dengue year after year, with seasonal spikes that swamp hospitals. During peak weeks, doctors are forced to triage thousands of feverish patients, often admitting only the most severe cases. Yet the very patients who look “stable” can slip into haemorrhagic shock without any of the WHO‑listed red‑flag symptoms – persistent vomiting, abdominal pain, mucosal bleeding, or lethargy.

Past research worldwide has chased similar signals – cytokine storms, platelet‑activating factors, viral load thresholds – but no single marker has proved reliable across diverse populations. The Kerala team hopes that a combination of several markers, perhaps a specific pattern of interleukins plus a drop in platelet‑derived growth factor, could serve as a practical bedside test.

In practice, if such a panel works, a simple blood draw on day three of fever could tell a physician whether to keep the patient under observation or safely discharge them. That would ease the burden on overcrowded wards and, more importantly, give families a clearer picture of what to expect.

Funding for the study comes from a blend of state health grants and a recent memorandum of understanding with the three medical colleges, which will handle sample collection and patient follow‑up. The researchers stress that while the work is ambitious, it’s still early days – validation will require larger, multi‑centre trials.

For now, the team continues to chase those elusive biochemical breadcrumbs, hoping that one day the “wait and see” approach will be replaced by a predictive, evidence‑based protocol. Until then, clinicians in Kerala and beyond must rely on vigilant clinical monitoring, even as science inches closer to a more precise answer.