Dengue viral infection in forensic autopsy cases (1/2) - Establishment of rapid dengue diagnostic process and molecular pathology test 

The 2015 dengue outbreak was severe in Taiwan. Institute of Forensic Medicine, Ministry of Justice performed 16 suspicious dengue forensic autopsy cases in the period and 6 cases were dengue viral antigen positive. The purpose of this project is to detect dengue virus infection in infected areas and develop dengue serologic testing and the diagnosis of molecular pathology. In the first year of the project, we established rapid dengue diagnostic test for forensic cases and the diagnostic techniques of molecular pathology, including immunohistochemistry and in situ hybridization. Retrospective 15 suspicious case studies from 2008 to 2013 and 2016, only two cases dengue IgG antibody was positive. We established the standard of procedure for suspicious dengue infection diagnosis and dengue virus infection formalin-fixed tissue and paraffin block bank. In 2017, Taiwan Med-X was reported 48 cases. We continued detect the dengue virus infected cases and retrospective analysis in forensic autopsy. To study the 6 dengue virus infected cases to realize pathogenesis of dengue virus. It provides precise evidences for the diagnosis of microbial forensics and clarification of the cause of death and elevates the ability of forensic pathological diagnosis. In addition, the operation of Taiwan Med-X surveillances epidemic of infectious diseases and provide the information for health policy.

Keywords: dengue, Taiwan Med-X, serologic testing, molecular pathology, forensic autopsy

Dengue viral infection in forensic autopsy cases (2/2)–serology and molecular pathology study

The 2015 dengue outbreak was severe in Taiwan. Institute of Forensic Medicine, Ministry of Justice performed 16 suspicious dengue forensic autopsy cases in the period and 6 cases were dengue viral antigen positive. The epidemic of infectious diseases was monitored by Taiwan Centers for Disease Control. In the aspect of judicial case often became a loophole of epidemic prevention if the judicial units didn’t report it. The project is a two years plan. We established dengue virus rapid diagnostic test and molecular pathology diagnostic techniques, including immunohistochemistry and in situ hybridization. We completed the standard of procedure for suspicious dengue virus infection diagnosis in forensic autopsy cases. We analyzed 69 cases that had fever or hemophagocytosis before death from 2008 to 2018 and further performed blood or molecular pathology tests. In order to realize the mechanism of dengue virus infection, we used the immunohistochemistry technique and found hemophagocytosis and emperipolesis both in bone marrow of positive case. We collected 76 cases (10positive) in dengue virus infection formalin-fixed tissue bank. Taiwan Med-X system reported 48 cases in 2017 and 19 cases in 2018. It provides precise evidences for the diagnosis of microbial forensics and clarification of the cause of death and elevates the ability of forensic pathological diagnosis through this project. In addition, the operation of Taiwan Med-X surveillances epidemic of infectious diseases and provide the information for health policy.

Keywords: dengue, Taiwan Med-X, serologic testing, molecular pathology, forensic autopsy