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What counts as a dengue case, when to admit and refer, and how to report. The first two sections summarise DEAG's current documents and name the revision; the third lists those documents. The linked document is always the authoritative copy.
Case classification
Summary of Dengue Expert Advisory Group (DEAG) · Revised February 2026
These revised criteria were issued by DEAG for the epidemic period, superseding the previous inter-epidemic criteria. The suspected and probable case definitions are unchanged; the confirmation criteria were revised for the epidemic phase.
Suspected case
Presence of 3 or more clinical criteria — fever of 2 to 10 days duration (essential criterion) and two of the following:
- Headache
- Retro-orbital pain
- Myalgia
- Arthralgia / severe backache / bone pains
- Rash
- Bleeding manifestations (epistaxis, hematemesis, bloody stools, menorrhagia, hemoptysis)
- Abdominal pain
- Decreased urinary output despite adequate fluid intake
- Irritability in infants
Probable case
Suspected case with both supportive laboratory findings:
- Thrombocytopenia ≤ 100,000/mm³
- Leukopenia ≤ 4,000/mm³
Confirmed case
Probable case with any one of the confirmatory findings:
- Detection of viral antigen (NS1 antigen in blood)
- Detection of virus by PCR
- Detection of IgM
- Demonstration of a four-fold or greater rise in IgG antibody titre in paired acute and convalescent serum
Laboratory tests for IgM, IgG and NS-1 by ELISA, using a kit covering all four dengue serotypes (DEN-1 to DEN-4).
Current dengue advisories for District Rawalpindi
Source: Criteria for Diagnosis of Dengue Fever (epidemic), revised February 2026
Reviewed by District Coordinator EP&C · As per DEAG/Punjab guidelines, current as of October 2026
Referral guidance
Summary of Dengue Expert Advisory Group (DEAG) · Revised April 2026
All suspected, probable and confirmed dengue patients with any warning sign or a platelet count below 70,000/mm³ must be admitted to hospital for careful monitoring and management. The two blocks after the criteria — where to refer, and how to notify — are DHA Rawalpindi's and the statute's, not DEAG's.
Warning signs
- HCT < 30 % or > 50 %
- No clinical improvement / worsening clinical parameters
- Persistent vomiting
- Severe abdominal pain
- Shortness of breath
- Lethargy and/or restlessness
- Giddiness
- Pale cold clammy extremities
- Bleeding (epistaxis, gum bleed, bloody stools, hematemesis, hemoptysis, menorrhagia, hematuria)
- Pulse pressure < 25 mmHg
- Capillary refill time more than 2 seconds
- Less/no urine output for 4–6 hours
- Patients with uncontrolled co-morbidities may be evaluated carefully for possible admission.
Also admit
DEAG's report forms (Form O and Form R, revised March 2026) list two further admission triggers beside a warning sign or a platelet count under 70,000/mm³:
- Ultra Sound (suggestive of leak)
- Vulnerable groups — Infant < 01 year · Elderly > 65 years · Pregnancy (Any trimester) · Co-morbids (Uncontrolled) · Immunocompromised · Living alone
Where to refer
Tertiary care hospitals named in DHA Rawalpindi's referral guidance for dengue:
- Holy Family Hospital (HFH)
- Benazir Bhutto Hospital (BBH)
- DHQ Hospital
Send a completed form with every referral: Referral Form (primary care providers → tertiary care hospital) · September 2022 · PDF
The form is DEAG's September 2022 instrument: its own per-parameter thresholds predate the April 2026 criteria above, so use it to refer, not to decide.
- All efforts made to optimize the patient's condition before and during transfer.
- The Emergency Department and/or Medical Department of the receiving hospital informed prior to transfer.
Rawalpindi Medical University-affiliated tertiary care hospitals, not DHA facilities.
How to notify
Private hospitals and laboratories must report dengue cases to the district health authorities within one hour of knowledge.
Punjab Infectious Diseases (Prevention and Control) Act 2020; Dengue (Temporary) Regulations 2011/2016, regulation 10(2).
- Report suspected and probable cases on DEAG Form R.
- For confirmed cases, fill the Dengue Case Report Form and report to the dengue dashboard, so the case status changes from suspected or probable to confirmed.
Reporting form: DEAG Form R · Revised, March 2026 · PDF
DHA Rawalpindi office: (051) 4831799
Source: Revised DEAG Admission Criteria for Dengue (epidemic), revised April 2026
Reviewed by District Coordinator EP&C · As per DEAG/Punjab guidelines, current as of October 2026
DEAG resources
- DEAG Form O
Issuing body: Dengue Expert Advisory Group (DEAG)
Version: Revised, March 2026 · PDF
- DEAG Form R
Issuing body: Dengue Expert Advisory Group (DEAG)
Version: Revised, March 2026 · PDF
- Dengue GCP Guidelines
Issuing body: Dengue Expert Advisory Group (DEAG)
Version: Second edition, 2020 · PDF
Documents and facility designations checked
The linked DEAG document is authoritative if it differs from this summary.
Checked again whenever DEAG re-issues these documents, and at the start of every season.
Book a refresher training
Dengue refresher training for doctors runs every Wednesday at the Department of Infectious Diseases, Holy Family Hospital (HFH), Rawalpindi. Choose a Wednesday below and the Dengue Cell will confirm your place.
Every Wednesday · Department of Infectious Diseases, Holy Family Hospital (HFH), Rawalpindi
Each batch seats 50 doctors. Up to 60 bookings are taken per Wednesday so a place is held through no-shows.
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Call the Dengue Cell's office: DHA Rawalpindi office (051) 4831799
DDHO referral directory
Every Deputy District Health Officer (DDHO) jurisdiction in District Rawalpindi, indexed by tehsil / town. Your concerned DDHO is the office for the area where the case is reported.
| Tehsil / town | Contact |
|---|---|
| Rawalpindi City | not yet published (pending verification) |
| Rawalpindi Saddar | not yet published (pending verification) |
| Rawalpindi Cantonment | not yet published (pending verification) |
| Gujar Khan | not yet published (pending verification) |
| Taxila | not yet published (pending verification) |
| Kahuta | not yet published (pending verification) |
| Kallar Syedan | not yet published (pending verification) |
Per-office DDHO numbers are not yet published. To reach a specific office, call the DHA Rawalpindi office on (051) 4831799, or the Punjab Healthline on 1033.
Contact directory on the home page. Tap-to-dial numbers for the DHA Rawalpindi office and the helplines.
Source: research-dha-rawalpindi.md §2