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Dengue

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Infection by fl aviviruses such as dengue virus serotypes (DENV 1–4), Japanese encephalitis
virus (JEV), tick-borne encephalitis virus (TBE), yellow fever virus (YFV), and West Nile
virus (WNV) impacts millions of lives and causes tens of thousands of mortalities each year.
Recent studies on global dengue burden indicated that there are at least 100 million human
symptomatic infections annually. This original estimate has recently been revised in 2013 to
about three times higher than the dengue burden estimate of the World Health Organization.
The urban-breeding Aedes aegypti mosquito has spread the DENV to more than 100 countries
around the world and ~50 % of the world’s population is now estimated to be at risk.
Dengue is a global public health emergency especially since there is no preventative vaccine
or antiviral treatment for dengue disease. Usually, infection with any one of the four DENV
serotypes leads to mild self-limiting dengue fever (DF) with lifelong immunity to that specifi
c serotype. Epidemiological evidence suggests that 90 % of the severe and potentially
fatal dengue diseases, dengue hemorrhagic fever (DHF), or dengue shock syndrome (DSS)
occur during secondary heterotypic infections where the protective antibodies from a previous
infection become pathogenic through the Antibody Dependent Enhancement (ADE)
phenomenon. The co-circulation of multiple serotypes in dengue epidemic countries
increases the risk of severe dengue diseases due to ADE. Dengue has also reappeared in the
United States of America: the combination of a low immunity in the population, increased
mosquito vector activity, and the continuous introduction of virus from the endemic countries
forms the right ingredient for explosive epidemics.

Kindle Edition

Published June 3, 2018

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