A New Approach to Reducing Mortality from Dengue

Abstract

In 2009, based on a multicenter study conducted in Asia and Latin America and subsidized by the Dengue Control (DENCO) Research Program, the World Health Organization (WHO) proposed a new classification for dengue cases. The purpose of the present study was to evaluate the applicability of the new classification, relative to its previous version [1]. The evaluation, conducted in Campo Grande county, Mato Grosso do Sul state, Brazil, drew on secondary data from referral healthcare centers that assist high-severity dengue patients. A total of 156 medical records of patients with laboratory diagnosis of dengue were investigated. The records covered two epidemic periods: summer of 2006-2007 and summer of 2009-2010. The results showed that 64.6% of cases classified as dengue fever under the 1997 criteria presented manifestations of severity, warranting their reclassification as dengue with warning signs (49) or severe dengue (15) under the 2009 revised criteria. Bleeding, persistent vomiting, and severe, continuous abdominal pain were the most prevalent warning signs, indicative of risk of progression to severe disease. The revised classification was proved less complex than the current version, facilitating the identification of cases and the clinical management of patients.

Physiologically Based Pharmacokinetic/Pharmacodynamic Model for the Treatment of Dengue Infections Applied to the Broad Spectrum Antiviral Soraphen A

“…, with paracetamol and measures to restore the hydration balance. However, mortality rates for DHF and DSS are still around 20% and can be reduced to 1% upon intensive care treatment. − Various small molecules, mainly nucleoside or protease inhibitors or repurposed drugs such as ivermectin or chloroquine, have proceeded to early clinical trials, but they could not meet the primary end point . Because there is clear evidence that higher viremia results in more severe disease and vice versa, − a treatment that decreases DENV serum levels and a subsequent overreaction of the immune system represents a currently unmet medical need.…”