Dengue epidemiology and pathogenesis: images of the future viewed through a mirror of the past

Abstract

Every year, millions of individuals throughout the world are seriously affected by dengue virus. The unavailability of a vaccine and of anti-viral drugs has made this mosquito-borne disease a serious health concern. Not only does dengue cause fatalities but it also has a profoundly negative economic impact. In recent decades, extensive research has been performed on epidemiology, vector biology, life cycle, pathogenesis, vaccine development and prevention. Although dengue research is still not at a stage to suggest definite hopes of a cure, encouraging significant advances have provided remarkable progress in the fight against infection. Recent developments indicate that both anti-viral drug and vaccine research should be pursued, in parallel with vector control programs.

Decoding the enigma of antiviral crisis: Does one target molecule regulate all?

“…Clinical manifestations of dengue range from dengue fever (DF) to more severe forms like dengue haemorrhagic fever (DHF) and, sometimes, dengue shock syndrome (DSS) [7]. Arthralgia, osteagia, myalgia, headache and skin rash are the most common clinical symptoms of DF [8,9], which persists for around one week, hence the common names of 'breakbone fever' and 'seven-day fever' [10].…”

A Putative Fifth Serotype of Dengue - Potential Implications for Diagnosis, Therapy and Vaccine Design

“…Over recent decades, the global prevalence of dengue has increased markedly, due partly to variance in genetic diversity, geographical origin and distribution of different serotypes of the virus. The disease is now endemic in excess of 100 countries in Africa, the Americas, the eastern Mediterranean, South East Asia and the Western Pacific, such that more than 2.5 billion people are at risk of infection [2]. Current global annual estimates are that approaching 400 million persons are infected by dengue, of whom a quarter present with clinical or subclinical severity [3].…”

Vigilance to Limit the Bidirectional Introduction and Co-circulation of Virus Serotypes Aims to Reduce Risk of Severe Dengue Disease in North East India

“…North East India comprises the contiguous so-called 'seven sister states' of Arunachal Pradesh, Assam, Manipur, Mizoram, Meghalaya, Nagaland and Tripura, as well as the Himalayan state of Sikkim (Figure 1), which borders Nepal to its west. This physiographical region was hypoendemic for dengue, despite being surrounded by dengue-endemic countries and so represented a bottleneck to the spread of dengue across the Asian continent [33]. However, of public health concern North East India is now reporting outbreaks of dengue [34][35][36].…”

“…Both these latter regions have been hyperendemic for dengue for a long time but the predominant circulating serotypes are usually distinct [33]. While Myanmar is also an established hyperendemic nation, with infections reported to be related to those circulating in Thailand [10], the resident populations of North East India, Bangladesh and Bhutan are at risk of suffering the more severe disease manifestations of dengue infection.…”