The WHO dengue classification and case definitions: time for a reassessment

Deen, Jacqueline; Harris, Eva; Wills, Bridget; Balmaseda, Ángel; Hammond, Samantha N.; Rocha, Crisanta; Dung, Nguyen Minh; Hưng, Nguyễn Thành; Hien, Tran Tinh; Farrar, Jeremy

doi:10.1016/s0140-6736(06)69006-5

Cited by 322 publications

(245 citation statements)

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“…Recent publications have suggested that the WHO syndromic case definition of DHF/DSS should be evaluated for clinical utility [58][59][60][61][62] . A prospective multi-centre study in several Latin-American and Southeast asian countries is planned that will provide standardized descriptions of dengue clinical presentations in the context of the current WHO case definitions.…”

Section: Clinical Signs and Immunological Responsementioning

confidence: 99%

Dengue: a continuing global threat

et al. 2010

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Dengue fever and dengue haemorrhagic fever are important arthropod-borne viral diseases. Each year, there are ~50 million dengue infections and ~500,000 individuals are hospitalized with dengue haemorrhagic fever, mainly in Southeast Asia, the Pacific and the Americas. Illness is produced by any of the four dengue virus serotypes. A global strategy aimed at increasing the capacity for surveillance and outbreak response, changing behaviours and reducing the disease burden using integrated vector management in conjunction with early and accurate diagnosis has been advocated. Antiviral drugs and vaccines that are currently under development could also make an important contribution to dengue control in the future.Dengue is the most important arthropod-borne viral infection of humans. Worldwide, an estimated 2.5 billion people are at risk of infection, approximately 975 million of whom live in urban areas in tropical and sub-tropical countries in Southeast Asia, the Pacific and the Americas 1 . Transmission also occurs in Africa and the Eastern Mediterranean, and rural Europe PMC Funders GroupAuthor Manuscript Nat Rev Microbiol. Author manuscript; available in PMC 2015 February 19. Published in final edited form as:Nat Rev Microbiol. 2010 December ; 8(12 0): S7-16. doi:10.1038/nrmicro2460. Europe PMC Funders Author ManuscriptsEurope PMC Funders Author Manuscripts communities are increasingly being affected. It is estimated that more than 50 million infections occur each year, including 500,000 hospitalizations for dengue haemorrhagic fever, mainly among children, with the case fatality rate exceeding 5% in some areas [1][2][3][4] . The geographical areas in which dengue transmission occurs have expanded in recent years (FIG. 1), and all four dengue virus serotypes (DENV-1-4) are now circulating in Asia, Africa and the Americas, a dramatically different scenario from that which prevailed 20 or 30 years ago (FIG. 2). The molecular epidemiology of these serotypes has been studied in an attempt to understand their evolutionary relationships 11 .This Review will provide an update on our understanding of the pathogenesis of this successful pathogen, how we diagnose and control infection and the progress that has been made in vaccine development. Dengue virus pathogenesisDengue viruses belong to the genus flavivirus within the Flaviviridae family. DENV-1-4 evolved in non-human primates from a common ancestor and each entered the urban cycle independently an estimated 500-1,000 years ago 12 . The virion comprises a spherical particle, 40-50 nm in diameter, with a lipopolysaccharide envelope. The positive singlestrand RNA genome (FIG. 3), which is approximately 11 kb in length, has a single open reading frame that encodes three structural proteins -the capsid (C), membrane (M) and envelope (E) glycoproteins -and seven non-structural proteins (NS1, NS2A, NS2B, NS3, NS4A, NS4B and NS5 [18][19][20] . ADE occurs when mononuclear phagocytes are infected through their Fc receptors by immune complexes that form between DE...

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Section: Clinical Signs and Immunological Responsementioning

confidence: 99%

Dengue: a continuing global threat

et al. 2010

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“…Furthermore, some countries report only dengue hemorrhagic fever while others include dengue fever in their surveillance 23,24 . Recently, however, the usefulness of the existing dengue classification scheme and case definitions for dengue hemorrhagic fever according to the WHO guidelines has come under scrutiny 34 although this issue first surfaced as far back as 1983 35 . Experiences from various parts of the world suggest that the usefulness of the case definition is not universal 29,35,36,37 .…”

Section: Current Developments In Southeast Asiamentioning

confidence: 99%

Dengue in Southeast Asia: epidemiological characteristics and strategic challenges in disease prevention

2009

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“…10 Classicamente as formas clínicas eram divididas em febre da dengue, febre hemorrágica da dengue e síndrome de choque da dengue. A OMS propõe uma nova classificação com duas categorias: dengue (com ou sem sinais de alerta) e dengue grave, seguindo alguns critérios 4,11,12 ( Fig. 1).…”

Section: Resultsunclassified

Dengue nos Países da Lusofonia: Que Ligações Epidemiológicas Poderemos Traçar?

Silvano

Abreu

2014

Acta Med Port

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Acta Med Port 2014 Jul-Aug;27(4):503-510 RESUMOIntrodução: A ocorrência recente de um conjunto de surtos de dengue em países da lusofonia previamente livres de doença, despertou-nos curiosidade quanto aos fatores concorrentes para o fenómeno e a necessidade de aprofundar conhecimentos quanto à patologia. Revemos a situação relativa à dengue nos países da lusofonia, relacionando os diferentes surtos e procurando contribuir para um melhor conhecimento do fenómeno. ABSTRACT Introduction:The recent occurrence of a number of outbreaks of dengue Portuguese speaking countries with no previous disease, aroused curiosity about the competing factors for the phenomenon and a need for better knowledge of the pathology. We review the dengue-related situation in Portuguese speaking countries, linking the various outbreaks and trying to contribute to a better understanding of the phenomenon. Material and Methods:Review of the literature on the topic and relevant information obtained from oral communications were included. Results:The outbreaks occurred between the years of 2009 and 2013 in Cabo Verde, Madeira and Angola (excluding the endemic phenomenon in Brazil), share the same vector Aedes aegypti, but are due to different viral serotypes, as shown by genotypic studies. The strong sub-notification of the disease in Africa and lack of diagnostic tools prevent a true characterization of the situation. Discussion: The hypothesis of a link between some of the outbreaks is not completely rejected. The Portuguese territory could be exposed to an increasingly high risk of dengue introduction, not only because of the proximity with these territories, but also because of the current climate changes. The main fight is, in spite of the yet utopic emergent tools, the vector control. Conclusion:A link between the outbreaks has not been proven but local preparation of healthcare professionals, creation of public health strategies and maintenance of surveillance systems are needed. More epidemiological and entomological studies are needed to characterize the real incidence of disease in Portuguese speaking countries.

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The WHO dengue classification and case definitions: time for a reassessment

Cited by 322 publications

References 25 publications

Dengue: a continuing global threat

Dengue: a continuing global threat

Dengue in Southeast Asia: epidemiological characteristics and strategic challenges in disease prevention

Dengue nos Países da Lusofonia: Que Ligações Epidemiológicas Poderemos Traçar?

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