Twenty-two years of dengue outbreaks in Bangladesh: epidemiology, clinical spectrum, serotypes, and future disease risks

Abstract

Dengue is the most rapidly spreading mosquito-borne disease and has become a major public health threat, particularly for tropical and subtropical countries including Bangladesh. This comprehensive review aims to summarize the overall scenario of dengue, including disease burden, clinical spectrum, seroprevalence, circulating serotypes/genotypes, and spatial distribution since the first recorded outbreak in Bangladesh. Since the first recorded outbreak in 2000, dengue epidemiology has shown the typical epidemic pattern with more frequent and bigger outbreaks and gradual geographic expansion to non-endemic regions in Bangladesh. For instance, highly confined Rohingya refugee camps that provide shelters to nearly 1.2 million forcibly displaced vulnerable Myanmar nationals in Cox’s Bazar district confronted a massive outbreak in 2022. Recent major outbreaks are found to be associated with the emergence of serotype DENV-3, which was undetected for a long time. Consequently, changes in serotypes might be attributed to increased severity in clinical manifestation in recent years. The existing weak surveillance and risk management systems are inadequate to deal with impending dengue risks. The healthcare system, particularly at the district level, is not prepared to manage impending large-scale dengue outbreaks in Bangladesh. Our findings would contribute to the development of strategies for dengue control and management in Bangladesh as well as other similar settings elsewhere in the world.

Dengue Virus Serotype 2 Cosmopolitan C Genotype Reemerges with a New Subclade in Southwest Region of Bangladesh

“…Our study that the dengue epidemic in 2023 was caused by DENV-2 Cosmopolitan genotype that evolved as a new subclade among C clade. The outbreaks of 2017 and 2018 in Bangladesh were also caused by DENV-2 Cosmopolitan genotype within B and C clade (Hossain et al, 2023), although the 2023 subclade were not resembled to any previous Bangladeshi C clade variants (2017, 2018 and 2019), suggesting a shift of new subclade. This 2023 subclade was more similar with India (n = 12, 2018-2021), China (n =1, 2022), Indonesia (n =1, 2020), Thailand (n =2, 2020), and USA (n = 3, 2023) (Figure 2).…”

“…DENV-2 Bangladeshi variants from 2006 to 2017 (n = 16) were Cosmopolitan within B clade, from 2017 to 2018 (n = 55) were Cosmopolitan C clade, whereas in 2017 the variants were in both Clade B and Clade C (Figure 2). Previous study showed that Bangladesh had no cosmopolitan sequences from 2020 to 2022 (Hossain et al, 2023). The Bangladesh 2023 subclade, we found in this study were Cosmopolitan C clade.…”

Upsurge of dengue outbreaks in several WHO regions: Public awareness, vector control activities, and international collaborations are key to prevent spread

“…The strain on healthcare systems has postponed the medical services for specific individuals, notably those residing in heavily populated regions. 55 The increased mortality rates observed among persons with severe dengue can be attributed to delayed access to healthcare, highlighting the significant impact of healthcare infrastructure on mitigating dengue-related fatalities. 56,57 The current dengue outbreak has demonstrated notable alterations in its pathophysiology, characterized by unusual clinical manifestations, a change in the distribution of severe cases across different age groups, and a heightened influence of secondary infections.…”

Community engagement and social participation in dengue prevention: A cross‐sectional study in Dhaka City

“…Dengue is a mosquito‐borne infectious disease that spreads rapidly and has become a major global public health concern 1–5 . According to the World Health Organization (WHO), dengue is one of the top 10 global health threats 1,5 . Currently, there is no widely available effective treatment or vaccine for dengue 1,3,4,6 .…”

“…Bangladesh, a nation in South Asia, is home to more than 180 million people and has been affected by dengue fever since the initial outbreak in 2000 1,12–15 . In recent years, Bangladesh has experienced a series of significant dengue fever outbreaks owing to a variety of risk factors 1,15,16 .…”