DENGUE VIRUS

Dengue virus infection causes a characteristic fever (DF) and in a subset of cases a more severe hemorrhagic fever (DHF).  There is an increasing prevalence of Dengue in tropical and sub-tropical areas of the world but over 100 countries are affected by outbreaks of Dengue virus infection. 50-100 million cases of DF occur worldwide, making it the most common and widespread arthropod-borne viral infection of humans.  The virus is transmitted by mosquito vectors, Aedes aegypti and Aedes albopictus. As many as 1 in 100 people are infected each year by one or more of the four Dengue serotypes.  Following an incubation period of 3-7 days there is sudden onset of fever, headache, retro-orbital pain, body aches, nausea, vomiting and weakness. Most patients recover within 7-10 days and 50-90% of infections are asymptomatic.  Dengue infection, mainly a secondary infection, can cause the more severe DHF and/or Dengue shock syndrome (DSS) which occur in 250-500,000 patients annually, with 1-5% of cases resulting in fatality.  DHF manifests by leakage of plasma into extravascular compartments, thrombocytopenia and  bleeding, while potentially fatal DSS causes fluid leakage into interstitial spaces leading to hypovolemic shock.  Estimates suggest individuals are 15-80 fold more likely to develop DHF as a result of a secondary infection with a Dengue serotype distinct from that responsible for a primary infection

 

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