Although intensive efforts have been made to study the early clinical pathophysiology of dengue infection with the objective to identify the potential cause of dhf, results or data that have accumulated from. Arbovirus laboratory request form and reporting form for. Dengue bulletin dengue volume 39, december 2016 bulletin issn 02508362 issn 02508362 who the who regional office for southeast asia publish the annual dengue bulletin. The salient features of the resolution of the fortysixth world health assembly wha in. Learn more dengue clinical case management elearning pathophysiology of severe dengue. An acute mosquitoborne viral illness of sudden onset with headache, fever, prostration, severe joint and muscle pain, swollen glands lymphadenopathy, and rash.
Summary much remains to be learned about the pathogenesis of the different manifestations of dengue virus denv infections in humans. In large part, this limitation is related to the lack of a suitable animal model of disease. Dengue fever is endemic throughout the tropics and subtropics. Once you are infected with one of the dengue viruses, you will develop immunity to that. The who estimates that 50100 million cases of dengue infection occur annually, with approximately 500,000 of those cases resulting in dengue hemorrhagic fever dhf, with an estimated 22,000 deaths per year, mostly in children. Symptoms typically begin three to fourteen days after infection. Dengue is a mosquitoborne disease caused by any one of four closely related.
Background dengue fever df and dengue hemorrhagic fever dhf are differentiated by the occurrence in dhf of plasma leakage into the interstitial space as. Summary dengue fever, a very old disease, has reemerged in the past 20 years with an expanded geographic distribution of both the viruses and the mosquito vectors, increased epidemic activity, the development of hyperendemicity the cocirculation of multiple serotypes, and the emergence of dengue hemorrhagic fever in new geographic regions. There is no specific treatment for dengue, but appropriate medical care. Global dengue research agenda the priority dengue research areas are organized around four major research streams, which will provide evidence and information for policymakers and control programmes. The disease is characterized by increased capillary permeability, thrombocytopenia and coagulopathy. Alternate hypothesis on the pathogenesis of dengue hemorrhagic fever dhfdengue shock syndrome dss in dengue virus infection.
The severity of the pain led to the term breakbone fever to describe dengue. Dengue haemorrhagic fever world health organization. Pathogenesis of dengue haemorrhagic fever and its impact. Studies on the pathophysiology of dengue haemorrhagic fever. Beginning in the 1950s, at the time when four different denvs were discovered, a lethal variant of dengue emerged. Treatment of acute dengue fever is supportive, with either oral or intravenous rehydration for. A severe form of dengue fever, also called dengue hemorrhagic fever, can cause severe bleeding, a sudden drop in blood pressure shock and death. A brief description of the pathophysiology, clinical features, warning signs, diagnosis and management of dengue fever. Dengue fever is a mosquitoborne viral disease caused by 1 of 4 closely related but antigenically distinct serotypes of dengue virus, serotypes denv. Dengue virus infection has been counted among emerging and reemerging diseases because of 1 the increasing number of patients, 2 the expansion of epidemic areas, and 3 the appearance of severe clinical manifestation of dengue hemorrhagic fever dhf dengue shock syndrome dss, which is often fatal if not properly treated. Health experts have known about dengue fever for more than 200 years. Hematology parameters in areas endemic for dengue hemorrhagic fever indicated that platelet counts of of dengue hemorrhagic fever dhf dengue shock syndrome dss in dengue virus infection sansanee noisakran and guey chuen perng experimental biology and medicine 2008 233. They are rna viruses that belong to the flavivirus genusflaviviridae family, which also includes the yellow fever virus, west nile virus, japanese encephalitis virus, zika virus, and the st louis encephalitis virus.
Secondary infection by a different dengue virus serotype has been confirmed as an important risk factor for the development of dhf. Pathophysiology of severe dengue centers for disease. Guidelines for dengue fever and dengue haemorrhagic fever. Dengue presents the most uptodate overview of the field, encompassing various aspects of epidemiology, virus research, clinical management of the disease, pathogenesis, vector control and diagnosis. The incidence of dengue has multiplied many times over the last five. Pdf on jan 1, 2016, anum jaweria and others published dengue. Dengue and dengue hemorrhagic fever clinical microbiology. From 1975 through 2009, symptomatic dengue virus infections were classified according to the who guidelines as dengue fever, dengue hemorrhagic fever dhf, and dengue shock syndrome the most severe form of dhf. Infection with one dengue serotype confers lifelong homotypic immunity and a brief period of partial heterotypic immunity 2 years, but each individual can eventually be infected by all. Dengue is an endemic tropical viral disease in many areas in the world. The clinical manifestations range from asymptomatic infection to undifferentiated fever, dengue fever and dengue hemorrhagic fever d. As the disease spreads to new geographical areas, the frequency of the outbreaks is increasing. Dengue fever has emerged as a global public health problem in the recent decades.
Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever vii dengue fever is the fastest emerging arboviral infection spread by aedes mosquitoes with major public health consequences in over 100 tropical and subtropical countries in southeast asia, the western pacific and south and central america. Here we investigate the immunoglobulin responses of patients with dengue fever df and. Mar 12, 2020 dengue is an infection caused by a virus. Studies on the pathophysiology of dengue haemorrhagic. In recent decades, the number of new cases of dengue has increased. Pathogenesis and pathophysiology of dengue hemorrhagic fever. Dengue hemorrhagic fever dengue shock syndrome dhfdss initially observed in southeast asia now has spread throughout the world.
Description of the clinical picture of dengue hemorrhagic feverdengue shock syndrome dhfdss in adults. Alternate hypothesis on the pathogenesis of dengue. Dengue fever is common in tropical areas, so take extra precautions if you travel somewhere with this type of climate. The submission form to accompany a sample should be completed thoroughly. Dengue fever, also known as breakbone fever, is a mosquitoborne infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a. Hyperlipidemia, statin use and dengue severity scientific. Dengue fever, an infectious tropical disease caused by a mosquitoborne virus, afflicts millions of people each year, causing fever, headache, muscle and joint pains and a characteristic skin rash. Viral hemorrhagic fever diagnostics clinical infectious. Although dhf can develop in patients with a first episode of dengue infection, it appears to be more likely following a.
If you think you have dengue pdf icon pdf 1 page see a healthcare provider if you develop a fever or have symptoms of dengue. Antibodydependent enhancement of disease and severe dengue. Mechanism of dengue virus entry into cells revealed. The role of ns1specific antibodies in the pathogenesis of dengue virus infection is poorly understood. The pathology of dengue hemorrhagic fever sciencedirect.
Clinical and serologic study of cuban children with dengue hemorrhagic feverdengue shock syndrome dhfdss. Since the second edition of dengue haemorrhagic fever. Studies on the pathophysiology of dengue haemorrhagic fever and dengue shock syndrome. Pathogenesis of dengue haemorrhagic fever and its impact on case management. The who regional office for southeast asia publish dengue.
Much remains to be learned about the pathogenesis of the different manifestations of dengue virus denv infections in humans. Department of health and human services centers for. Focusing on the serious form of dengue, the forms with overt bleeding dengue hemorrhagic fever and shock dengue shock syndrome are classified as dengue with high severity. Dengue and dengue hemorrhagic fever 1 dengue and dengue hemorrhagic fever information for health care practitioners dengue is a mosquitoborne disease caused by any one of four closely related dengue viruses denv1, 2, 3, and 4. Dengue fever is a virus transmitted to humans through bites from the aedes mosquito, a daybiting mosquito. Impact of dengue virus infection and its control pathogens.
Dengue is a mosquitoborne disease caused by a flavivirus. Mild dengue fever causes a high fever, rash, and muscle and joint pain. Dengue fever df is the fastest emerging arboviral infection spread by aedes aegypti. Dengue fever is a mosquitoborne viral disease caused by 1 of 4 closely related but antigenically distinct serotypes of dengue virus, serotypes denv1 through den4. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of dengue, there is a. The common severe syndromedengue haemorrhagic feverdengue shock syndrome dhfdssis characterised by sudden vascular permeability generated by cytokines released when t cells attack dengueinfected cells. Dengue is a febrile illness caused by a flavivirus transmitted by aedes aegypti or aedes albopictus mosquitoes while taking a blood meal.
The presence of fever, rash, and headache the dengue triad is characteristic. Dengue fever develops from dengue virus infection following a mosquito bite. Rhesus monkeys develop viremia similar in pattern to humans after dengue virus challenge but do not develop clinical disease. Clinical implications and treatment of dengue core. Multiple in vitro and mice model studies suggest statins may attenuate dengue severity. Although infection with the dengue virus denv is associated with a self. However, little is known about statin use and dengue severity in adult dengue patients with hyperlipidemia. Dengue fever is a mosquitoborne tropical disease caused by the dengue virus. Dengue fever is a severe, flulike illness that affects infants, young children and adults, but seldom causes death. It is an important cause of fever in the returned traveller. Dengue virus denv infections of humans were long thought to be selflimited and of low mortality. Dengue is an acute infectious disease of viral etiology characterized by biphasic. Nov 25, 2015 dengue virus denv infections of humans were long thought to be selflimited and of low mortality. Symptoms include a high fever, headaches, joint and muscle pain, vomiting, and a rash.
Thrombocytopenia with hemorrhagic manifestations warrants platelet transfusions. Dengue hemorrhagic feverdengue shock syndrome dhfdss initially observed in southeast asia now has spread throughout the world. Pathophysiology and management of dengue hemorrhagic fever. Pathophysiology and pathogenesis of dengue hemorrhagic fever, in monograph on denguedengue haemorrhagic fever. According to the pan american health organization paho, the clinical description of dengue fever is an acute febrile illness of 27 days duration associated with 2 or more of the following. The actual dengue burden of dengue infection is likely more than 3 times the burden estimate clinical practice guidelines of denguedengue hemorrhagic fever management for asian economic community. The four dengue viruses are transmitted in tropical countries that circle the globe. Dengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. Nov 21, 2018 multiple in vitro and mice model studies suggest statins may attenuate dengue severity. Minor hemorrhagic manifestations may occur in the form of petechiae, epistaxis, and gingival bleeding. Who has issued a document focusing on the guidelines for treatment of dengue fever and dhfdss. Spak spak dengue virus family flaviviridae genus flavivirus enveloped, single strand rna viruses genomic rna 11 kb and encodes 3 structural proteins. Dengue fever usually results in abrupt onset of high fever, headache, myalgias, arthralgias, and generalized lymphadenopathy, followed by a rash that appears with a 2nd temperature rise after an afebrile period.
Infection with one serotype of denv provides immunity to that. Pathogenesis of vascular leak in dengue virus infection. The objective of the bulletin is to disseminate updated information on the current status of dengue feverdengue haemorrhagic fever infection, changing. Transmission occurs through the bite of infected aedes mosquitoes, principally aedes aegypti, which is also the principal urban vector of yellow fever. This disease used to be called breakbone fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking. Severe dengue commonly referred to as dengue haemorrhagic feverdengue shock syndrome dhfdss to distinguish it from classic dengue fever df is characterised by an increase of vascular permeability that can lead to lifethreatening hypovolemic shock. Dengue virus infection is spread primarily by the mosquito vector aedes aegypti and causes significant morbidity and mortality worldwide. The main medical complications of classic dengue fever are febrile.
This outbreak of dengue was the first in hawaii since world war ii ended. Pathophysiology and management of dengue hemorrhagic fever ampaiwan chuansumrit md department of pediatrics, faculty of medicine, ramathibodi hospital, mahidol university, bangkok, thailand. May 03, 2019 classic dengue fever is marked by rapid onset of high fever, headache, retroorbital pain, diffuse body pain both muscle and bone, weakness, vomiting, sore throat, altered taste sensation, and a centrifugal maculopapular rash, among other manifestations. Dengue infection is caused by any of four dengue virus serotypes. Role of ns1 antibodies in the pathogenesis of acute. Dengue often presents in the form of large outbreaks. Jan 27, 2016 introduction dengue and dengue hemorrhagic fever dhf result from infection by any of four serotypes of dengue viruses. Dengue fever is a viral infection that can cause lifethreatening illness, milder flulike illness, or no symptoms at all. Role of ns1 antibodies in the pathogenesis of acute secondary.
Racgp dengue clinical and public health ramifications. Dengue dengue hemorrhagic hemorrhagic fever fever pathogenesis and pathophysiology alan alan r. Dengue infection is caused by 4 antigenically distinct dengue virus serotypes. The clinical features of dengue fever vary according to the age of the patient. Dengue viruses continue to expand their range, as shown by movement of dengue virus type 1 denv1 into hawaii in 200102. Dengue is an endemic tropical viral disease in many areas in the world including the caribbean and. Infants and young children may have a nonspecific febrile illness with rash. Only mild disease was reported, the most severe cases being of dengue fever. Pathogenesis of dengue haemorrhagic fever and its impact on. Dengue shock syndrome is the most severe form of dengue that can be fatal. Dengue viral infections postgraduate medical journal. Treat the symptoms of dengue and see your healthcare provider.
Dengue is a mosquitoborne disease caused by any one of four closely related dengue viruses. There are four dengue virus denv types denv1, denv2, denv3, and denv4, all of which are capable of inducing severe disease dengue hemorrhagic fever dhf dengue shock syndrome dss. Dengue as a public health problem and efforts to increase understanding. Substantial gaps remain in the comprehensive understanding of the pathogenesis of dengue virus infections. Dengue virus infection has been counted among emerging and reemerging diseases because of 1 the increasing number of patients, 2 the expansion of epidemic areas, and 3 the appearance of severe clinical manifestation of dengue hemorrhagic fever dhfdengue shock syndrome dss, which is often fatal if not properly treated. Viral virulence, infection enhancing antibodies, cytokines and chemical mediators in the setting of intense immune activation are the key players implicated in the pathogenesis of dhf. Classic dengue fever is marked by rapid onset of high fever, headache, retroorbital pain, diffuse body pain both muscle and bone, weakness, vomiting, sore throat, altered taste sensation, and a centrifugal maculopapular rash, among other manifestations. National center for emerging and zoonotic infectious diseases. The objective of the bulletin is to disseminate updated information on the current status of dengue fever dengue haemorrhagic fever infection, changing. World health organization, regional office for southeast. May 03, 2019 dengue fever presents in a nonspecific manner and may not be distinguishable from other viral or bacterial illness.
These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Most severe cases and fatalities occur among children and adolescents. Clinical practice guidelines of denguedengue hemorrhagic. As both cell tropism and tissue tropism of denv are considered major.