Dengue: pathogenesis, prevention and treatment – A mini review

Tahir Hussain, Muhsin Jamal, Tayyab ur Rehman, Saadia Andleeb


Dengue is a threatening tropical disease which has become the cause of significant mortality, morbidity and economic burden. Dengue is an epidemic in over 100 countries, and it causes up to 25000 deaths every year. There is no specific cure available for the disease, hence fluid resuscitation is the only ultimate treatment given to patients in severe conditions. Dengue is more threatening in Southeast Asia, where it is the leading cause of deaths in children, and where all four serotypes of the dengue virus and the vector, Aedes aegypti, are endemic. In last few decades, an overwhelming increase was seen in dengue infections around the world and it is estimated that two fifths of the world's population is now at risk from dengue with the mortality rate of about 5%. To control dengue infection, combination of care measures are utilized which depends on the symptoms and severity of the fever, including oral rehydration solution or isotonic intravenous fluids and/or blood transfusions. Currently, the only effective way of preventing the dengue epidemics is eliminating the vector. This review covers pathogenesis, prevention and treatment of dengue infection.

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Guzmán MG, Kouri G, Bravo J, Valdes L, Susana V, et al. Effect of age on outcome of secondary dengue 2 infections. International Journal of Infectious Diseases, (2002); 6(2): 118-124.

Gibbons RV, Vaughn DW. Dengue: an escalating problem. BMJ: British Medical Journal, (2002); 324(7353): 1563.

Pouliot SH, Xiong X, Harville E, Paz-Soldan V, Tomashek KM, et al. Maternal dengue and pregnancy outcomes: a systematic review. Obstetrical & Gynecological Survey, (2010); 65(2): 107-118.

Chastel C. Eventual role of asymptomatic cases of dengue for the introduction and spread of dengue viruses in non-endemic regions. Frontiers in Physiology, (2012); 3.

Basu A, Chaturvedi UC. Vascular endothelium: the battlefield of dengue viruses. FEMS Immunology & Medical Microbiology, (2008); 53(3): 287-299.

Hammond SN, Balmaseda A, Perez L, Tellez Y, Saborío SI, et al. Differences in dengue severity in infants, children, and adults in a 3-year hospital-based study in Nicaragua. The American Journal of Tropical Medicine and Hygiene, (2005); 73(6): 1063-1070.

Kittigul L, Pitakarnjanakul P, Sujirarat D, Siripanichgon K. The differences of clinical manifestations and laboratory findings in children and adults with dengue virus infection. Journal of Clinical Virology, (2007); 39(2): 76-81.

Halstead SB. Dengue in the Americas and Southeast Asia: do they differ? Revista Panamericana de Salud Publica, (2006); 20(6): 407-415.

Halstead SB. Dengue. The Lancet, (2007); 370(9599): 1644-1652.

Kliks SC, Nisalak A, Brandt WE, Wahl L, Burke DS (1989) Antibody-dependent enhancement of dengue virus growth in human monocytes as a risk factor for dengue hemorrhagic fever. DTIC Document.

Kurane I, Innis BL, Nisalak A, Hoke C, Nimmannitya S, et al. Human T cell responses to dengue virus antigens. Proliferative responses and interferon gamma production. Journal of Clinical Investigation, (1989); 83(2): 506.

Trpis M, Hausermann W. Genetics of house-entering behaviour in East African populations of Aedes aegypti (L.)(Diptera: Culicidae) and its relevance to speciation. Bulletin of Entomological Research, (1978); 68(03): 521-532.

Holmes EC, Twiddy SS. The origin, emergence and evolutionary genetics of dengue virus. Infection, Genetics and Evolution, (2003); 3(1): 19-28.

Ubol S, Chareonsirisuthigul T, Kasisith J, Klungthong C. Clinical isolates of dengue virus with distinctive susceptibility to nitric oxide radical induce differential gene responses in THP-1 cells. Virology, (2008); 376(2): 290-296.

Hesse RR. Dengue virus evolution and virulence models. Clinical Infectious Diseases, (2007); 44(11): 1462-1466.

Gubler DJ. Dengue, urbanization and globalization: the unholy trinity of the 21st century. Tropical Medicine and Health, (2011); 39(4 Suppl): 3.

Kyle JL, Harris E. Global spread and persistence of dengue. Annual Reviews of Microbiology, (2008); 6271-92.

Limon‐Flores AY, Perez‐Tapia M, Estrada‐Garcia I, Vaughan G, Escobar‐Gutierrez A, et al. Dengue virus inoculation to human skin explants: an effective approach to assess in situ the early infection and the effects on cutaneous dendritic cells. International Journal of Experimental Pathology, (2005); 86(5): 323-334.

Durbin AP, Vargas MJ, Wanionek K, Hammond SN, Gordon A, et al. Phenotyping of peripheral blood mononuclear cells during acute dengue illness demonstrates infection and increased activation of monocytes in severe cases compared to classic dengue fever. Virology, (2008); 376(2): 429-435.

Kwan W-H, Helt A-M, Marañón C, Barbaroux J-B, Hosmalin A, et al. Dendritic cell precursors are permissive to dengue virus and human immunodeficiency virus infection. Journal of Virology, (2005); 79(12): 7291-7299.

Kou Z, Quinn M, Chen H, Rodrigo W, Rose RC, et al. Monocytes, but not T or B cells, are the principal target cells for dengue virus (DV) infection among human peripheral blood mononuclear cells. Journal of Medical Virology, (2008); 80(1): 134-146.

Jessie K, Fong MY, Devi S, Lam SK, Wong KT. Localization of dengue virus in naturally infected human tissues, by immunohistochemistry and in situ hybridization. Journal of Infectious Diseases, (2004); 189(8): 1411-1418.

Vaughn DW. Invited commentary: Dengue lessons from Cuba. American Journal of Epidemiology, (2000); 152(9): 800-803.

Srikiatkhachorn A. Plasma leakage in dengue haemorrhagic fever. Thrombosis and Haemostasis, (2009); 102(6): 1042-1049.

Krishnamurti C, Kalayanarooj S, Cutting MA, Peat RA, Rothwell SW, et al. Mechanisms of hemorrhage in dengue without circulatory collapse. The American Journal of Tropical Medicine and Hygiene, (2001); 65(6): 840-847.

Faheem M, Raheel U, Riaz MN, Kanwal N, Javed F, et al. A molecular evaluation of dengue virus pathogenesis and its latest vaccine strategies. Molecular Biology Reports, (2011); 38(6): 3731-3740.

Wang J, Chen Y, Gao N, Wang Y, Tian Y, et al. Inhibitory effect of glutathione on oxidative liver injury induced by dengue virus serotype 2 infections in mice. PloS One, (2013); 8(1): e55407.

Martina BE, Koraka P, Osterhaus AD. Dengue virus pathogenesis: an integrated view. Clinical Microbiology Reviews, (2009); 22(4): 564-581.

Martínez‐Betancur V, Marín‐Villa M, Martínez‐Gutierrez M. Infection of epithelial cells with dengue virus promotes the expression of proteins favoring the replication of certain viral strains. Journal of Medical Virology, (2014); 86(8): 1448-1458.

Peyrefitte CN, Pastorino B, Grau GE, Lou J, Tolou H, et al. Dengue virus infection of human microvascular endothelial cells from different vascular beds promotes both common and specific functional changes. Journal of Medical Virology, (2006); 78(2): 229-242.

Bethell DB, Gamble J, Loc PP, Dung NM, Chau TTH, et al. Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever. Clinical Infectious Diseases, (2001); 32(2): 243-253.

Chen H-C, Hofman FM, Kung JT, Lin Y-D, Wu-Hsieh BA. Both virus and tumor necrosis factor alpha are critical for endothelium damage in a mouse model of dengue virus-induced hemorrhage. Journal of Virology, (2007); 81(11): 5518-5526.

Kyle JL, Beatty PR, Harris E. Dengue virus infects macrophages and dendritic cells in a mouse model of infection. Journal of Infectious Diseases, (2007); 195(12): 1808-1817.

Guzman MG, Halstead SB, Artsob H, Buchy P, Farrar J, et al. Dengue: a continuing global threat. Nature Reviews Microbiology, (2010); 8S7-S16.

Miagostovich M, Ramos R, Nicol A, Nogueira R, Cuzzi-Maya T, et al. Retrospective study on dengue fatal cases. Clinical neuropathology, (1996); 16(4): 204-208.

Whitehorn J, Farrar J. Dengue. British Medical Bulletin, (2010); 95(1): 161-173.

Varatharaj A. Encephalitis in the clinical spectrum of dengue infection. Neurology India, (2010); 58(4): 585.

Mackenzie JS, Gubler DJ, Petersen LR. Emerging flaviviruses: the spread and resurgence of Japanese encephalitis, West Nile and dengue viruses. Nature medicine, (2004); 10S98-S109.

Jin X, Lee M, Shu J. Dengue fever in China: an emerging problem demands attention. Emerging Microbes & Infections, (2015); 4(1): e3.

Duchin JS, Koster FT, Peters C, Simpson GL, Tempest B, et al. Hantavirus pulmonary syndrome: a clinical description of 17 patients with a newly recognized disease. New England Journal of Medicine, (1994); 330(14): 949-955.

Wills BA, Dung NM, Loan HT, Tam DT, Thuy TT, et al. Comparison of three fluid solutions for resuscitation in dengue shock syndrome. New England Journal of Medicine, (2005); 353(9): 877-889.

Rajapakse S, Rodrigo C, Maduranga S, Rajapakse AC. Corticosteroids in the treatment of dengue shock syndrome. Infection and drug resistance, (2014); 7137.

Erlanger T, Keiser J, Utzinger J. Effect of dengue vector control interventions on entomological parameters in developing countries: a systematic review and meta‐analysis. Medical and Veterinary Entomology, (2008); 22(3): 203-221.

Guzman MG, Harris E. Dengue. The Lancet, (2014); 385(9966): 453-465.


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