Clinical and pathologic manifestation of dengue virus infection. Dengue is currently one of the most important arboviral disease in the world. Dengue fever df is common mosquito born disease caused by dengue virus 1. There are four dengue virus denv types denv1, denv2, denv3, and denv4, all of which are capable of inducing severe disease dengue hemorrhagic fever dhfdengue shock syndrome dss. Currently, there is no antiviral treatment to diminish severe illness or a vaccine to induce protection from infection.
Dengue antibody test, dengue pcr test and dengue antigen test were able to detect dengue virus infection from days 1 to 8 in 72. Dengue virus infections cause significant morbidity and mortality worldwide. Dengue and severe dengue world health organization. Prevalence of dengue and chikungunya virus infections in. Pathobiology of dengue virus infection linkedin slideshare. Dengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. This includes 100 to 200 cases in the united states, mostly in people who have recently traveled abroad. Fully immature dengue virus particles becomes highly infectious in the presence of prm antibodies. Cocirculation of multiple dengue virus serotypes has been reported from many parts of the world including india, however concurrent infection with more than one serotype of dengue viruses in the same individual is rarely documented. The disease is caused by four serologically and genetically distinct viruses termed dengue virus denv 1, 2, 3 and 4. Without treatment, the virus can cause damage to blood and lymph vessels and lead to dengue hemorrhagic fever, which is marked by difficulty breathing, bruising and bleeding from the nose, gums or under the skin. Infection by any one of the four serotypes of dengue virus denv remains asymptomatic in the vast majority. For patients presenting during the first week after fever onset, diagnostic testing should include a test for dengue virus rtpcr or ns1 and igm figure 401.
Antibodies generated by a previous bout of the disease put a person at risk of more severe second infection. The previous 3 days he experienced fever up to 38,9 c, he. Dengue is likely underrecognized and underreported in africa because of low awareness by health care providers, other prevalent febrile illnesses, and lack of diagnostic testing and systematic surveillance. There are between 50 and 100 million infections each year, with approximately 500,000 cases admitted to hospital with severe and potentially lifethreatening disease. Molecular cloning methods have led to a greater understanding of the structure of the rna genome and definition of virusspecific structural and nonstructural proteins. Clinical and physiologic manifestations of dengue hemorrhagic fever in thailand, 1964. There are 2 main factors affecting severity of dengue fever. The existence of four serotypes of denv with partial immunologic crossreactivity creates the opportunity for individuals to experience multiple acute denv infections over the course of their lifetimes. Molecular insight into dengue virus pathogenesis and its.
Dengue chapter 4 2020 yellow book travelers health. Biphasic fever and rash are the most characteristic features of c l asi d ngu fv r. In dengue virus infection, t and b lymphocytes were shown to be the target of dengue virus infection. Dengue and chikungunya virus infection in man in thailand, 19621964. T cell immunopathogenesis of dengue virus infection. An effective dengue vaccine that protects against all four denv serotypes is a high priority for endemic countries and several candidates are in development by various united. Dengue is a febrile illness caused by a flavivirus transmitted by aedes aegypti or aedes albopictus mosquitoes while taking a blood meal. Imunocompetent mice model for dengue virus infection.
Blood samples were collected from 1550 patients experiencing a febrile illness clinically consistent with dengue infection. Denv has expanded its global range, with sustained outbreaks in south america, and reintroduction into north america. The number of nations and people affected has increased steadily and today is considered the most widely spread arbovirus arthropodborne viral disease. Dengue virus denv is a mosquitotransmitted rna virus that infects an estimated 390 million humans each year. A total of 208 sera from patients suspected of having dengue virus infection were collected and tested for dengue antibody, dengue genome and dengue ns1 antigen. For patients presenting 1 week after fever onset, an igm test is most useful. The dengue virus infection is prevalent across the tropical belt in over 100 countries, with 2. Each year, an estimated 390 million people are infected.
Concurrent infections of dengue viruses serotype 2 and 3. An outbreak of dengue hemorrhagic feverdengue shock syndrome dhfdss occurred in and around delhi in 2006. Dengue is the leading arthropodborne viral infection in the world and represents a major global human health concern. Dengue virus infection causes dengue fever df, dengue hemorrhagic fever dhf, and dengue shock syndrome dss, whose pathogeneses are not clearly understood. In asia, dengue is spread from the aedes albopictus, which has similar breeding and feeding habits to the aedes aegypti mosquito. Each denv has four or more genetic groups or genotypes. Dengue fever is a noncontagious infectious disease caused by dengue virus denv.
A risk to anyone traveling to a tropical or subtropical region of the world where dengue virus is found. Dengue virus denv is a mosquitotransmitted single stranded rna virus belonging to genus flavivirus. An overview of diagnostic approach to dengue virus infection. Monoclonal antibodymediated enhancement of dengue virus infection in vitro and in vivo and strategies for prevention. In the last 50 years, dengue incidence has increased 30fold, worldwide. Dengue virus denv is endemic in more than 100 countries with up to 3 billion people in tropical regions of the world at risk of infection. Dengue, currently found in 128 countries, is an important mosquitoborne viral disease posing a threat to health of many global communities. Immunopathogenesis versus protection in dengue virus infections alan l. There are between 50 and 100 million infections each year in tropical and subtropical countries, with approximately 500 000 cases admitted to hospital with severe and potentially life. Serological confirmation of dengue infection was done using dengue duo igm.
Denv consisted of four antigenically distinct but genetically similar serotypes, which are designated as denv1, denv2, denv3 and denv4. Pdf t cell immunopathogenesis of dengue virus infection. University of groningen molecular mechanisms of dengue. Dengue fever usually starts with a fever, joint pain, rash and nausea. Clinical features of dengue virus infection are usually nonspecific ranging right from selflimiting disease like fever, headache, myalgia, rashes, and arthralgia to dengue haemorrhagic fever and dengue shock syndrome. Although it is known that cells infected with dengue virus release substantial amounts of. The virus is endemic in the tropical and subtropical countries of the world, causing diseases classified according to symptoms and severity from mild to severe as dengue fever, dengue hemorrhagic fever, and dengue shock syndrome.
Although initially believed to be an infection afflicting mainly the paediatric age group, this infection has been. They may range from subclinical infection to dengue fever, dengue hemorrhagic fever dhf, and eventually dengue shock syndrome dss. Immunopathogenesis versus protection in dengue virus. Cause dengue fever can be caused by any one of four types of dengue virus. Denv belongs to the family flaviviridae, genus flavivirus, and is classified into four antigenically distinct serotypes. It is caused by the 4 serotype of dengue virus and is transmitted with in human through female aedes mosquito. Four distinct serotypes of the dengue virus dengue1, dengue2, dengue3, and dengue4 exist, with numerous virus strains found worldwide. Current and historical conditions indexed list of current and historical nationally notifiable conditions.
Concurrent infections by all four dengue virus serotypes. Pathobiology of dengue virus infection fadel muhammad garishah pathobiology of infectious diseases faculty of medicine diponegoro university 2014 2. Dengue fever is an acute febrile illness with headache, retroorbital pain, myalgia, arthralgia, rash, leukopenia and mild thrombocytopenia. Dengue virus denv continues to spread globally and is a major cause of morbidity and mortality. This disease used to be called breakbone fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking. Autoantibodyassociated immunopathogenesis of dengue hemorrhagic fever. Dengue virus disease dengue fever, or dengue is a viral disease spread by mosquitoes in many tropical and subtropical parts of the world including africa, asia, south america and occasionally, some parts of northern queensland. A typical presentation of dengue virus infection a wijesinghe, n gnanapragash, g ranasinghe, mk ragunathan abstract introduction with more than onethird of the worlds population living in areas at risk for transmission, dengue fever is a leading cause of illness and death in. Characteristics of the dengue virus the dengue virus is a single stranded rna virus belonging to the flaviviridae family. Current hypotheses of antibodydependent enhancement, virus virulence, and ifn.
Dengue is an acute infectious disease of viral etiology characterized by biphasic fever. This study aimed at determining the seroprevalence and prevalence of acute infections of dengue and chikungunya virus among participants presenting with malarialike symptoms fever. Hence there is a lacunae in diagnosing dengue virus infection early both in relation to clinical features and laboratory tests. Text boxes in the figure note immune responses activated in the infected cell denvinfected.
Dengue virus infection causes aberrant immune responses including cd4cd8 ratio inversion, monocytosis, and atypical. Focusing on the pathogenesis of dengue, a pattern of acute viral infection can be seen. Pathophysiology of dengue infection 14,15,16,17,18,19,20. How dengue virus infects cells national institutes of. The virus responsible for causing dengue, is called dengue virus denv.
The more dengue virus, the more target cell infection. Dengue virus denv infection can cause lifethreatening dengue hemorrhagic fever dhf and dengue shock syndrome dss. Prothrombin time pt and activated partial thromboplastin time aptt are usually prolonged while fibrinogen level is reduced in dengue virus infection 6. Dengue virus denv 14 represents a major emerging arthropodborne pathogen. In vivo enhancement of dengue virus infection in rhesus monkeys by passively transferred antibody. Dengue is a globally important arboviral infection transmitted by aedes mosquitoes that endangers an estimated 2. The battle between infection and host immune responses of. This enveloped virus contains a positive singlestranded rna genome. Generally, dengue is classified as a blood infection and the. Dengue viruses denv are mosquitoborne viruses that cause significant morbidity. Dengue virus belongs to the genus flavivirus, family flaviviridae and has four. The disease results from infection with dengue virus denv, which consists of four antigenically distinct serotypes known as denv1, denv2, denv3 and denv4 from the genus flavivirus in the family flaviviridae. Many more cases likely go unreported because some health care providers do not recognize the disease. Clinical spectrum among symptomatic infection ranges from undifferentiated fever viral syndrome, dengue fever df, and dengue haemorrhagic fever dhf to the expanded dengue syndrome with isolated organopathy unusual manifestations.
Pdf immunopathogenesis versus protection in dengue virus. The transmission area of this disease continues to expand due to many direct and indirect factors linked to urban sprawl, increased travel and global warming. Immunopathogenesis of dengue virus infection springerlink. All four denv serotypes are prevalent in the sub tropical regions of the world and infect 50100 million individuals annually. In spite of increasing reports of dengue and chikungunya activity in tanzania, limited research has been done to document the general epidemiology of dengue and chikungunya in the country. Dengue infection is a systemic and dynamic disease. Whereas the majority of denv infections proceed asymptomatically or result in selflimited dengue fever, an increasing number of patients present more severe manifestations, such as. Research over the past several years has revealed complex interactions between denv and the human innate and. Dengue serology testing dengue is spread by the aedes aegypti mosquito, a daybiting mosquito that prefers to feed on humans and breeds in standing water. Clinical vignette a 5 yearsold boy was referred from a public health center to general hospital due to a rapidly decreasing of platelets. Dengue is the most important arboviral infection transmitted by aedes mosquitoes, leading to severe disease in 25 billion people, and represents a rapidly growing major public health concern.
Dengue is a mosquitoborne disease caused by any one of four closely related dengue viruses. Pathogenesis of dengue haemorrhagic fever and its impact. Observations related to pathogenesis of dengue hemorrhagic. The disease is caused by infection of dengue virus denv, which is transmitted to human through the bites of aedes spp. Dengue is among the most important mosquitoborne viral disease in the world. Ecoepidemiological analysis of dengue infection during an. Epidemiology who reports 30x increase in cases since 1960 no. Dengue is a disease caused by infection with one of the four dengue virus serotypes denv1, 2, 3, and 4. Nimmannitya s, halstead sb, cohen sn, margiotta mr. This study was designed to find out a relationship of dengue infection with climatic factors such as rainfall, temperature and relative humidity during the dengue fever epidemic in the year 2003.
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