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Dengue Virus
Dengue Declassified
 Family: Flaviviridae
 Genus: Flavivirus
 Species: Dengue virus
Dengue Virus
 Arbovirus
 Arthropod, Mosquito, born
 (Aedes aegypti)
 It is a pathogen that causes
 Dengue fever (DF)
 Dengue hemorrhagic fever (DHF)
 Can lead to Dengue shock syndrome (DSS)
 Has four different serotypes (DEN-1,2,3,4)
 First reported epidemics in 1780 in Asia, Africa,
and North America
Target tissues
 Dengue induces cytokine production in cells
 Cytotoxic factor effects endothelial cells
involved in most of the following:
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Heart
Liver
Kidneys
Lungs
Intestines
Spleen
Lymph nodes
Brain
Skin (inflammatory rashes)
Symptoms: DHF
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Fever
Headache
Muscle and joint pain
Dehydration
Nausea and/or Haematemesis (vomiting of blood)
Epistaxis (Bleeding from the nose, mouth, or gums)
Haematuria (Blood in Urine)
Pain behind the eyes
Plasma leakage
Respiratory distress
Petechia (Skin rash) and/or Purpura (Lesions)
Diagnostic tests
 Virus isolation by infection of mice using
infected mosquitoes
 Detection of IgM antibodies in the blood by
PCR or Viral isolation (Serology)
 ELISA (Enzyme-Linked Immunoabsorbent
assay)
 Thrombopenia
 Raised hematocrit
Pathogenesis and infection
process of Dengue
 Humans are initially infected through a mosquito vector
 Initial interaction with cell occurs with the viruses ability
to infect cell
 Primary target, Phagocytes
 Virus uses cell receptor molecule to enter cell
 Cell receptor molecules include:
 Glycosaminoglycan
 Heparan Sulfate (Expressed in almost all cell types)
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Virus replicates in target organs
Infects white blood cells and lymphatic tissues
Virus is released and circulates in blood
Alternate mosquito then bites host and receives virus
DHF
Treatment:
Prevention:
There is no specific treatment
Relieving symptoms and
complications:
 Plasma volume replacement
 Sedatives for restless patients
 Blood transfusion with
patients with significant blood
loss
 Aspirin should be avoided
 All efforts of control are aimed
against mosquitoes
 Elimination of breeding areas
 Actions to prevent mosquito
bites (repellant, nets, and
vapors)
 Vaccinations are pending
 Problem is that the
vaccination needs to prevent
all four serotypes
Epidemiology
 Affects humans
 Is prominent in tropical environments
 Ideal for Mosquito habitats
What is promoting the disease?
 Global warming is causing climate changes which is
causing the disease to move to more environments
 (higher altitudes and amplitudes)
 More habitats for mosquitoes to thrive in
 Spread has been increased by urbanization and
population growth
 Inability of mosquito control in countries is also a major
factor
Morbidity and Mortality
 More than 2.5 Billion people live in areas
that have a risk of infection
 Over 100 million cases of Dengue
infection are reported each year globally
 500,000 cases pertain to DHF
 DHF has a 5% fatality rate for those
infected
 People at high risk are children and the
elderly
Bibliography
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Chambers, Thomas J., Yan Liang, Deborah A. Droll, Jacob J. Schlesinger, Andrew D.
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and human services. 6 Dec. 2006 <http://www.ncbi.nlm.nih.gov>.
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Bibliography
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"Dengue: Clinical and Public Health Aspects." CDC. 1 Dec. 2005. Department of Health and
Human Services. 10 Dec. 2006 <http://www.cdc.gov>.
"Treatment." WHO. 1997. 10 Dec. 2006
<www.who.int/entity/csr/resources/publications/dengue/024-33.pdf>.
"Dengue/DHF: Fact Sheet on Dengue Fever and Dengue Haemorrhagic Fever." WHO. 4 Aug.
2006. 10 Dec. 2006 <http://www.searo.who.int>.
Cabrera-Hernandez, Arturo, and Duncan R. Smith. "Mammalian Dengue Virus Receptors."
WHO. 2005. 10 Dec. 2006 <http://www.searo.who.int>.
Simasathien, S, and V Watanaveeradej. "Dengue Vaccine." Journal of the Medical Association
of Thailand. Nov. 2005. Pub Med. 11 Dec. 2006 <http://www.ncbi.nlm.nih.gov>.
Schnittler, H J., and H Feldmann. "Viral Hemorrhagic Fever--a Vascular Disease?" Thrombosis
and Haemostasis. June 2003. Pub Med. 11 Dec. 2006 <http://www.ncbi.nlm.nih.gov>.
Rigau-Perez, Jose G., Duane J. Gubler, and Gary G. Clark. "Travelers' Health: Yellow Book
CH: 4 - Prevention of Specific Infectious Diseases; Dengue Fever." CDC. 2005. 11 Dec. 2006
<http://www.ncid.cdc.gov>.
Clyde, Karen, Jennifer L. Kyle, and Eva Harris. "Recent Advances in Deciphering Viral and
Host Determinants of Dengue Virus Replication and Pathogenesis." JVI. Dec. 2006. ASM
Journals. 11 Dec. 2006 <http://www.ncbi.nlm.nih.gov>.
Anandarao, Ravulapalli, Sathyamangalam Swaminathan, Sirimali Fernando, Asha M. Jana,
and Navin Khanna. "Recombinant Multiepitope Protein for Early Detection of Dengue
Infections." CVI. Jan. 2006. ASM. 11 Dec. 2006 <http://cvi.asm.org/>.