Dengue Virus Disease

From Origin to Outbreak

Adnan I. Qureshi, Omar Saeed, Adnan I. Qureshi, Omar Saeed

• Publisher: Academic Press
• Year: 2019
• ISBN:
  9780128182710
• Topic: Biological Sciences
• Subtopic: Microbiology
• Index: Biological Sciences

Dengue Virus Disease: From Origin to Outbreak provides a detailed accounting of one of the world's fastest growing infections. According to the World Health Organization, Dengue virus incidence has increased 30-fold over the past 50 years, with up to 50 to 100 million infections occurring annually in over 100 endemic countries. This estimate puts nearly half the world's population at risk. This book reviews the history, clinical and diagnostic aspects of dengue virus, also presenting our current knowledge on the pathophysiology of severe dengue and addressing the importance of dengue virus infections in those traveling to parts of the world where it is endemic.

• Covers every important aspect of Dengue virus disease, from biological, to its social and economic impacts
• Highlights the unique aspects of Dengue virus infection and the evolving nature of our understanding of the virus
• Provides a complete description of Dengue virus disease, with details on more recent outbreaks, clinical features, first hand experiences, treatment modalities, and recent novel treatment regimens
• Gives insights into the detailed psychological impact the disease has caused in outbreak regions

Chapter 1

Dengue virus infection

Adnan I. Qureshi Executive Director, Zeenat Qureshi Stroke Institute, St. Cloud, MN, United States Professor, Department of Neurology at University of Missouri, Columbia, United States

Abstract

The World Health Organization website states “Dengue is a mosquito-borne viral disease that has rapidly spread in all regions of World Health Organization in recent years”. In April 2016, World Health Organization issued a conditional recommendation on the use of the vaccine for areas, in which Dengue virus infection is highly endemic, which is defined by population seroprevalence of 70% or higher. Health officials in the Philippines in July 2019 declared a national emergency after a record-breaking 106,630 cases of Dengue fever were reported since January 2019. The World Health Organization (WHO) estimates that 50–100 million Dengue infections occur each year and that almost half the world's population lives in countries where dengue is endemic. This chapter gives a brief introduction into the current Dengue virus epidemic, the role international organizations are playing to prevent spread and future need for more research in treatment and vaccination options.

Keywords

Dengue virus disease; dengue virus infection; research and training in tropical diseases; vaccination; world health organization

Introduction

The World Health Organization website states “Dengue is a mosquito-borne viral disease that has rapidly spread in all regions of World Health Organization in recent years”. In April 2016, World Health Organization issued a conditional recommendation on the use of the vaccine for areas, in which Dengue virus infection is highly endemic, which is defined by population seroprevalence of 70% or higher. Dengue virus infection mainly causes a self-limiting flu-like illness and may remain asymptomatic (Fig. 1.1). A reader may wonder why a book should be dedicated to this disease. There are several reasons: 1. The infection can develop into a potentially severe Dengue virus illness which can be fatal and now a major cause of severe illness among children; 2. The disease is increasing exponentially in prevalence; 3. There is no specific treatment for the disease. The global incident map website provides a detailed list of hundreds of Dengue viral illness outbreaks since 2010. The first and last page of the listing is provided to give a better perspective of large number of incident cases in the world. The global map from new Dengue virus disease cases from May 2019 also provides a regional perspective on the disease (Fig. 1.2).

Health officials in the Philippines in July 2019 declared a national emergency after a record-breaking 106,630 cases of Dengue viral fever were reported since January 2019 [1]. This represented a 85% increase than the number of cases in the same period in 2018. Approximately 500 people have died from the Dengue viral illness in 2019. Military hospitals and clinics were put on alert for a possible surge in Dengue viral illness patients [2].

World Health Organization/Department of Control of Neglected Tropical Diseases released a detailed document “The Global Strategy for dengue prevention and control, 2012–20”. (Fig. 1.3) The executive summary of the document states:

“Dengue is a major public-health concern throughout tropical and sub-tropical regions of the world. It is the most rapidly spreading mosquito- borne viral disease, with a 30-fold increase in global incidence over the past 50 years. The World Health Organization (WHO) estimates that 50–100 million Dengue infections occur each year and that almost half the world's population lives in countries where dengue is endemic. In some countries, the burden of dengue is comparable to that of tuberculosis and other communicable diseases with high disease burdens; unexpected surges in cases and the challenge to health systems of triaging thousands of cases without knowing which severe cases will require hospital care are additional challenges … This Global strategy for dengue prevention and control, 2012–20 aims to address this need.

Figure 1.1 List of country with Dengue hemorrhagic fever [9].

Figure 1.2 Map of Dengue virus disease outbreak around the world [8].

Figure 1.3 List of country with Dengue hemorrhagic fever [9].

Dengue morbidity can be reduced by implementing improved outbreak prediction and detection through coordinated epidemiological and entomological surveillance; promoting the principles of integrated vector management and deploying locally-adapted vector control measures including effective urban and household water management. Effective communication can achieve behavioural outcomes that augment prevention programmes.

Figure 1.4 Website of special program for research and training in tropical disease [8].

Research will continue to play an important role in reversing the trend in dengue, a neglected tropical disease, by improving methods and systems for surveillance, prevention and control.

Reversing the trend requires commitments and obligations from partners, organizations and countries, as well as leadership by WHO and increased funding. Dengue prevention and management can now exploit opportunities presented by promising advances in vector control technology interventions, diagnostics, prognostic systems for triage, evidence-based clinical interventions and candidate vaccine developments.”

TDR, the Special Program for Research and Training in Tropical Diseases, which is a scientific collaboration supports efforts to combat diseases of poverty has a dedicated section on Dengue virus disease. The program was developed by World Health Organization, and is sponsored by the United Nations Children's Fund, the United Nations Development Program, and the World Bank. On the programs by TDR is the web based tool “Operational Guide: The Early Warning and Response System (EWARS) for Dengue Outbreaks” which acts as a resource for: (i) analysis of historic dengue datasets; (ii) identify appropriate alarm indicators that can predict forthcoming outbreaks; and (iii) use these results and analyses to build an early warning system to detect dengue outbreaks (Fig. 1.4). Another handbook by TDR “Technical handbook for dengue surveillance, dengue outbreak prediction/detection and outbreak response” provides a “model contingency plan” is to assist program managers and planners in developing a Dengue virus illness outbreak response plan through clearly defined and validated alarm signals and organize an early response “emergency response” once an outbreak has started (Fig. 1.5).

Figure 1.5 World Health organization publication of Dengue viral illness prevention and control [8].

Another controversy is whether donated blood should be screened for presence of Dengue virus [3]. Dengue virus like West Nile virus and Chikungunya virus may be transmitted through blood transfusions. One study tested 15,350 blood donation samples; Dengue virus RNA was detected in 29 samples for a prevalence of 1 per 529 (0.19%). Dengue virus types 1, 2, and 3 with viral titers of 105–109 copies/mL were detected by type specific reverse transcriptase polymerase chain reaction in 12 samples of which all were infectious in mosquito culture [4]. Another study in Portugal found that 43 of 1948 blood donations tested positive for Dengue virus genome (further identified as Den...