Dengue
Dengue fever is a mosquito-borne disease caused by dengue virus, prevalent in tropical and subtropical areas. Mild cases happen frequently; asymptomatic infections are uncommon. Symptoms typically begin 3 to 14 days after infection. They may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin itching and skin rash. Recovery generally takes two to seven days. In a small proportion of cases, the disease develops into severe dengue (previously known as dengue hemorrhagic fever or dengue shock syndrome) with bleeding, low levels of blood platelets, blood plasma leakage, and dangerously low blood pressure.
Dengue virus has four confirmed serotypes; infection with one type usually gives lifelong immunity to that type, but only short-term immunity to the others. Subsequent infection with a different type increases the risk of severe complications, so-called Antibody-Dependent Enhancement (ADE). The symptoms of dengue resemble many other diseases including malaria, influenza, and Zika. Blood tests are available to confirm the diagnosis including detecting viral RNA, or antibodies to the virus.
Treatment of dengue fever is symptomatic, as there is no specific treatment for dengue fever. In mild cases, treatment focuses on treating pain. Severe cases of dengue require hospitalisation; treatment of acute dengue is supportive and includes giving fluid either by mouth or intravenously.
Dengue is spread by several species of female mosquitoes of the Aedes genus, principally Aedes aegypti. Infection can be prevented by mosquito elimination and the prevention of bites. Two types of dengue vaccine have been approved and are commercially available. Dengvaxia became available in 2016, but it is only recommended to prevent re-infection in individuals who have been previously infected. The second vaccine, Qdenga, became available in 2022 and is suitable for adults, adolescents and children from four years of age.
The earliest descriptions of a dengue outbreak date from 1779; its viral cause and spread were understood by the early 20th century. Already endemic in more than one hundred countries, dengue is spreading from tropical and subtropical regions to the Iberian Peninsula and the southern states of the US, partly attributed to climate change. It is classified as a neglected tropical disease. During 2023, more than 5 million infections were reported, with more than 5,000 dengue-related deaths. As most cases are asymptomatic or mild, the actual numbers of dengue cases and deaths are under-reported.
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