1. Dengue Fever
Amy Whitesell
March 22, 2016

2. Dengue Shock Syndrome & Dengue Hemorrhagic Fever
Dengue can range from a relatively mild flu-like illness to a life-threatening Hemorrhagic fever.
“A leading cause of severe illness and death among children in some Asian and Latin American countries.” – The WHO
Symptoms:
Febrile, Critical, and Recovery Phase
Critical Phase: leakage of plasma from blood vessels
Dengue Shock Syndrome & Dengue Hemorrhagic Fever
Risk Factors:
Young or old age, overweight, previous infections of different serotype

3. Dengue Fever can be caused by four different serotypes of the Dengue virus
Image from:

4. The mosquito Aedes aegypti is the primary vector for the Dengue virus.
Global Spread: Dengue Virus
Global Spread: Aedes aegypti
The female Aedes aegypti is the primary vector for the Dengue virus. It lives in urban habitats, breeds in man-made containers, and typically bites during the day.
Dengue map =
Aedes map =

5. The Dengue virus infects Langerhans Cells, and most symptoms are caused by the host immune response.
Dengue Virus Life Cycle
Dengue Virus Structure
Image:
RNA Flavivirus
Binds to DC-SIGN, mannose receptors, or CLEC5A of Langerhans Cells and enters cell
Positive-sense RNA transcribed and virus assembles in host rough endoplasmic reticulum
Viral proteins receive glycoproteins in Golgi Apparatus
Viruses released from the host cell

6. A live attenuated tetravalent dengue vaccine, Dengvaxia, has been approved in 3 countries as of December 2015.
Vector Control Measures
Early Detection and Supportive Care
Fluids in mild infections
Blood transfusions for serious infections
Dengvaxia approved in 3 countries

7. Dengue is considered an “emerging infectious disease.”
Global Burden of Dengue (WHO 2013)
Before 1970 epidemics in 9 countries, now endemic in ~110 countries
1943 – Dengue Virus is isolated in Japan
1950’s – severe Dengue in Thailand and the Philippines
2013 – 5th strain of Dengue identified
December 2015 – vaccine approved for use in 3 countries
April 2016 – WHO set to review vaccine efficacy
~390 million cases per year

8. Rainfall, Temperature and Dengue Aedes aegypti Breeding Locations
Ecological factors such as rainfall and temperature & Social factors such as poverty, urbanization, and efficacy of vector control measures influence the spread of Dengue.
Rainfall, Temperature and Dengue
Aedes aegypti Breeding Locations

9. Other factors including globalization, industrialization, and climate change have the potential to affect the transmission of the disease.
Recent Outbreaks: China, Japan, Hawaii, and Florida.
Aedes has a larger range than the virus => potential reservoir for disease

10. Work Cited
"Antibody-dependent Enhancement." Wikipedia. Wikimedia Foundation, Bhamarapravati, N., and Y. Sutee. "Live Attenuated Tetravalent Dengue Vaccine." Live Attenuated Tetravalent Dengue Vaccine. Elsevier B.V., 16 May "Dengue." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, "Dengue Fever." Mayo Clinic. Mayo Foundation for Medical Education and Research, 19 Sept "Dengue Fever." Wikipedia. Wikimedia Foundation, "Dengue Virus Life Cycle | HHMI's BioInteractive." The Howard Hughes Medical Institute. Howard Hughes Medical Institute, "Dengue Viruses." Scitable. Nature Education, "History and Origin of Dengue Virus." Dengue Virus Net. Dengue Virus Net, Méndez-Lázaro, Pablo, Frank E. Muller-Karger, Daniel Otis, Matthew J. McCarthy, and Marisol Peña-Orellana. "Assessing Climate Variability Effects on Dengue Incidence in San Juan, Puerto Rico." MDPI. MDPI AG, Spiropoulou, Christina F., and Anon Srikiatkhachorn. "The Role of Endothelial Activation in Dengue Hemorrhagic Fever and Hantavirus Pulmonary Syndrome." Taylor & Francis. Informa UK Limited, 10 July Web. 21 Mar World Health Organization. WHO 2016, 2016.
(5th serotype)