Dengue fever is a viral infection that can cause lifethreatening illness, milder flulike illness, or no symptoms at all. Pathogenesis of dengue haemorrhagic fever and its impact on case management. Dengue virus is prevalent throughout the tropics and subtropics. Dengue chapter 4 2020 yellow book travelers health. The mosquito becomes infected when it bites a person with dengue virus in their blood. Dengue virus denv infections of humans were long thought to be selflimited and of low mortality.
Rhesus monkeys develop viremia similar in pattern to humans after dengue virus challenge but do not develop clinical disease. Pathophysiology and management of dengue hemorrhagic fever. The mechanisms and pathogenesis of dhf are still yet fully understood. Page 1 objective at the end of the session the learner will be able to. Pdf dengue is a major public health concern throughout the tropical and. Pathophysiology and pathogenesis of dengue hemorrhagic fever, in monograph on dengue dengue haemorrhagic fever. Denguehow best to classify it clinical infectious diseases. Your doctor will likely ask about your medical and travel history. Dengue fever is a mosquitoborne viral disease caused by 1 of 4 closely related but antigenically distinct serotypes of dengue virus, serotypes denv1.
Substantial gaps remain in the comprehensive understanding of the pathogenesis of dengue virus infections. The clinical manifestations range from asymptomatic infection to. Undifferentiated fevermay be the most common manifestation ofdengueprospective study found that 87% of patientsinfected were either asymptomatic or only mildlysymptomaticother prospective. Dengue fever has emerged as a global public health problem in the recent decades. Dengue is the most rapidly spreading arboviral disease globally, occurring in over 100 countries. Since the second edition of dengue haemorrhagic fever. They may range from subclinical infection to dengue fever, dengue hemorrhagic fever dhf, and eventually dengue shock syndrome dss. Dengue fever is a disease caused by a family of viruses transmitted by infected mosquitoes. Severe dengue infection can lead to death, therefore, clinicians should should aim for. Health experts have known about dengue fever for more than 200 years. Buy dengue and dengue hemorrhagic fever, 2nd edition. The dengue virus is a member of the flaviviridae family, transmitted by aedes aegypti mosquitoes. Learn more dengue clinical case management elearning pathophysiology of severe dengue.
The severity of the disease can be affected by the infecting virus itself and the age, immune status, and genetic predisposition of the person infected. Dengue is not included in the generic integrated management of childhood illness imci algorithm, but due to its importance, it was incorporated in several asian and latin american imci adaptations. Dengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. Dengue hemorrhagic fever dengue shock syndrome dhfdss initially observed in southeast asia now has spread throughout the world. Aug 29, 2014 activity adults aedes aegypti albopictus american journal antigen antiviral assay associated binding biological cells chen clinical dengue and dengue dengue fever dengue hemorrhagic fever dengue infection dengue transmission dengue vaccine dengue virus dengue virus infection dengue virus type denv detection diagnosis domain encephalitis. The presence of fever, rash, and headache the dengue triad is characteristic of dengue fever. Who reports that dengue is currently endemic in more than 100 countries, mostly in tropical and subtropical regions.
It is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen lymph nodes lymphadenopathy, and rash. Dengue is a mosquitoborne disease caused by a flavivirus. Pathophysiology and pathogenesis of dengue haemorrhagic fever. Mechanism of dengue virus entry into cells revealed.
I recently co wrote a chapter of a book published by cabi whitehorn j et al. Summary much remains to be learned about the pathogenesis of the different manifestations of dengue virus denv infections in humans. The who regional office for southeast asia publish dengue. Feb 16, 2018 diagnosing dengue fever can be difficult, because its signs and symptoms can be easily confused with those of other diseases such as malaria, leptospirosis and typhoid fever. But the mosquitoborne virus can be incredibly painful. Dengue is a mosquitotransmitted virus and the leading cause of arthropodborne viral disease in the world. Mar 12, 2020 dengue is an infection caused by a virus. Dengue infection is caused by 4 antigenically distinct dengue virus serotypes.
Shots health news the odds are that a victim will recover. Home rish academy best medical education website for students. Understanding dengue pathogenesis and in particular, risk factors for. Department of health and human services centers for. Dengue viral infections are one of the most important mosquito borne diseases in the world. Since the 1970s, clinical dengue has been classified according to the world health organization guideline as dengue fever and dengue hemorrhagic fever.
Dengue is common in more than 100 countries around the world. Dengue fever is a virus transmitted to humans through bites from the aedes mosquito, a daybiting mosquito. It has been registered for use in individuals 945 years of age living in endemic areas. This increase is believed to be to be due to multiple factors. Dengue fever is a disease caused by a family of viruses transmitted by aedes mosquitoes symptoms of dengue fever include severe joint and muscle pain, swollen lymph nodes, headache, fever, exhaustion, and rash. In recent decades, the number of new cases of dengue has increased. Pathophysiology of severe dengue centers for disease. Summary dengue fever, a very old disease, has reemerged in the past 20 years with an expanded geographic distribution of both the viruses and the mosquito vectors, increased epidemic activity, the development of hyperendemicity the cocirculation of multiple serotypes, and the emergence of dengue hemorrhagic fever in new geographic regions. Classic dengue fever is marked by rapid onset of high fever, headache, retroorbital pain, diffuse body pain both muscle and bone, weakness, vomiting, sore throat, altered taste sensation, and a centrifugal maculopapular rash, among other manifestations. Once you are infected with one of the dengue viruses, you will develop immunity to that. The first dengue vaccine, dengvaxia cydtdv by sanofi pasteur, was first licensed in december, 2015, in mexico. This syndrome is termed severe dengue also known as dengue hemorrhagic fever and dengue shock syndrome. Plasma leakage and intrinsic coagulopathy are the pathological hall marks in dengue haemorrhagic fever dhf.
The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. There are an estimated 50 million infections per year with the dengue virus, which is transmitted primarily by urbanadapted aedes aegypti mosquitoes. Mild dengue fever causes a high fever, rash, and muscle and joint pain. They may be asymptomatic or may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever dhf, or dengue shock syndrome.
They are rna viruses that belong to the flavivirus genusflaviviridae family, which also includes the yellow fever virus, west nile virus, japanese encephalitis virus, zika virus, and the st louis encephalitis virus. Although most cases are asymptomatic, severe illness and death may occur. It is also known as breakbone fever due to the severity of muscle spasms and joint pain, dandy fever, or sevenday fever because of the usual duration of symptoms. Dengue has become a widespread infection over the past few year, extending from endemic to nonendemic areas. In large part, this limitation is related to the lack of a suitable animal model of disease. The burden of dengue has increased at least fourfold over the last three decades. Cydtdv is a live recombinant tetravalent vaccine based on the yellow fever 17d backbone and is registered as a 3dose vaccine given on a 06. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever.
Pathogenesis of dengue haemorrhagic fever and its impact. An estimated 390 million cases of dengue fever occur annually with 96 million manifesting clinical disease including at least 500,000 with severe disease and up to 20,000 deaths. The clinical manifestations range from asymptomatic infection to undifferentiated fever, dengue fever and dengue hemorrhagi. Comprehensive guidelines for prevention and control of dengue. Dengue and dengue hemorrhagic fever 1 dengue and dengue hemorrhagic fever information for health care practitioners dengue is a mosquitoborne disease caused by any one of four closely related dengue viruses denv1, 2, 3, and 4. Viral virulence, infection enhancing antibodies, cytokines and chemical mediators in the setting of intense immune activation are the key players implicated in the pathogenesis of dhf. Pathogenesis of dengue haemorrhagic fever and its impact on.
The dengue virus dv is a positivesense, singlestranded rna surrounded by an icosahedral nucleocapsid. The first suspected outbreaks of dengue like disease were reported in 1635 in martinique and guadeloupe and 1699 in panama. Dengue fever is transmitted by the bite of an aedes mosquito infected with a dengue virus. According to the pan american health organization paho, the clinical description of dengue fever is an acute febrile illness of 27 days duration associated with 2. Dengue fever is a mosquitoborne tropical disease caused by the dengue virus. Dengue, dengue haemorrhagic fever and dengue shock. Dengue is an arboviral disease caused by dengue virus.
Clinical findings include nausea, vomiting, rash, aches and pains, a positive tourniquet test, leukopenia, and the following warning signs. Dengue presents the most uptodate overview of the field, encompassing various aspects of epidemiology, virus research, clinical management of the disease, pathogenesis, vector control and diagnosis. A severe form of dengue fever, also called dengue hemorrhagic fever, can cause severe bleeding, a sudden drop in blood pressure shock and death. This chapter describes the diagnosis, pathology and pathogenesis of dengue, focusing on histopathology, immunohistochemistry, molecular and other diagnostic modalities. World health organization, regional office for southeast asia. Dengue viruses are spread to people through the bite of an infected aedes species ae. Primarily a disease of the tropics, dengue fever is caused by a virus caused by a mosquito which prefers to feed on humans and is native to the tropics. Much remains to be learned about the pathogenesis of the different manifestations of dengue virus denv infections in humans. Dengue fever is a disease spread by the aedes aegypti mosquito and is caused by one of four dengue viruses.
Dengue is an arboviral disease that exerts a significant public health. Summary dengue infection is caused by any of four dengue virus serotypes. Rish academy download presentations, books, pdfs, flashcards, mnemonics and thousands of other study materials. It can be lifethreatening, and are caused by four closely related virus serotypes of the genus flavivirus, family flaviviridae. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. If you think you have dengue pdf icon pdf 1 page see a healthcare provider if you develop a fever or have symptoms of dengue. Symptoms include a high fever, headaches, joint and muscle pain, vomiting, and a rash. Dengue chapter 4 2020 yellow book travelers health cdc. Uptodate, electronic clinical resource tool for physicians and patients that provides information on adult primary care and internal medicine, allergy and immunology, cardiovascular medicine, emergency medicine, endocrinology and diabetes, family medicine, gastroenterology and hepatology, hematology, infectious diseases, nephrology and. Infection with one serotype of denv provides immunity to that.
Forty percent of the worlds population, about 3 billion people, live in areas with a risk of dengue. Antibodydependent enhancement of disease and severe dengue. Dengue hemorrhagic fever may arise from repeated infection with different serotypes of the dengue virus. Part of the flavivirus family, the dengue virus is a 50 nm virion with three structural and seven nonstructural proteins, a lipid.
Dengue hemorrhagic fever diseases and disorders medical. Transmission from human to human is predominantly by the mosquito aedes aegypti, which bites in the daytime, is adapted to human habitats and has a preference for human blood meals. Dengue infection is caused by any of four dengue virus serotypes. Dengue hemorrhagic fever can occur when someone is bitten by a mosquito or exposed to blood infected with the dengue virus. Dengue fever presents in a nonspecific manner and may not be distinguishable from other viral or bacterial illness. The clinical manifestations range from asymptomatic infection to undifferentiated fever, dengue fever and dengue hemorrhagic fever d. We expand specifically on the role of the dermis in dengue virus infection, the contribution of cellular and humoral immune responses to. This disease used to be called breakbone fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking.
Thus, it should be noted that the proportions given in. Mar 19, 20 clinical manifestations of dengue and dengue hemorrhagic fever undifferentiated fever classic dengue fever dengue hemorrhagic fever dengue shock syndrome 14. Dengue fever is a viral infection with potentially fatal consequences. Treat the symptoms of dengue and see your healthcare provider. Recent advances in dengue pathogenesis and clinical management. Refer to standard textbooks of clinical care for more detailed information regarding. Pathogenesis and pathophysiology of dengue hemorrhagic fever. We describe the virus characteristics and risk factors for dengue and dhf, and compare incidence and the case fatality rates in endemic regions southeast asia, western pacific, and the americas. Dengue fever usually results in abrupt onset of high fever, headache, myalgias, arthralgias, and generalized lymphadenopathy, followed by a rash that appears with a 2nd temperature rise after an afebrile period. Dengue fever df is the fastest emerging arboviral infection spread by aedes aegypti. Each year, 50100 million cases of dengue fever and several hundred thousand cases of dengue hemorrhagic fever occur.
The pathology of dengue hemorrhagic fever sciencedirect. It is a vasculopathy that consists in endothelial lesions which allow plasma leakage and hemorrhages. Beginning in the 1950s, at the time when four different denvs were discovered, a lethal variant of dengue emerged. Dengue is an important differential diagnosis of fever in children presenting to firstlevel health facilities in tropical asia and latin america. Dengue is a mosquitoborne disease caused by any one of four closely related dengue viruses. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of dengue. Be sure to describe international trips in detail, including the countries you visited and the dates. Dengue fever is common in tropical areas, so take extra precautions if you travel somewhere with this type of climate. Dengue fever is a mosquitoborne virus disease that has rapidly spread to several regions in recent times. National center for emerging and zoonotic infectious diseases. The salient features of the resolution of the fortysixth world health assembly wha in. The severity of the pain led to the term breakbone fever to describe dengue. Dengue virus infection causes a wide range of clinical manifestations. The clinical picture and the pathogenesis of the severe disease are explained.
Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Feb 16, 2018 dengue denggey fever is a mosquitoborne disease that occurs in tropical and subtropical areas of the world. Home rish academy best medical education website for. I recently cowrote a chapter of a book published by cabi whitehorn j et al. Dengue is a vectorborne viral infection and a globally important public health problem. Dengue fever symptoms, causes, contagious, rash, prevention. May 03, 2019 classic dengue fever is marked by rapid onset of high fever, headache, retroorbital pain, diffuse body pain both muscle and bone, weakness, vomiting, sore throat, altered taste sensation, and a centrifugal maculopapular rash, among other manifestations. Dengue has emerged as a major public health problem worldwide. Apr 01, 2007 infectious period and extrinsic incubation period of dengue fever caused by dengue virus denv4. Dengue fever, and its more recent severe form known as dengue hemorrhagic fever, is the most important arthropodtransmitted viral disease of humans in the world today.
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