Dengue Fever You Need To Know

As summer approaches, the threat of dengue fever looms once again. This mosquito-borne illness is a serious concern in many parts of the world, causing flu-like symptoms and even death in severe cases.

Dengue is an acute viral infection that continues to plague many countries across the world, including Brazil, Philippines, India, etc. Almost over 40% of the world's population is living in areas where there is a high risk of dengue. It is still considered one of the leading causes of illness in many countries.

Dengue fever is an acute systemic infectious disease caused by the bite of a female mosquito carrying the Dengue virus (DENV). Dengue fever infects approximately 390 million people annually and affecting more than 120 countries, most severely in Africa, the Americas, Southeast Asia and the Western Pacific. The spread of Dengue fever is now spreading to temperate and cold zones and higher altitudes as global warming increases, and the prevalence of serotypes is changing. Dengue fever has become a significant public health problem, and the increasing geographical spread of the virus, the number of cases and the severity of the disease pose a global threat to human health and socioeconomic.

About Dengue: What You Need to Know

·Dengue viruses are spread to people through the bite of an infected Aedes species (Ae. aegypti or Ae. albopictus) mosquito. These mosquitoes also spread Zika, Chikungunya and other viruses.

• ·Almost half of the world’s population, about 4 billion people, live in areas with a risk of dengue. Dengue is often a leading cause of illness in areas with risk.
• Each year, up to 400 million people are infected by a dengue virus. Approximately 100 million people get sick from infection, and 40,000 die from severe dengue.
• Dengue is caused by one of any of four related viruses: dengue virus 1, 2, 3, and 4.  A person  can be infected with dengue multiple times in their life.

DENV contains four serotypes: DENV-1, DENV-2, DENV-3 and DENV-4; DENV-1, DENV-3, and DENV-4 contain five genotypes (GI ~GV). In 2013, Mustafa et al. identified a fifth serotype, DENV-5, through virus isolation and gene sequence analysis in Malaysia, posing a new challenge for vaccine development.

Symptoms

• Mild symptoms of dengue can be confused with other illnesses that cause fever, aches and pains, or a rash.

The most common symptom of dengue is fever with any of the following:

• Nausea, vomiting
• Rash
• Aches and pains (eye pain, typically behind the eyes, muscle, joint, or bone pain)
• Any warning sign

Symptoms of dengue typically last 2–7 days. Most people will recover after about a week.

Severe dengue

• About 1 in 20 people who get sick with dengue will develop severe dengue.
• Severe dengue can result in shock, internal bleeding, and even death.
• If you have had dengue in the past, you are more likely to develop severe dengue.
• Infants and pregnant women are at higher risk for developing severe dengue.

Symptoms of severe dengue

Warning signs of severe dengue

Watch for signs and symptoms of severe dengue. Warning signs usually begin in the 24–48 hours after your fever has gone away.

Immediately go to a local clinic or emergency room if you or a family member has any of the following symptoms.

• Belly pain, tenderness
• Vomiting (at least 3 times in 24 hours)
• Bleeding from the nose or gums
• Vomiting blood, or blood in the stool
• Feeling tired, restless, or irritable

Transmission

Dengue viruses are spread to people through the bites of infected Aedes species mosquitoes (Ae. aegypti or Ae. albopictus).  Aedes aegypti and Aedes albopictus prefer temperate climates. Domestic water storage and decorative plant containers, waste food and drink containers, drains, and buildings under construction are preferred sites for Aedes aegypti and Aedes albopictus to live and breed. One of the current measures to contain DF is to control the DENV vector by eliminating or managing the larval environment and using biological agents and insecticides to kill the larvae .

These are the same types of mosquitoes that spread Zika and chikungunya viruses.

• These mosquitoes typically lay eggs near standing water in containers that hold water, like buckets, bowls, animal dishes, flower pots, and vases.
• · These mosquitoes prefer to bite people, and live both indoors and outdoors near people.
• · Mosquitoes that spread dengue, chikungunya, and Zika bite during the day and night.
• · Mosquitoes become infected when they bite a person infected with the virus. Infected mosquitoes can then spread the virus to other people through bites.

From mother to child

• · A pregnant woman already infected with dengue can pass the virus to her fetus during pregnancy or around the time of birth.
• · To date, there has been one documented report of dengue spread through breast milk. Because of the benefits of breastfeeding, mothers are encouraged to breastfeed even in areas with risk of dengue.

Through infected blood, laboratory, or healthcare setting exposures

Rarely, dengue can be spread through blood transfusion, organ transplant, or through a needle stick injury.

Historic Data (2010-2023)

The incidence of dengue has grown dramatically around the world in recent decades, with cases reported to WHO increased from 505 430 cases in 2000 to 5.2 million in 2019. A vast majority of cases are asymptomatic or mild and self-managed, and hence the actual numbers of dengue cases are under-reported. Many cases are also misdiagnosed as other febrile illnesses. According to WHO, there are 50 million cases of dengue infection worldwide every year and the disease is an epidemic in over 100 countries.

Dengue fever is endemic in many countries, like in Southeast and South Asia, South America, etc, with incidences occurring throughout the year and showing clear seasonal peaks.

Here below is the historic data of Jurisdictions including 50 states. District of Columbia, five United States territories, and three freely associated states.

DENV is a significant public health problem in tropical and subtropical regions. DENV transmission is expanding, and the virus is becoming more infectious. In addition to being transmitted by mosquito vectors, DF can also be transmitted through blood, organ transplantation needle sticks, etc. DF infections are primarily seen in children and adolescents. The prevalence of DF is seasonal and climate-related, and global warming is expanding the geographical range of Aedes aegypti. With economic development, greater global accessibility and mobility of populations, DENV infections are exchanged in different regions. In the context of the new coronavirus epidemic, the dual transmission of DENV and novel coronaviruses has occurred in several countries, posing a severe threat to public health. According to WHO recommendations, there is no specific treatment for dengue infection. Therefore, early detection of cases, recognition of any early warning signs of severe Dengue and timely access to appropriate clinical management are critical elements of care to reduce the risk of severe Dengue complications and death due to Dengue fever.

Solution

Dengue NS1 antigen is a highly-conserved glycoprotein that is present at high concentrations in the sera of dengue-infected patients during the early clinical phase of the disease. NS1 antigen is found from the first day and up to 9 days after onset of fever in whole blood or serum / plasma sample of primary or secondary dengue infected patients.

Serological studies have shown that during primary infections, dengue-specific IgM antibodies are found by 5th day of infection and remain in circulation for 30-60 days, while IgG antibodies appear by the 14th day of infection and persist for life. In contrast, during secondary dengue virus infection, specific IgG and IgM levels significantly increase at 1- 2 days and the 20th day after infection, respectively. Thus, different profiles of humoral immune responses in primary and secondary dengue viral infections can be used for differential diagnosis. This is of clinical significance in predicting the progression and prognosis of the disease.

ACCUFAST Dengue NS1 and IgG/IgM combo test uses immunochromatographic assay to demonstrate results in 10 minutes. It has high sensitivity within 7 days of symptom, making it a simple, efficient, and high-quality option.

The test is intended for professional use in the diagnosis of Dengue virus infections.

References

[1] https://www.cdc.gov/dengue/about/index.html

[2] https://www.who.int/home/search-results?indexCatalogue=genericsearchindex1&searchQuery=Dengue%20infected%20data&wordsMode=AnyWord

[3] WANG Y, SI L L, GUO X L, et al. Substitution of the precursor peptide prevents anti-PRM antibody-mediated antibody-dependent enhancement of dengue virus infection［J］. Virus res, 2017, 15(229): 57-64.

[4] KARUNA R, YOKOKAWA F, WANG K, et al. A cyclic phosphoramidate prodrug of 2'-deoxy-2'-fluoro-2'-C-methy-lguanosine for the treatment of dengue infection ［J］. Antimicrob Agents Chemother, 2020, 64 (12): 11-12.

[5] Rexliene J, Sridhar J. Genetic diversity and evolutionary dynamics of dengue isolates from India [J]. Virus disease,2019, 30(3) :354.

[6] de Bruycker -Nogueira F， Mir D， Dos Santos FB， et al. Evolutionary history and spatiotemporal dynamics of DENV-1 genotype V in the Americas[J]. Infect Genet Evol, 2016(45): 454-460.

[7] GUTIERREZ-BARBOSA H, MEDINA-MORENO S, ZAPATA JC, et al. Dengue infections in Colombia: epidemiological trends of a hyperendemic country［J］. Trop Med Infect Dis, 2020, 5(4): 156.