Updated September 2023
Summary
The article provides information on dengue, including its background, symptoms, transmission, treatment, complications, available vaccines, and vaccination campaigns. It highlights the impact of climate change and human migration on the risk of dengue in developed nations. The Aedes species of mosquitoes transmit the dengue virus, and there is no cure for the disease. Severe dengue can occur in individuals who have had a previous exposure to the virus. The Dengvaxia vaccine is recommended for people with a lab-confirmed previous instance of dengue, as it is highly effective at preventing severe dengue disease and associated hospitalizations.
Background
In 1962, . With that elimination came the elimination of infectious diseases, like dengue and yellow fever, transmitted by those mosquitoes. However, most countries in North and South America abandoned eradication efforts. As a result, the Aedes species mosquitoes are now found as far south as Chile and as far north as the United States. While most infections associated with Aedes mosquitoes have a strong socioeconomic component, climate change and political instability — along with the human migration that comes with them — are elevating the risk of dengue in the United States and other developed nations.
Symptoms and Causative Agent
Dengue virus is an RNA virus from the Flaviviridae family, Flavivirus genus. There are four recognized serotypes (1-4), and infection with one serotype does not give immunity to the other three.
Many people infected with dengue . The exact proportion of asymptomatic infected people is unknown, because not everyone infected gets tested. But there are those who have tested positive for the infection but reported no symptoms. Those who develop symptoms of dengue fever have reported:
- Fever
- Headache
- Pain behind the eyes
- Muscle and joint pain
- Nausea, vomiting, and other digestive problems
- Swelling of the glands in the neck, under the armpits, or in the groin
- Skin Rash
People who are infected once with the strain of dengue virus are at high risk for a more severe second infection. This is due to their own immune system overreacting in the second infection, leading to severe dengue. Symptoms of severe dengue include:
- Abdominal pain, vomiting, and other digestive problems
- Bleeding gums or nose, or other bleeding disorders
- Severe weakness/fatigue
- Rapid breathing
Dengue is known as “bone break fever” because the muscle and joint pain feels as if the person’s bones were broken, or severely injured.
Transmission
Dengue virus is transmitted by the Aedes species of mosquitoes. These mosquitoes are found in all continents except Antarctica, but their range within those continents varies.
Treatment and Care
There is no cure for dengue disease. Treatment is supportive and depends on the symptoms and severity of the disease.
Complications
As mentioned above, there is a higher risk of severe complication from exposure to dengue in people who have had a previous exposure to the virus.
Available Vaccines and Vaccination Campaigns
In the United States, only one vaccine (®) (places where dengue transmission is common). These areas include the overseas territories of the United States, and not the contiguous 48 states, Alaska or Hawaii. Because of the risk of severe dengue after an initial infection (or vaccination), Dengvaxia is recommended for people with a lab-confirmed previous instance of dengue. When used as recommended, .
Resources and Additional Readings
- Brathwaite Dick O, San Martín JL, Montoya RH, del Diego J, Zambrano B, Dayan GH. The history of dengue outbreaks in the Americas. Am J Trop Med Hyg. 2012;87(4):584-593. doi:10.4269/ajtmh.2012.11-0770
- Kosasih H, Alisjahbana B, Nurhayati, et al. The Epidemiology, Virology and Clinical Findings of Dengue Virus Infections in a Cohort of Indonesian Adults in Western Java. PLoS Negl Trop Dis. 2016;10(2):e0004390. Published 2016 Feb 12. doi:10.1371/journal.pntd.0004390
- Laporta GZ, Potter AM, Oliveira JFA, Bourke BP, Pecor DB, Linton Y-M. Global Distribution of Aedes aegypti and Aedes albopictus in a Climate Change Scenario of Regional Rivalry. Insects. 2023; 14(1):49.