3 What is the Dengue Virus? ArbovirusArthropod, Mosquito, born(Aedes aegypti)It is a pathogen that causesDengue fever (DF)Dengue hemorrhagic fever (DHF)Can lead to Dengue shock syndrome (DSS)Has four different serotypes (DEN-1,2,3,4)First reported epidemics in 1780 in Asia, Africa, and North America
4 Target tissues Dengue induces cytokine production in cells Cytotoxic factor effects endothelial cells involved in most of the following:HeartLiverKidneysLungsIntestinesSpleenLymph nodesBrainSkin (inflammatory rashes)
5 Symptoms: DHF Fever Headache Muscle and joint pain Dehydration Nausea and/or Haematemesis (vomiting of blood)Epistaxis (Bleeding from the nose, mouth, or gums)Haematuria (Blood in Urine)Pain behind the eyesPlasma leakageRespiratory distressPetechia (Skin rash) and/or Purpura (Lesions)
6 Diagnostic testsVirus isolation by infection of mice using infected mosquitoesDetection of IgM antibodies in the blood by PCR or Viral isolation (Serology)ELISA (Enzyme-Linked Immunoabsorbent assay)ThrombopeniaRaised hematocrit
7 Pathogenesis and infection process of Dengue Humans are initially infected through a mosquito vectorInitial interaction with cell occurs with the viruses ability to infect cellPrimary target, PhagocytesVirus uses cell receptor molecule to enter cellCell receptor molecules include:GlycosaminoglycanHeparan Sulfate (Expressed in almost all cell types)Virus replicates in target organsInfects white blood cells and lymphatic tissuesVirus is released and circulates in bloodAlternate mosquito then bites host and receives virus
9 DHF Treatment: Prevention: There is no specific treatment Relieving symptoms and complications:Plasma volume replacementSedatives for restless patientsBlood transfusion with patients with significant blood lossAspirin should be avoidedAll efforts of control are aimed against mosquitoesElimination of breeding areasActions to prevent mosquito bites (repellant, nets, and vapors)Vaccinations are pendingProblem is that the vaccination needs to prevent all four serotypes
10 Epidemiology What is promoting the disease? Affects humans Is prominent in tropical environmentsIdeal for Mosquito habitatsWhat is promoting the disease?Global warming is causing climate changes which is causing the disease to move to more environments(higher altitudes and amplitudes)More habitats for mosquitoes to thrive inSpread has been increased by urbanization and population growthInability of mosquito control in countries is also a major factor
11 Morbidity and Mortality More than 2.5 Billion people live in areas that have a risk of infectionOver 100 million cases of Dengue infection are reported each year globally500,000 cases pertain to DHFDHF has a 5% fatality rate for those infectedPeople at high risk are children and the elderly
13 BibliographyChambers, Thomas J., Yan Liang, Deborah A. Droll, Jacob J. Schlesinger, Andrew D. Davidson, Peter J. Wright, and Xiaoshan Jiang. "Yellow Fever Virus/Dengue-2 Virus and Yellow Fever Virus/Dengue-4 Virus Chimeras: Biological Characterization, Immunogenicity, and Protection Against Dengue Encephalitis in the Mouse Model." JVI. 30 Aug Dec <http://www.journals.asm.org/>.Dark, Graham. "On-Line Medical Dictionary." University of Newcastle. 6 Dec <http://www.cancerweb.ncl.ac.uk>.Aqeep, A K., A A. Malik, and M S. Elkarsani. "Clinical Presentations and Laboratory Finding in Suspected Cases of Dengue Virus." Saudi medical journal. 27 Nov Department of health and human services. 6 Dec <http://www.ncbi.nlm.nih.gov>.Palmer, D R., P Sun, C Celluzzi, J Bisbing, S Pang, W Sun, M A. Marovich, and T Burgess. "Differential effects of dengue virus on infected and bystander dendritic cells." Journal of virology. Feb Department of Viral diseases. 6 Dec <http://www.pubmed.gov>.Reiter, Paul, Sarah Lathrop, Michel Bunning, Brad Biggerstaff, Daniel Singer, Tejpratap Tiwari, Laura Baber, Manuel Amador, Jaime Thirion, Jack Hayes, Calixto Seca, Jorge Mendez, Bernardo Ramierez, Jerome Robinson, Julie Rawlings, Vance Vorndam, Stephen Waterman, Duane Gubler, Gary Clark, and Edward Hayes. "Texas Lifestyle Limits Transmission of Dengue Virus." CDC. Jan Dec <http://www.cdc.gov>.Thomas, Clayton L., ed. Taber's Cyclopedic Medical Dictionary. 18th ed. Philadelphia: F. a. Davis Company,Seet, R C., A M. Quek, and E C. Lim. "Symptoms and Risk Factors of Ocular Complications Following Dengue Infection." Journal of clinical virology. 1 Dec Dec <www.pubmed.com>.
14 Bibliography"Dengue: Clinical and Public Health Aspects." CDC. 1 Dec Department of Health and Human Services. 10 Dec <http://www.cdc.gov>."Treatment." WHO Dec <www.who.int/entity/csr/resources/publications/dengue/ pdf>."Dengue/DHF: Fact Sheet on Dengue Fever and Dengue Haemorrhagic Fever." WHO. 4 Aug Dec <http://www.searo.who.int>.Cabrera-Hernandez, Arturo, and Duncan R. Smith. "Mammalian Dengue Virus Receptors." WHO Dec <http://www.searo.who.int>.Simasathien, S, and V Watanaveeradej. "Dengue Vaccine." Journal of the Medical Association of Thailand. Nov Pub Med. 11 Dec <http://www.ncbi.nlm.nih.gov>.Schnittler, H J., and H Feldmann. "Viral Hemorrhagic Fever--a Vascular Disease?" Thrombosis and Haemostasis. June Pub Med. 11 Dec <http://www.ncbi.nlm.nih.gov>.Rigau-Perez, Jose G., Duane J. Gubler, and Gary G. Clark. "Travelers' Health: Yellow Book CH: 4 - Prevention of Specific Infectious Diseases; Dengue Fever." CDC Dec <http://www.ncid.cdc.gov>.Clyde, Karen, Jennifer L. Kyle, and Eva Harris. "Recent Advances in Deciphering Viral and Host Determinants of Dengue Virus Replication and Pathogenesis." JVI. Dec ASM Journals. 11 Dec <http://www.ncbi.nlm.nih.gov>.Anandarao, Ravulapalli, Sathyamangalam Swaminathan, Sirimali Fernando, Asha M. Jana, and Navin Khanna. "Recombinant Multiepitope Protein for Early Detection of Dengue Infections." CVI. Jan ASM. 11 Dec <http://cvi.asm.org/>.