Abstract
Dengue viruses cause a variable spectrum of disease that ranges from an undifferentiated fever to dengue fever to the potentially fatal dengue shock syndrome. Due to the increased incidence and geographical distribution of dengue in the last 50 years, dengue is becoming increasingly recognised as one of the world’s major infectious diseases. This article will review clinical and diagnostic aspects of dengue virus infections. It also presents our current knowledge of the pathophysiology of severe dengue and addresses the importance of dengue virus infections in those travelling to parts of the world where dengue is endemic.
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References
Guzman MG, Kouri G (2002) Dengue: an update. Lancet Infect Dis 2:33–42
Kuhn RJ, Zhang W, Rossmann MG et al (2002) Structure of dengue virus: implications for flavivirus organization, maturation, and fusion. Cell 108:717–725
Henchal EA, Putnak JR (1990) The dengue viruses. Clin Microbiol Rev 3:376–396
Rigau-Perez JG, Clark GG, Gubler DJ et al (1998) Dengue and dengue haemorrhagic fever. Lancet 352:971–977
Vazeille-Falcoz M, Adhami J, Mousson L, Rodhain F (1999) Aedes albopictus from Albania: a potential vector of dengue viruses. J Am Mosq Control Assoc 15:475–478
Romi R, Di Luca M, Majori G (1999) Current status of Aedes albopictus and Aedes atropalpus in Italy. J Am Mosq Control Assoc 15:425–427
Schaffner F, Karch S (2000) First report of Aedes albopictus (Skuse, 1984) in metropolitan France. C R Acad Sci III 323:373–375
Hales S, de Wet N, Maindonald J, Woodward A (2002) Potential effect of population and climate changes on global distribution of dengue fever: an empirical model. Lancet 360:830–834
Kautner I, Robinson MJ, Kuhnle U (1997) Dengue virus infection: epidemiology, pathogenesis, clinical presentation, diagnosis, and prevention. J Pediatr 131:516–524
Hammon WM, Rudnick A, Sather G et al (1960) New hemorrhagic fevers of children in the Philippines and Thailand. Trans Assoc Am Physicians 73:140–155
Kouri G, Mas P, Guzman MG et al (1983) Dengue hemorrhagic fever in Cuba, 1981: rapid diagnosis of the etiologic agent. Bull Pan Am Health Organ 17:126–132
World Health Organisation (1997) Dengue hemorrhagic fever: diagnosis, treatment, prevention and control, 2nd edn. WHO, Geneva
Ellerin T, Hurtado R, Lockman S, Baden L (2003) Fever in a returned traveler: an “off the cuff” diagnosis. Clin Infect Dis 36:1004–1005, 1074–1075
Nimmannitya S (1987) Clinical spectrum and management of dengue haemorrhagic fever. Southeast Asian J Trop Med Public Health 18:392–397
Sumarmo, Wulur H, Jahja E et al (1983) Clinical observations on virologically confirmed fatal dengue infections in Jakarta, Indonesia. Bull World Health Organ 61:693–701
Guzman MG, Alvarez M, Rodriguez R et al (1999) Fatal dengue hemorrhagic fever in Cuba, 1997. Int J Infect Dis 3:130–135
Zagne SM, Alves VG, Nogueira RM et al (1994). Dengue haemorrhagic fever in the state of Rio de Janeiro, Brazil: a study of 56 confirmed cases. Trans R Soc Trop Med Hyg 88:677–679
Rigau-Perez JG (1997) Clinical manifestations of dengue hemorrhagic fever in Puerto Rico, 1990–1991. Puerto Rico Association of Epidemiologists. Rev Panam Salud Publica 1:381–388
Kalayanarooj S, Vaughn DW, Nimmannitya S et al (1997) Early clinical and laboratory indicators of acute dengue illness. J Infect Dis 176:313–321
Solomon T, Dung NM, Vaughn DW et al (2000) Neurological manifestations of dengue infection. Lancet 355:1053–1059
Lawn SD, Tilley R, Lloyd G et al (2003) Dengue hemorrhagic fever with fulminant hepatic failure in an immigrant returning to Bangladesh. Clin Infect Dis 37:e1–e4
Haritoglou C, Dotse SD, Rudolph G et al (2002) A tourist with dengue fever and visual loss. Lancet 360:1070
Haritoglou C, Scholz F, Bialasiewicz A, Klauss V (2000) Ocular manifestation in dengue fever. Ophthalmologe 97:433–436
Bhamarapravati N (1989) Hemostatic defects in dengue hemorrhagic fever. Rev Infect Dis 11(Suppl 4):826–829
Bhamarapravati N, Tuchinda P, Boonyapaknavik V (1967) Pathology of Thailand haemorrhagic fever: a study of 100 autopsy cases. Ann Trop Med Parasitol 61:500–510
Huerre MR, Lan NT, Marianneau P et al (2001) Liver histopathology and biological correlates in five cases of fatal dengue fever in Vietnamese children. Virchows Arch 438:107–115
Couvelard A, Marianneau P, Bedel C et al (1999) Report of a fatal case of dengue infection with hepatitis: demonstration of dengue antigens in hepatocytes and liver apoptosis. Hum Pathol 30:1106–1110
Rosen L, Khin MM, Tin U (1989) Recovery of virus from the liver of children with fatal dengue: reflections on the pathogenesis of the disease and its possible analogy with that of yellow fever. Res Virol 140:351–360
Sahaphong S, Riengrojpitak S, Bhamarapravati N, Chirachariyavej T (1980) Electron microscopic study of the vascular endothelial cell in dengue hemorrhagic fever. Southeast Asian J Trop Med Public Health 11:194–204
Bokisch VA, Top FH Jr, Russell PK, Dixon FJ, Muller-Eberhard HJ (1973) The potential pathogenic role of complement in dengue hemorrhagic shock syndrome. N Engl J Med 289:996–1000
Green S, Vaughn DW, Kalayanarooj S et al (1999) Early immune activation in acute dengue illness is related to development of plasma leakage and disease severity. J Infect Dis 179:755–762
Mairuhu AT, Mac Gillavry MR, Setiati TE et al (2003) Is clinical outcome of dengue-virus infections influenced by coagulation and fibrinolysis? A critical review of the evidence. Lancet Infect Dis 3:33–41
Vaughn DW, Green S, Kalayanarooj S et al (2000) Dengue viremia titer, antibody response pattern, and virus serotype correlate with disease severity. J Infect Dis 181:2–9
Burke DS, Nisalak A, Johnson DE, Scott RM (1988) A prospective study of dengue infections in Bangkok. Am J Trop Med Hyg 38:172–180
Halstead SB, Nimmannitya S, Cohen SN (1970) Observations related to pathogenesis of dengue hemorrhagic fever. IV. Relation of disease severity to antibody response and virus recovered. Yale J Biol Med 42:311–328
Russell PK, Yuill TM, Nisalak A et al (1968) An insular outbreak of dengue hemorrhagic fever. II. Virologic and serologic studies. Am J Trop Med Hyg 17:600–608
Sangkawibha N, Rojanasuphot S, Ahandrik S et al (1984) Risk factors in dengue shock syndrome: a prospective epidemiologic study in Rayong, Thailand. I. The 1980 outbreak. Am J Epidemiol 120:653–669
Kurane I, Meager A, Ennis FA (1989) Dengue virus-specific human T cell clones. Serotype crossreactive proliferation, interferon gamma production, and cytotoxic activity. J Exp Med 170:763–775
Kliks SC, Nimmanitya S, Nisalak A, Burke DS (1988) Evidence that maternal dengue antibodies are important in the development of dengue hemorrhagic fever in infants. Am J Trop Med Hyg 38:411–419
Martinez E, Guzman MG, Valdes M, Soler M, Kouri G (1993) Dengue fever and hemorrhagic dengue in infants with a primary infection. Rev Cubana Med Trop 45:97–101
Scott RM, Nimmannitya S, Bancroft WH, Mansuwan P (1976) Shock syndrome in primary dengue infections. Am J Trop Med Hyg 25:866–874
Morens DM, Sather GE, Gubler DJ, Rammohan M, Woodall JP (1987) Dengue shock syndrome in an American traveler with primary dengue 3 infection. Am J Trop Med Hyg 36:424–426
Guzman MG, Kouri G, Bravo J et al (2002) Effect of age on outcome of secondary dengue 2 infections. Int J Infect Dis 6:118–124
Kouri GP, Guzman MG, Bravo JR, Triana C (1989) Dengue haemorrhagic fever/dengue shock syndrome: lessons from the Cuban epidemic, 1981. Bull World Health Organ 67:375–380
Gamble J, Bethell D, Day NP et al (2000) Age-related changes in microvascular permeability: a significant factor in the susceptibility of children to shock? Clin Sci (Lond) 98:211–216
Guzman MG, Kouri GP, Bravo J et al (1990) Dengue hemorrhagic fever in Cuba, 1981: a retrospective seroepidemiologic study. Am J Trop Med Hyg 42:179–184
Loke H, Bethell D, Phuong CX et al (2002) Susceptibility to dengue hemorrhagic fever in Vietnam: evidence of an association with variation in the vitamin D receptor and Fc gamma receptor IIa genes. Am J Trop Med Hyg 67:102–106
Loke H, Bethell DB, Phuong CX et al (2001) Strong HLA class I-restricted T cell responses in dengue hemorrhagic fever: a double-edged sword? J Infect Dis 184:1369–1373
Stephens HA, Klaythong R, Sirikong M et al (2002) HLA-A and -B allele associations with secondary dengue virus infections correlate with disease severity and the infecting viral serotype in ethnic Thais. Tissue Antigens 60:309–318
Wang WK, Chao DY, Kao CL et al (2003) High levels of plasma dengue viral load during defervescence in patients with dengue hemorrhagic fever: implications for pathogenesis. Virology 305:330–338
Lanciotti RS, Calisher CH, Gubler DJ, Chang GJ, Vorndam AV (1992) Rapid detection and typing of dengue viruses from clinical samples by using reverse transcriptase-polymerase chain reaction. J Clin Microbiol 30:545–551
Morita K, Maemoto T, Honda S et al (1994) Rapid detection of virus genome from imported dengue fever and dengue hemorrhagic fever patients by direct polymerase chain reaction. J Med Virol 44:54–58
Warrilow D, Northill JA, Pyke A, Smith GA (2002) Single rapid TaqMan fluorogenic probe based PCR assay that detects all four dengue serotypes. J Med Virol 66:524–528
Sudiro TM, Zivny J, Ishiko H et al (2001) Analysis of plasma viral RNA levels during acute dengue virus infection using quantitative competitor reverse transcription-polymerase chain reaction. J Med Virol 63:29–34
Young PR, Hilditch PA, Bletchly C, Halloran W (2000) An antigen capture enzyme-linked immunosorbent assay reveals high levels of the dengue virus protein NS1 in the sera of infected patients. J Clin Microbiol 38:1053–1057
Koraka P, Burghoorn-Maas CP, Falconar A et al (2003) Detection of immune-complex-dissociated nonstructural-1 antigen in patients with acute dengue virus infections. J Clin Microbiol 41:4154–4159
Alcon S, Talarmin A, Debruyne M et al (2002) Enzyme-linked immunosorbent assay specific to dengue virus type 1 nonstructural protein NS1 reveals circulation of the antigen in the blood during the acute phase of disease in patients experiencing primary or secondary infections. J Clin Microbiol 40:376–381
Vaughn DW, Green S, Kalayanarooj S et al (1997) Dengue in the early febrile phase: viremia and antibody responses. J Infect Dis 176:322–330
Cuzzubbo AJ, Vaughn DW, Nisalak A et al (2000) Comparison of PanBio Dengue Duo IgM and IgG capture ELISA and Venture Technologies Dengue IgM and IgG dot blot. J Clin Virol 16:135–144
Miagostovich MP, Nogueira RM, dos Santos FB et al (1999) Evaluation of an IgG enzyme-linked immunosorbent assay for dengue diagnosis. J Clin Virol 14:183–189
Vaughn DW, Nisalak A, Kalayanarooj S et al (1998) Evaluation of a rapid immunochromatographic test for diagnosis of dengue virus infection. J Clin Microbiol 36:234–238
Branch SL, Levett PN (1999) Evaluation of four methods for detection of immunoglobulin M antibodies to dengue virus. Clin Diagn Lab Immunol 6:555–557
Wu SJ, Paxton H, Hanson B et al (2000) Comparison of two rapid diagnostic assays for detection of immunoglobulin M antibodies to dengue virus. Clin Diagn Lab Immunol 7:106–110
Groen J, Koraka P, Velzing J, Copra C, Osterhaus AD (2000) Evaluation of six immunoassays for detection of dengue virus-specific immunoglobulin M and G antibodies. Clin Diagn Lab Immunol 7:867–871
Halstead SB, Deen J (2002) The future of dengue vaccines. Lancet 360:1243–1245
Monath TP, McCarthy K, Bedford P et al (2002) Clinical proof of principle for ChimeriVax: recombinant live, attenuated vaccines against flavivirus infections. Vaccine 20:1004–1018
Guirakhoo F, Pugachev K, Arroyo J et al (2002) Viremia and immunogenicity in nonhuman primates of a tetravalent yellow fever-dengue chimeric vaccine: genetic reconstructions, dose adjustment, and antibody responses against wild-type dengue virus isolates. Virology 298:146–159
Guirakhoo F, Arroyo J, Pugachev KV et al (2001) Construction, safety, and immunogenicity in nonhuman primates of a chimeric yellow fever-dengue virus tetravalent vaccine. J Virol 75:7290–7304
Winch PJ, Leontsini E, Rigau-Perez JG et al (2002) Community-based dengue prevention programs in Puerto Rico: impact on knowledge, behavior, and residential mosquito infestation. Am J Trop Med Hyg 67:363–370
Degallier N, Vilarinhos PT, de Carvalho MS, Knox MB, Caetano J Jr (2000) People’s knowledge and practice about dengue, its vectors, and control means in Brasilia (DF), Brazil: its relevance with entomological factors. J Am Mosq Control Assoc 16:114–123
Iyngkaran N, Yadav M, Harun F, Kamath KR (1992) Augmented tumour necrosis factor in Reye’s syndrome associated with dengue virus. Lancet 340:1466–1467
Terry SI, Golden MH, Hanchard B, Bain B (1980) Adult Reye’s syndrome after dengue. Gut 21:436–438
Ngo NT, Cao XT, Kneen R et al (2001) Acute management of dengue shock syndrome: a randomized double-blind comparison of 4 intravenous fluid regimens in the first hour. Clin Infect Dis 32:204–213
Dung NM, Day NP, Tam DT et al (1999) Fluid replacement in dengue shock syndrome: a randomized, double-blind comparison of four intravenous-fluid regimens. Clin Infect Dis 29:787–794
Tassniyom S, Vasanawathana S, Dhiensiri T, Nisalak A, Chirawatkul A (1997) Failure of carbazochrome sodium sulfonate (AC-17) to prevent dengue vascular permeability or shock: a randomized, controlled trial. J Pediatr 131:525–528
Tassniyom S, Vasanawathana S, Chirawatkul A, Rojanasuphot S (1993) Failure of high-dose methylprednisolone in established dengue shock syndrome: a placebo-controlled, double-blind study. Pediatrics 92:111–115
Leong KW, Srinivas P (1993) Corticosteroid-responsive prolonged thrombocytopenia following dengue haemorrhagic fever. Med J Malaysia 48:369–372
Ostronoff M, Ostronoff F, Florencio R et al (2003) Serious thrombocytopenia due to dengue hemorrhagic fever treated with high dosages of immunoglobulin. Clin Infect Dis 36:1623–1624
Pea L, Roda L, Moll F (2001) Desmopressin treatment for a case of dengue hemorrhagic fever/dengue shock syndrome. Clin Infect Dis 33:1611–1612
Chuansumrit A, Chantarojanasiri T, Isarangkura P et al (2000) Recombinant activated factor VII in children with acute bleeding resulting from liver failure and disseminated intravascular coagulation. Blood Coagul Fibrinolysis 11(Suppl 1):101–105
Dengue: current epidemics and risks to travellers (1995) Commun Dis Rep CDR Wkly 5:201
Jelinek T (2000) Dengue fever in international travellers. Clin Infect Dis 31:144–147
Lopez-Velez R, Perez-Casas C, Vorndam AV, Rigau J (1996) Dengue in Spanish travelers returning from the tropics. Eur J Clin Microbiol Infect Dis 15:823–826
Schwarz TF, Jager G, Gilch S (1995) Imported dengue virus infections in German tourists. Zentralbl Bakteriol 282:533–536
Jacobs MG, Brook MG, Weir WR, Bannister BA (1991) Dengue haemorrhagic fever: a risk of returning home. Br Med J 302:828–829
Schwartz E, Mendelson E, Sidi Y (1996) Dengue fever among travelers. Am J Med 101:516–520
Wittesjo B, Eitrem R, Niklasson B (1993) Dengue fever among Swedish tourists. Scand J Infect Dis 25:699–704
Trofa AF, DeFraites RF, Smoak BL et al (1997) Dengue fever in U.S. military personnel in Haiti. J Am Med Assoc 277:1546–1548
Shirtcliffe P, Cameron E, Nicholson KG, Wiselka MJ (1998) Don’t forget dengue! Clinical features of dengue fever in returning travellers. J R Coll Physicians (Lond) 32:235–237
Jelinek T, Dobler G, Holscher M, Loscher T, Nothdurft HD (1997) Prevalence of infection with dengue virus among international travelers. Arch Intern Med 157:2367–2370
Lindback H, Lindback J, Tegnell A, Janzon R, Vene S, Ekdahl K (2003) Dengue fever in travelers to the tropics, 1998 and 1999. Emerg Infect Dis 9:438–442
Jelinek T, Muhlberger N, Harms G et al (2002) Epidemiology and clinical features of imported dengue fever in Europe: sentinel surveillance data from TropNetEurop. Clin Infect Dis 35:1047–1052
Potasman I, Srugo I, Schwartz E (1999) Dengue seroconversion among Israeli travelers to tropical countries. Emerg Infect Dis 5:824–827
O’Leary DR, Rigau-Perez JG, Hayes EB et al (2002) Assessment of dengue risk in relief workers in Puerto Rico after Hurricane Georges, 1998. Am J Trop Med Hyg 66:35–39
Schwartz E, Moskovitz A, Potasman I et al (2000) Changing epidemiology of dengue fever in travelers to Thailand. Eur J Clin Microbiol Infect Dis 19:784–786
Cobelens FG, Groen J, Osterhaus AD et al (2002) Incidence and risk factors of probable dengue virus infection among Dutch travellers to Asia. Trop Med Int Health 7:331–338
Acknowledgement
The Royal Netherlands Academy of Arts and Sciences funded a project on Dengue virus infections (project number 99-MED-04) in which all authors are involved. Funding sources had no involvement in the writing of this report.
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Mairuhu, A.T.A., Wagenaar, J., Brandjes, D.P.M. et al. Dengue: an arthropod-borne disease of global importance. Eur J Clin Microbiol Infect Dis 23, 425–433 (2004). https://doi.org/10.1007/s10096-004-1145-1
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DOI: https://doi.org/10.1007/s10096-004-1145-1