Pathogen of the Month, Viruses

Dengue Fever and What You Need to Know

Author Chandana Balasubramanian , 28-Jul-2021

Halfway through every Hollywood disaster movie, when all hell breaks loose, a few rogue scientists are brought in. This handful of experts would have predicted the disease outbreak or catastrophe years, or sometimes decades, before. But their advice would have fallen on deaf ears – until it was almost too late.

Meanwhile, in real life, a large and vocal group of researchers and public health organizations are sounding the alarm about Dengue as a pandemic-level threat in the near future.

The relatively good news is that Dengue, a vector-borne illness, is not transmissible between humans. So, we can prevent a full-blown Dengue pandemic if the global community of public health officials:

But why is Dengue such a colossal threat? Why is prevention important?

Dengue Cases On The Rise

Currently, Dengue cases are estimated to be anywhere from 5 – 100 million. This wide range is because many cases stay unreported, or the symptoms of Dengue are confused for other diseases. But the number of Dengue cases is expected to boom in the next few decades, with 60% growth by 2080 [1].

Tracking the geographical spread of the Dengue virus by different vectors is complex.

Reported Dengue cases in different regions, 1980 – 2020

Graph illustrating Dengue cases in different regions, 1980 - 2020

Image: Graph illustrating Dengue cases in different regions, 1980 – 2020. Copyright © GIDEON Informatics, Inc.

 

Dengue Mosquito Spreads Its Wings Worldwide

While Dengue cases are primarily found in the tropical regions of Asia, Africa, and the Americas, this is rapidly changing. The study from Spain determined that other regions now at risk are South-East ChinaPapua New Guinea, North Australia, South USA, parts of ColombiaVenezuelaMadagascar, and even Japan and South and Central Europe. The study predicts that Dengue could spread to Argentina and South-West Asia, from Pakistan and the Arabian Peninsula.

Ideally, public health officials in these regions will begin training their healthcare professionals to diagnose and treat Dengue early and raise awareness among their populations.

For example, initially, Egypt’s Ministry of Health dismissed reports of Dengue fever in certain regions. But eventually, they reviewed published reports of Dengue outbreaks in studies that used GIDEON’s clinical tools. This prompted them to develop a training program for their health workers for the early detection and treatment of Dengue [5].

Two significant factors accelerating dengue virus transmission worldwide are the 2.9 trillion U.S dollar global travel and tourism industry and climate change.

Many studies indicate that international travelers are at considerable risk for Dengue spread. Ratnam et al. from Australia concluded that Dengue infections in international travelers occur frequently and may be associated with substantial morbidity [6].

What is worrisome is that while Dengue is not directly contagious among humans, it is transmittable from an infected human to an infection-free aedes aegypti mosquito. So, if a Dengue-infected individual travels to another country during the viremic or infection-spreading period, a native Aedes mosquito may bite the individual and become infected [7]. This newly infected mosquito can infect other individuals.

Additionally, climate change is a contributor because rising temperatures in previously colder environments are fertile grounds for mosquitoes to thrive. Higher temperatures also shorten the cycle of a mosquito picking up a dengue virus infection and transmitting it.

Captured in La Paz, Honduras, this August 2019 photograph, depicted Dr. Liliana Sanchez-Gonzales on the left, an Epidemiologist with the Centers for Disease Control and Prevention’s (CDC) Dengue Branch, along with an unidentified Honduran physician, as they were examining the chest x-ray of a patient, who was on the verge of developing severe dengue. The x-ray revealed the presence of fluid in her lungs, possibly due to plasma leakage, as she was going into dengue-related shock.

Captured in La Paz, Honduras, this August 2019 photograph, depicted Dr. Liliana Sanchez-Gonzales on the left, an Epidemiologist with the Centers for Disease Control and Prevention’s (CDC) Dengue Branch, along with an unidentified Honduran physician, as they were examining the chest x-ray of a patient, who was on the verge of developing severe dengue. The x-ray revealed the presence of fluid in her lungs, possibly due to plasma leakage, as she was going into dengue-related shock.

 

Why is the Virus Dangerous?

According to WHO, severe Dengue is a leading cause of serious illness, hospitalization, and death among children and adults in some Asian and Latin American countries [4]. Severe Dengue involves severe bleeding, liver, heart, and other organ impairment, and plasma leakage.

Many Dengue infections are mild with flu-like symptoms, but a lack of awareness and early detection could lead to severe Dengue. And since the incubation period varies from four to ten days, it may be overlooked or misdiagnosed until it becomes severe. Additionally, because there are four different types of the Dengue virus, individuals once affected by Dengue can be re-infected up to four times.

The Dengue vaccine is only available in certain countries and, as per WHO is restricted to those aged 9 to 45 and individuals previously infected by DENV. Hopefully, we get a better alternative. But until then, we need to raise awareness about early detection and treatment on the frontlines and track outbreaks closely.

Diagnosing Dengue Fever and Addressing Symptoms

Dengue fever is a viral infection that is transmitted by mosquitoes. Dengue fever symptoms can range from mild to severe, and they typically include fever, headache, nausea, vomiting, muscle and joint pain, and rash. In some cases, dengue fever can also lead to more serious complications, such as hemorrhagic fever and dengue shock syndrome.

Early diagnosis of dengue fever is important in order to provide the best possible treatment and outcome for the patient. There are several methods that can be used to diagnose dengue fever, including clinical examination, laboratory testing, and imaging studies. A detailed history and physical examination can often provide clues to the diagnosis of dengue fever, but laboratory confirmation is usually necessary.

Laboratory tests that may be ordered include complete blood count, serum electrolytes, liver function tests, and serology. Imaging studies are generally not needed for the diagnosis of dengue fever, but they may be helpful in assessing for complications. Treatment of dengue fever focuses on relieving symptoms and supporting the patient through the acute phase of the illness. There is no specific antiviral therapy for dengue fever, so treatment is supportive in nature.

Preventing the Spread of Dengue Fever

Dengue fever is a disease caused by a virus that is spread by mosquitoes. It is a leading cause of illness and death in many tropical and subtropical countries. The best way to prevent it is to avoid mosquito bites. Mosquitoes that spread dengue fever bite during the day, so it is important to use insect repellent, wear long-sleeved shirts and pants, and stay in air-conditioned or well-screened rooms. You can also reduce the risk of mosquito bites by emptying containers of standing water, where mosquitoes lay their eggs.

Taking these steps can help to prevent the spread of dengue fever. We can also help prevent the spread by becoming more informed and making data accessible to care providers, that is where GIDEON comes into play.

The GIDEON Difference

GIDEON is one of the most well-known and comprehensive global databases for infectious diseases. Data is refreshed daily, and the GIDEON API allows medical professionals and researchers access to a continuous stream of data. Whether your research involves quantifying data, learning about specific microbes, or testing out differential diagnosis tools– GIDEON has you covered with a program that has met standards for accessibility excellence.

You can also review our eBooks on Rheumatic Fever and Scarlet FeverSchistosoma HaematobiumTaenia and Diphyllobothrium, and more. Or check out our global status updates on countries like Senegal, Comoros and MayotteMaldives, and more!

 

References

[1]World Health Organization, “Global strategy for Dengue prevention and control, 2012-2020,” World Health Organization, Genève, Switzerland, 2012.
[2]A. A.-S. e. al., “Worldwide dynamic biogeography of zoonotic and anthroponotic Dengue,” PLoS Negl. Trop. Dis., vol. 15, no. 6, p. e0009496, 2021.
[3]B. S, “Dengue: Global Status,” GIDEON Informatics, Inc., Los Angeles, California, USA, 2015.
[4]W. W. H. Organization, “Dengue and Severe Dengue Fact Sheet,” World Health Organization, 19 May 2021. [Online] [Accessed 04 07 2021].
[5]Department of Tropical Medicine, Ain Shams University, Cairo, Egypt, “Dengue fever, Correspondence to Nadia A Abdelkader, MD,” Egypt J Intern Med, vol. 30, pp. 47-48, 2018.
[6]F. Irani Ratnam, “Dengue Fever and International Travel,” Journal of Travel Medicine, vol. 20, no. 6, p. 384–393, 2013.
[7]J. P. Messina, “The current and future global distribution and population at risk of Dengue,” Nature Microbiology, vol. 4, p. 1508–1515, 2019.
Author
Chandana Balasubramanian

Chandana Balasubramanian is an experienced healthcare executive who writes on the intersection of healthcare and technology. She is the President of Global Insight Advisory Network, and has a Masters degree in Biomedical Engineering from the University of Wisconsin-Madison, USA.

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