Pathophysiology of severe dengue centers for disease. This video aims to describe the mode of replication of dengue virus and the pathophysiology of dengue. The incidence of dengue has increased dramatically in recent decades, with estimates of 40%50% of the. Dengue is the most common and important arthropodborne viral arboviral illness in humans. Dengue guidelines for diagnosis, treatment, prevention and control dengue guidelines for diagnosis, treatment, prevention and control new edition neglected tropical diseases ntd tdr world health organization hivaids, tuberculosis and malaria htm 20, avenue appia world health organization 1211 geneva 27. Rhesus monkeys develop viremia similar in pattern to humans after dengue virus challenge but do not develop clinical disease. Dengue infection is caused by any of four dengue virus serotypes. Dengue is an important differential diagnosis of fever in children presenting to firstlevel health facilities in tropical asia and latin america. However, since dengue shares clinical features with a wide variety of illnesses especially during the early febrile phase, large numbers of patients with possible dengue are often admitted to healthcare facilities in endemic areas, primarily for observation, and seasonal.
Dengue fever df is the fastest emerging arboviral infection spread by aedes aegypti. National center for emerging and zoonotic infectious diseases. The rapidly expanding global footprint of dengue is a public health challenge with a high economic burden. Dengue feverdengue hemorrhagic fever dengue feverdengue hemorrhagic fever bruce r. Introduction dengue and dengue hemorrhagic fever dhf result from infection by any of four serotypes of dengue viruses. Summary much remains to be learned about the pathogenesis of the different manifestations of dengue virus denv infections in humans. Pathogenesis people bitten by aedes aegypti mosquito are diagnosed with high fever and severe joint pain that are the common symptoms of dengue fever 16. Dengue pathogenesis, clinical manifestation, lab diagnosis and treatment. Dengue infection is caused by 4 antigenically distinct dengue virus serotypes.
Dengue viruses occur as four antigenically related but distinct serotypes transmitted to humans by aedes aegypti mosquitoes. Dengue virus denv belongs to the family flaviviridae, genus flavivirus, and is transmitted to humans by aedes mosquitoes, mainly aedes aegypti. The clinical manifestations range from asymptomatic infection to undifferentiated fever, dengue fever and dengue hemorrhagic fever dhf. Arun vasireddy dengue fever subject seminar 6th july,2015. They may be asymptomatic or may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever dhf, or dengue shock syndrome. Dengue fever is a virus transmitted to humans through bites from the aedes mosquito, a daybiting mosquito. May 03, 2019 dengue is the most common and important arthropodborne viral arboviral illness in humans. Pathophysiology and management of dengue hemorrhagic fever. Dengue presents the most uptodate overview of the field, encompassing various aspects of epidemiology, virus research, clinical management of the disease, pathogenesis, vector control and diagnosis. The ane significant potential clinical implications in covid19. Based on neutralization assay data, four serotypes denv1, denv2, denv3, and denv4 can be distinguished. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of dengue, there is a critical need for adequate tropism assays, animal models, and human autopsy data. Pathophysiology plasma leakage denvinfected cells release inflammatory mediators, immune complexes are formed, and the complement cascade is activated resulting in increased vascular permeability and hemorrhagic manifestations that characterize severe dengue. The salient features of the resolution of the fortysixth world health assembly wha in.
It would present with persistent diarrhea, sometimes bloody. It is transmitted by mosquitoes of the genus aedes, which are widely distributed in subtropical and tropical areas of the world see the image below. It is almost always responsive to appropriate antibiotics. They are rna viruses that belong to the flavivirus genusflaviviridae family, which also includes the yellow fever virus, west nile virus, japanese encephalitis virus, zika virus, and the st louis encephalitis virus.
Df is classically a selflimiting, nonspecific illness characterized by fever, headache, myalgia, and constitutional symptoms. It is the fastest spreading vectorborne viral disease and is now endemic in over 100 countries, resulting in 40% of the worlds population living in an area at risk for dengue. Bacterial dysentery is serious and can be life threatening. Dengue fever has emerged as a global public health problem in the recent decades. Annually, 100 million cases of dengue fever and half a million cases of dhf occur worldwide. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of dengue, there is a. Dengue is a mosquitoborne flavivirus found in tropical and subtropical regions of the world, mostly in urban and semiurban settings.
Here we investigate the immunoglobulin responses of patients with dengue fever df and. Guerdan, md, mph abstract in september 2009 the first documented, locally acquired cases of dengue fever in eighty years were diagnosed in individuals living in or visiting key west, florida. Aetiology,pathophysiology and diagnosis of dengue infection. Apr 24, 2020 dengue has become a widespread infection over the past few year, extending from endemic to nonendemic areas. Infection with one dengue serotype confers lifelong homotypic immunity and a brief period of partial heterotypic immunity 2 years, but each individual can eventually be infected by all. Dengue fever is a mosquitoborne viral disease caused by 1 of 4 closely related but antigenically distinct serotypes of dengue virus, serotypes denv1 through den4. Although dengue is a very old disease but recently an alarming increase has been seen in the geographic range, along with the severity of infection 17. A global strategy on dengue fever and dhf was developed in 1995 and its implementation was bolstered in 1999. Infection may be asymptomatic or present with a broad range of clinical manifestations including a mild febrile illness to a lifethreatening shock syndrome. Typhoid fever pathophysiology free download as word doc. Plasma leakage and intrinsic coagulopathy are the pathological hall marks in dengue haemorrhagic fever dhf.
The incidence of dengue has increased dramatically in recent decades, with estimates of 40%50% of the worlds population at risk for the. Dengue and its severe forms, namely, dengue haemorrhagic fever dhf and dengue shock syndrome dss, caused by four serotypes of dengue virus denv, have become a major public health concern that is straining the health systems of both developing and developed countries. Dengue fever is common in tropical areas, so take extra precautions if you travel somewhere with this type of. Feb 16, 2018 dengue denggey fever is a mosquitoborne disease that occurs in tropical and subtropical areas of the world. Learn more dengue clinical case management elearning pathophysiology of severe dengue. However, since dengue shares clinical features with a wide variety of illnesses especially during the early febrile phase, large numbers of patients with possible dengue are often admitted to healthcare facilities in endemic areas, primarily for observation, and seasonal epidemics may overwhelm health service capacity. Get the knowledge you need in order to pass your classes and more. May 03, 2019 dengue has been called the most important mosquitotransmitted viral disease in terms of morbidity and mortality.
A severe form of dengue fever, also called dengue hemorrhagic fever, can cause severe bleeding, a sudden drop in blood pressure shock and death. Beginning in the 1950s, at the time when four different denvs were discovered, a lethal variant of dengue emerged. Role of ns1 antibodies in the pathogenesis of acute. World health organization, regional office for southeast asia. Since the last major pandemic in 1998, epidemics have recurred in much of the area. Transmission occurs through the bite of infected aedes mosquitoes, principally aedes aegypti, which is also the principal urban vector of yellow fever. The pathology of dengue hemorrhagic fever sciencedirect. Mild dengue fever causes a high fever, rash, and muscle and joint pain. Recent advances in dengue pathogenesis and clinical. Pdf autoimmune pathogenesis in dengue virus infection. Dengue hemorrhagic fever dengue shock syndrome dhfdss initially observed in southeast asia now has spread throughout the world.
Dengue pathogenesis, clinical manifestation, lab diagnosis. Guidelines for diagnosis, treatment, prevention and control. Dengue virus denv infections of humans were long thought to be selflimited and of low mortality. Dengue fever is a mosquitoborne viral illness found throughout the. Doctor answers on symptoms, diagnosis, treatment, and more. Although dengue is a very old disease but recently an alarming increase has been seen in the geographic range, along with the severity of. Much remains to be learned about the pathogenesis of the different manifestations of dengue virus denv infections in humans. Jul 11, 2018 dengue part 1 pathophysiology by dr ariff arithra duration.
Secondary infection by a different dengue virus serotype has been confirmed as an important risk factor for the development of dhf. Substantial gaps remain in the comprehensive understanding of the pathogenesis of dengue virus infections. Severe dengue infection can lead to death, therefore, clinicians should should aim for. The vaccine manufacturer, sanofi pasteur, announced in 2017 that people who receive the vaccine and have not been previously infected with a dengue virus may be at risk of developing severe dengue if they get dengue after being vaccinated. The who estimates that 50100 million cases of dengue infection occur annually, with approximately 500,000 of those cases resulting in dengue hemorrhagic fever dhf, with an estimated 22,000 deaths per year, mostly in children.
Nov 25, 2015 dengue virus denv infections of humans were long thought to be selflimited and of low mortality. The cause of thrombocytopenia in dengue is thought to be an immunerelated process. They may range from subclinical infection to dengue fever, dengue hemorrhagic fever dhf, and eventually dengue shock syndrome dss. Endothelial cells elicit immuneenhancing responses to dengue virus infection n. Dengue bulletin dengue volume 39, december 2016 bulletin issn 02508362 issn 02508362 who the who regional office for southeast asia publish the annual dengue bulletin. The objective of the bulletin is to disseminate updated information on the current status of dengue fever dengue haemorrhagic fever infection, changing. Dengue fever epidemiology pathogenesis symptoms diagnosis management complications 1.
Pathophysiology of dengue associated acute kidney injury several mechanisms have been postulated for the pathogenesis of dengue associated aki daki, including direct action by the virus, haemodynamic instability, rhabdomyolysis, haemolysis, and acute glomerular injury. Appropriate management of the burden of dengue is hindered by several issues,including lack of understanding of the exact pathophysiology. The overall incidence of df has increased exponentially worldwide over the last three decades. Dengue is a febrile illness caused by infection with one of four dengue viruses denv transmitted by aedes aegypti or aedes albopictus mosquitoes during the taking of a blood meal. Typhoid fever pathophysiology salmonella public health. Dengue hemorrhagic fever can occur when someone is bitten by a mosquito or exposed to blood infected with the dengue virus. Sep 17, 2010 aetiology, pathophysiology and diagnosis of dengue infection dr lee oi wah peg. In large part, this limitation is related to the lack of a suitable animal model of disease. Antibodydependent enhancement of disease and severe dengue. Severe dengue most commonly occurs among infants and patients with secondary dengue virus denv infections i. Dengue viral infections are one of the most important mosquito borne diseases in the world. Pathophysiology of dysentery what you need to know.
The clinical manifestations range from asymptomatic infection to undifferentiated fever, dengue fever and dengue hemorrhagic fever d. Viral virulence, infection enhancing antibodies, cytokines and chemical mediators in the setting of intense immune activation are the key players implicated in the pathogenesis of dhf. The most widely cited hypothesis for this occurrence is antibody dependent enhancement ade of disease. Pathogenesis of dengue haemorrhagic fever and its impact. Dec 08, 2017 the vaccine manufacturer, sanofi pasteur, announced in 2017 that people who receive the vaccine and have not been previously infected with a dengue virus may be at risk of developing severe dengue if they get dengue after being vaccinated. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. The role of ns1specific antibodies in the pathogenesis of dengue virus infection is poorly understood. Pathogenesis and pathophysiology of dengue hemorrhagic fever. The who regional office for southeast asia publish dengue. Dengue fever is a mosquitoborne viral disease caused by 1 of 4 closely related but antigenically distinct serotypes of dengue virus, serotypes denv1. Dengue fever df and dengue hemorrhagic fever dhf are 2 apparently distinct clinical manifestations of dengue virus infection, and each may be caused by any of the 4 antigenically related dengue virus serotypes 1, 2. Dengue viral infections postgraduate medical journal.1202 1274 1494 1476 1291 208 3 26 421 894 101 950 1111 329 1520 266 923 1120 1317 65 586 892 1015 938 637 1142 955 613 1170 159