What is Dengue?
Dengue is an acute viral infection caused by the dengue virus, which is transmitted primarily by the Aedes aegypti mosquito. It is a significant public health concern in tropical and subtropical regions around the world. The disease can lead to severe flu-like symptoms and, in some cases, can develop into severe dengue, which is a leading cause of serious illness and death in some Asian and Latin American countries.
Transmission and Vector
The primary vector for dengue is the Aedes aegypti mosquito, although Aedes albopictus can also transmit the virus. These mosquitoes are most active during the day, with peak biting periods early in the morning and before dusk. The virus is transmitted to humans through the bite of an infected female mosquito. After feeding on a person infected with the dengue virus, the mosquito becomes a carrier and can transmit the virus to other people.Epidemiology and Disease Burden
Dengue is endemic in over 100 countries, with an estimated 390 million dengue infections occurring each year. Of these, about 96 million manifest clinically. The World Health Organization (WHO) considers dengue to be one of the top ten threats to global health. Urbanization, international travel, and climate change are contributing factors to the increasing incidence and geographic spread of dengue.Symptoms and Clinical Presentation
The incubation period of dengue is typically 4-10 days after the bite of an infected mosquito. Symptoms include sudden high fever, severe headaches, pain behind the eyes, joint and muscle pain, rash, and mild bleeding (such as nose or gum bleeding). Severe dengue, also known as dengue hemorrhagic fever or dengue shock syndrome, can lead to plasma leakage, fluid accumulation, respiratory distress, severe bleeding, or organ impairment.Diagnosis and Treatment
Dengue diagnosis is primarily based on clinical presentation and confirmed through laboratory tests such as nucleic acid amplification tests (NAATs), serological tests (IgM and IgG), and non-structural protein 1 (NS1) antigen detection. There is no specific antiviral treatment for dengue. Management focuses on relieving symptoms, maintaining hydration, and monitoring for complications.Prevention and Control
Prevention of dengue focuses on mosquito control measures and reducing human-mosquito contact. Strategies include the use of insect repellent, wearing long-sleeved clothing, using mosquito nets, and eliminating standing water where mosquitoes breed. Community-based efforts and public health campaigns are essential for effective control. The dengue vaccine (Dengvaxia) is approved for use in some countries but has limitations and requires careful consideration regarding its implementation.Surveillance and Response
Effective surveillance systems are crucial for the early detection and response to dengue outbreaks. This includes monitoring mosquito populations, tracking cases, and identifying hotspots of transmission. Public health authorities use this data to implement targeted interventions and mobilize resources to control the spread of the disease.Challenges and Future Directions
The control of dengue faces several challenges, including insecticide resistance in mosquito populations, rapid urbanization, and climate change, which affects the distribution and behavior of mosquitoes. Research is ongoing to develop more effective vaccines, antiviral treatments, and innovative vector control methods. Collaborative efforts at local, national, and international levels are essential to combat the global threat of dengue.
