Dengue - What is it?

by Houssem Djeridi

Dengue is a mosquito-borne viral infection, usually transmitted by Aedes aegypti mosquitoes.
The infection causes flu-like illness, and occasionally develops into a potentially lethal complication called severe dengue.
The global incidence of dengue has grown dramatically in recent decades. About half of the world's population is now at risk.
Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas. Severe dengue is a leading cause of serious illness and death among children in some Asian and Latin American countries.
In 2018, dengue has been reported from Bangladesh, Cambodia, India, Myanmar, Malaysia, Pakistan, Philippines, Thailand, and Yemen.
Recently dengue virus outbreak has been reported in Cuba, according to Cinco de Septiembre, official newspaper of Cienfuegos in south central Cuba. This type of dengue has not been reported in Cuba since 1977. "A new epidemic of dengue has broken out, causing alarm and clinical developments, but luckily we have not had to mourn the loss of life up until now," the newspaper quoted provincial health director Salvador Tamayo Muniz, speaking to regional leaders. The last time this form of dengue was active in Cuba, more than 500,000 people from the eastern area of the island became infected.

​In Africa, dengue virus is not well recognized, On 27 September 2018 an investigation has been instituted in Senegal and it identified 180 cases that met the dengue fever case definition; of these 120 were investigated. Blood specimens were collected from suspected cases, an additional 21 cases among symptomatic patients tested positive for dengue fever by polymerase chain reaction (PCR). Further analysis carried out by the Institute Pasteur Dakar show a circulation of dengue fever virus serotype 1 (DENV-1).

Dengue infection is cause by four serotypes; DEN-1, DEN-2, DEN-3, and DEN-4, each one of these viruses has different interactions with the antibodies in human blood serum.
There is no specific treatment for dengue/ severe dengue, but early detection and access to proper medical care lowers fatality rates below 1%. Laboratory diagnosis is carried out by virus isolation, demonstration of viral antigen, presence of viral nucleic acid, and antibodies. Further, recombinant dengue envelope protein can be used to detect specific antibodies, both IgG and IgM against all four serotypes of virus using an E. coli vector. The purified protein can then be used for detection of dengue specific IgG or IgM antibodies in patient serum with higher sensitivity and specificity, than that of traditional assays. Molecular detection can be accomplished by a one-step, single-tube, rapid, multiplex, RT-PCR for serotype determination. Despite many advantages of the modern techniques, isolation of virus is still considered as "gold-standard" in dengue diagnosis.

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