Dengue Virus

By: Inna Gnipp and

Hamza Iqbal

Dengue Declassified

Family: Flaviviridae
Genus: Flavivirus
Species: Dengue virus

What is the Dengue

Virus?
Arbovirus
Arthropod, Mosquito, born

(Aedes aegypti)
It is a pathogen that causes
Dengue fever (DF)
Dengue hemorrhagic fever (DHF)
Can lead to Dengue shock syndrome (DSS)

Has four different serotypes (DEN-1,2,3,4)

First reported epidemics in 1780 in Asia, Africa,
and North America

Target tissues
Dengue induces cytokine production in cells
Cytotoxic factor effects endothelial cells
involved in most of the following:

Heart
Liver
Kidneys
Lungs
Intestines
Spleen
Lymph nodes
Brain
Skin (inflammatory rashes)

Symptoms: DHF

Fever
Headache
Muscle and joint pain
Dehydration
Nausea and/or Haematemesis (vomiting of blood)
Epistaxis (Bleeding from the nose, mouth, or gums)
Haematuria (Blood in Urine)
Pain behind the eyes
Plasma leakage
Respiratory distress
Petechia (Skin rash) and/or Purpura (Lesions)

Diagnostic tests
Virus isolation by infection of mice using
infected mosquitoes
Detection of IgM antibodies in the blood by
PCR or Viral isolation (Serology)
ELISA (Enzyme-Linked Immunoabsorbent
assay)
Thrombopenia
Raised hematocrit

Pathogenesis and infection

process of Dengue
Humans are initially infected through a mosquito vector
Initial interaction with cell occurs with the viruses ability
to infect cell
Primary target, Phagocytes

Virus uses cell receptor molecule to enter cell

Cell receptor molecules include:
Glycosaminoglycan
Heparan Sulfate (Expressed in almost all cell types)

Virus replicates in target organs

Infects white blood cells and lymphatic tissues
Virus is released and circulates in blood
Alternate mosquito then bites host and receives virus

DHF
Treatment Prevention:
: There is no specific treatment All efforts of control are aimed
against mosquitoes
Relieving symptoms and
complications:
Plasma volume replacement
Sedatives for restless patients
Blood transfusion with
patients with significant blood
loss
Aspirin should be avoided

Elimination of breeding areas

Actions to prevent mosquito
bites (repellant, nets, and
vapors)

Vaccinations are pending

Problem is that the
vaccination needs to prevent
all four serotypes

Epidemiology
Affects humans
Is prominent in tropical environments
Ideal for Mosquito habitats

What is promoting the disease?

Global warming is causing climate changes which is

causing the disease to move to more environments
(higher altitudes and amplitudes)
More habitats for mosquitoes to thrive in

Spread has been increased by urbanization and

population growth
Inability of mosquito control in countries is also a major
factor

Morbidity and Mortality

More than 2.5 Billion people live in areas
that have a risk of infection
Over 100 million cases of Dengue
infection are reported each year globally
500,000 cases pertain to DHF

DHF has a 5% fatality rate for those

infected
People at high risk are children and the
elderly

Bibliography

Chambers, Thomas J., Yan Liang, Deborah A. Droll, Jacob J. Schlesinger, Andrew D.
Davidson, Peter J. Wright, and Xiaoshan Jiang. "Yellow Fever Virus/Dengue-2 Virus and
Yellow Fever Virus/Dengue-4 Virus Chimeras: Biological Characterization, Immunogenicity,
and Protection Against Dengue Encephalitis in the Mouse Model." JVI. 30 Aug. 2002. 06 Dec.
2006 <http://www.journals.asm.org/>.
Dark, Graham. "On-Line Medical Dictionary." University of Newcastle. 6 Dec. 2006
<http://www.cancerweb.ncl.ac.uk>.
Aqeep, A K., A A. Malik, and M S. Elkarsani. "Clinical Presentations and Laboratory Finding in
Suspected Cases of Dengue Virus." Saudi medical journal. 27 Nov. 2006. Department of
health and human services. 6 Dec. 2006 <http://www.ncbi.nlm.nih.gov>.
Palmer, D R., P Sun, C Celluzzi, J Bisbing, S Pang, W Sun, M A. Marovich, and T Burgess.
"Differential effects of dengue virus on infected and bystander dendritic cells." Journal of
virology. Feb. 2005. Department of Viral diseases. 6 Dec. 2006 <http://www.pubmed.gov>.
Reiter, Paul, Sarah Lathrop, Michel Bunning, Brad Biggerstaff, Daniel Singer, Tejpratap Tiwari,
Laura Baber, Manuel Amador, Jaime Thirion, Jack Hayes, Calixto Seca, Jorge Mendez,
Bernardo Ramierez, Jerome Robinson, Julie Rawlings, Vance Vorndam, Stephen Waterman,
Duane Gubler, Gary Clark, and Edward Hayes. "Texas Lifestyle Limits Transmission of
Dengue Virus." CDC. Jan. 2003. 6 Dec. 2006 <http://www.cdc.gov>.
Thomas, Clayton L., ed. Taber's Cyclopedic Medical Dictionary. 18th ed. Philadelphia: F. a.
Davis Company, 1997. 505.
Seet, R C., A M. Quek, and E C. Lim. "Symptoms and Risk Factors of Ocular Complications
Following Dengue Infection." Journal of clinical virology. 1 Dec. 2006. 10 Dec. 2006
<www.pubmed.com>.

Bibliography

"Dengue: Clinical and Public Health Aspects." CDC. 1 Dec. 2005. Department of Health and
Human Services. 10 Dec. 2006 <http://www.cdc.gov>.
"Treatment." WHO. 1997. 10 Dec. 2006
<www.who.int/entity/csr/resources/publications/dengue/024-33.pdf>.
"Dengue/DHF: Fact Sheet on Dengue Fever and Dengue Haemorrhagic Fever." WHO. 4 Aug.
2006. 10 Dec. 2006 <http://www.searo.who.int>.
Cabrera-Hernandez, Arturo, and Duncan R. Smith. "Mammalian Dengue Virus Receptors." WHO.
2005. 10 Dec. 2006 <http://www.searo.who.int>.
Simasathien, S, and V Watanaveeradej. "Dengue Vaccine." Journal of the Medical Association of
Thailand. Nov. 2005. Pub Med. 11 Dec. 2006 <http://www.ncbi.nlm.nih.gov>.
Schnittler, H J., and H Feldmann. "Viral Hemorrhagic Fever--a Vascular Disease?" Thrombosis
and Haemostasis. June 2003. Pub Med. 11 Dec. 2006 <http://www.ncbi.nlm.nih.gov>.
Rigau-Perez, Jose G., Duane J. Gubler, and Gary G. Clark. "Travelers' Health: Yellow Book CH: 4
- Prevention of Specific Infectious Diseases; Dengue Fever." CDC. 2005. 11 Dec. 2006
<http://www.ncid.cdc.gov>.
Clyde, Karen, Jennifer L. Kyle, and Eva Harris. "Recent Advances in Deciphering Viral and Host
Determinants of Dengue Virus Replication and Pathogenesis." JVI. Dec. 2006. ASM Journals. 11
Dec. 2006 <http://www.ncbi.nlm.nih.gov>.
Anandarao, Ravulapalli, Sathyamangalam Swaminathan, Sirimali Fernando, Asha M. Jana, and
Navin Khanna. "Recombinant Multiepitope Protein for Early Detection of Dengue Infections." CVI.
Jan. 2006. ASM. 11 Dec. 2006 <http://cvi.asm.org/>.