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Epidemiology, Disease Transmission, Prevention, and Control
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Control activities may reflect compromises among different intervention measures. Dengue prevention involves control of an urban mosquito, Aedes aegypti, at the larval and adult stages. Programs staffed with thousands of employees were able to eradicate this mosquito from several countries of Central and South America in the middle 1960s. Because of lack of continued surveillance, these mosquitoes were reintroduced and the countries were reinfested in the late 1970s. Since then, dengue has spread. Actually, today employing the same tools as were used in the 1960s is impossible for economic reasons. Funds are not available to support thousands of employees going house to house to eliminate breeding sources and spraying for adult mosquitoes. What is now possible is education to obtain the help of the community to implement source reduction by eliminating receptacles containing water that may serve as breeding places, or making them unsuitable as breeding places for the mosquitoes. Vaccination is probably one of the most effective means for control of infectious disease. However, in order to be implemented, a vaccine must be available and an effective delivery system must be in place. The health services system to be used to deliver the vaccine must provide universal coverage and the population must be cooperative. Other elements to be considered are available resources, time constraints, personnel available, and potential complications of the proposed control measures.
Mosquitoes
Published in Jerome Goddard, Public Health Entomology, 2022
Dengue fever. Dengue is caused by a virus in the family Togaviridae, and is responsible for widespread morbidity (breakbone fever) and some mortality [dengue hemorrhagic fever (DHF)] in much of the tropics and subtropics each year (Figure 9.7). Most dengue infections result in relatively mild illness characterized by fever, headache, myalgia, rash, nausea, and vomiting. However, DHF may be severe, causing petechiae, purpura, mild gum bleeding, nosebleeds, gastrointestinal bleeding, and dengue shock syndrome. Worldwide, as many as 400 million cases of dengue occur annually, and several hundred thousand cases of DHF.9 Although the disease literally “knocks on the door” of the continental United States each year, it infrequently becomes established here. However, in 2009, there was an outbreak of locally acquired dengue in the Florida Keys.10
Zika: An Ancient Virus Incipient into New Spaces
Published in Jagriti Narang, Manika Khanuja, Small Bite, Big Threat, 2020
Bennet Angel, Neelam Yadav, Jagriti Narang, Surender Singh Yadav, Annette Angel, Vinod Joshi
Past medical details, locality, details of traveling to flavivirus-prone areas etc. should be captured. The patients mental state, hydration state, abdominal tenderness, and other parameters should be checked. The blood/serum sample should then be drawn to diagnose routine blood- and dengue-related tests. Plenty of fluids and ORS are recommended, and proper rest is advised. As per the WHO, no treatment is available for ZIKV infection or its associated diseases. Symptoms of ZIKV infection are usually mild. People with symptoms such as fever, rash, or arthralgia should get plenty of rest, drink fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. Pregnant women living in areas with Zika transmission or who develop symptoms of ZIKV infection should seek medical attention for laboratory testing and other clinical care (WHO guidelines, 2009).
Diagnostic approaches for dengue infection
Published in Expert Review of Molecular Diagnostics, 2023
Gaythri Thergarajan, Shamala Devi Sekaran
Dengue can be diagnosed clinically; however, laboratory tests are still needed for confirmation of the infection. Definitive diagnosis is important not only for clinical management of patients but also for interventions during outbreaks, epidemiological surveillance, for vaccine development and monitoring. Many are still developing assays and newer more advance technologies are being developed though validation is an issue. The main hurdle lies in the incompletely understood pathogenesis of dengue and that multiple sequential infections occur notwithstanding the issues with primary and secondary infection status that further complicate the diagnosis. To effectively manage a disease, it’s important to have confidence in the diagnostic test used, particularly during the early stages of the illness and for identifying its severity. An ideal test for diagnosing dengue would be affordable, simple, and able to differentiate between primary and secondary infections, as well as serotype the virus with high sensitivity and specificity. However, this is a difficult goal to achieve as the optimal time frame for diagnosis is within the first ten days after infection, and many patients seek medical attention late or resort to traditional remedies in some parts of the world. It is also important to note that 2% do not seroconvert and a high number are asymptomatic.
Cardiovascular sequelae of dengue fever: a systematic review
Published in Expert Review of Cardiovascular Therapy, 2022
Abdur Rahim, Ali Hameed, Uzma Ishaq, Jahanzeb Malik, Syed Muhammad Jawad Zaidi, Hajra Khurshid, Asmara Malik, Danish Iltaf Satti, Hifza Naz
Although most of the dengue infections are asymptomatic or present with mild symptoms, a proportion of patients (1%–5%) develop complications, including organ shutdown, bleeding, and plasma leakage from capillaries [6]. Dengue is divided into three stages of the disease progression: a febrile stage, lasting up to 7 days, during which the patient can experience high-grade fever, myalgias, headache, malaise, and vomiting; a critical phase, lasting 2–3 days, during which severe clinical manifestations become apparent; and recovery phase, for 2–5 days, when there is clinical improvement associated with resorption of leaked extracellular fluid. An increase in capillary permeability causes intravascular hypovolemia, leading to DSS. This is the most commonly known cardiovascular (CV) complication associated with dengue. However, various other CV manifestations have been reported, ranging from subtle electrocardiogram (ECG) changes to fulminant myocarditis, causing functional myocardial dysfunction and arrhythmias [7–94].
Murine models of dengue virus infection for novel drug discovery
Published in Expert Opinion on Drug Discovery, 2022
Alana B. Byrne, Cybele C. García, Elsa B. Damonte, Laura B. Talarico
At present, no specific antiviral agents nor effective vaccines are available. Treatment of dengue disease is mainly symptomatic, directed towards reducing aches, pains, and fever as well as maintaining patient´s body fluid volume to counteract plasma extravasation in severe dengue disease. Currently, several vaccines against DENV are in development [15]. One of them, Dengvaxia®, a chimeric yellow fever-dengue-tetravalent dengue vaccine (CYD-TDV) has been approved in around 20 countries in individuals 9–45 years of age with previously confirmed DENV infections. Phase III efficacy tests have shown that this vaccine has limited efficacy in individuals not previously exposed to DENV and could increase disease severity in children aged 2–5 years of age [16]. Even though there is no specific antiviral agent currently available for the treatment of dengue, potential antiviral compounds are being tested in pre-clinical and clinical studies [17].