Dengue Virus

Dengue virus (DENV) is a single-stranded RNA virus that belongs to the genus Flavivirus, which includes Zika virus, West Nile virus and Japanese Encephalitis virus. Dengue virus infection is transmitted to humans by mosquitoes, primarily Aedes aegypti species. It is a febrile illness that affects infants, young children and adults with symptoms appearing 3-14 days after the infective bite. Symptoms range from mild fever, to incapacitating high fever, with severe headache, pain behind the eyes, muscle and joint pain, and rash. Severe dengue (also known as dengue hemorrhagic fever) is a potentially lethal complication that is characterized by fever, abdominal pain, persistent vomiting, bleeding and breathing difficulty (1). Dengue virus infection is caused by any one of four related viruses DEN-1, DEN-2, DEN-3 and DEN-4, also referred to as serotypes, which co-circulate in endemic areas. Infection with one dengue serotype confers lifelong immunity but subsequent infection with other dengue serotypes is associated with an increased risk of developing severe dengue disease. Early clinical diagnosis and careful clinical management are essential for increasing patient survival.

Dengue is an emerging disease that is a leading cause of illness and death in the tropics and subtropics, with more than one-third of the world’s population living in areas at risk of transmission (2). Currently, there is no antiviral therapy for the treatment of dengue or severe dengue disease. Prophylactic vaccines are in development and the first dengue vaccine, Dengvaxia (CYD-TDV) a live recombinant tetravalent vaccine by Sanofi Pasteur, was licensed in Mexico in December 2015, with several other vaccine candidates in clinical or pre-clinical stages of development (3).

Early diagnosis of dengue and dengue serotypes is a vital step in patient management. However, many of the proteins expressed by Flaviruses are very similar, and serological testing for these viruses can be complicated by problems of cross-reactivity.  In this context, the use of highly purified antigens, that are glycosylated and folded as native proteins can be highly important in the development of accurate immunoassays.

References

  1. World Health Organization (WHO) – Dengue and severe dengue
  2. WHO – Guidelines for diagnosis, treatment, prevention and control (2009)
  3. WHO – Dengue vaccine research

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