Prevention and treatment of dengue virus infection
- Alan L Rothman, MD
Alan L Rothman, MD
- University of Rhode Island
- Anon Srikiatkhachorn, MD
Anon Srikiatkhachorn, MD
- Assistant Professor of Medicine
- University of Massachusetts Medical School
- Siripen Kalayanarooj, MD
Siripen Kalayanarooj, MD
- Consultant, DHF Center of Excellence
- Queen Sirikit National Institute of Child Health (QSNICH)
Dengue is a febrile illness that is caused by any one of four serotypes of this flavivirus (DENV-1, DENV-2, DENV-3, and DENV-4). It is endemic in more than 100 countries in tropical and subtropical regions of the world and causes an estimated 50 million infections annually worldwide [1-3].
Mild dengue disease and dengue fever (DF) contributes more than half of the total public health burden of dengue-associated illness . The more serious manifestations of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) are the major impetus for efforts to prevent infection . Epidemiologic studies have demonstrated that the greatest risk factor for the development of DHF or DSS is secondary infection with a different dengue serotype from the original infecting virus . Thus, severe disease occurs primarily in patients who reside in hyperendemic areas where multiple serotypes circulate simultaneously.
Dengue virus infection is a risk for anyone living in or traveling in a dengue endemic region, especially in tropical Asia, Central and South America, and the Caribbean. In most of these regions, dengue virus transmission occurs year-round. However, the risk of infection tends to be seasonal and can be expected to be highest during a recognized outbreak of dengue infections. The objectives of programs to prevent dengue infections differ depending upon whether local residents or visitors are targeted. There is no direct therapy available against the dengue virus, which increases the importance of prevention.
Measures to prevent dengue and supportive treatment for the different clinical features of dengue virus infection will be reviewed here. The epidemiology, pathogenesis, clinical manifestations, and diagnosis of infection are discussed separately. (See "Epidemiology of dengue virus infections" and "Pathogenesis of dengue virus infection" and "Clinical manifestations and diagnosis of dengue virus infection".)
The greatest risk for dengue virus infection is among individuals residing in endemic areas, rather than travelers.
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- Endemic areas
- - Mosquito control
- - Vaccination
- Early recognition of DHF/severe dengue
- Management of fever
- Management of significant bleeding
- Management of plasma leakage
- - Treatment of shock
- - Adjunctive therapies
- FUTURE DIRECTIONS
- INFORMATION FOR PATIENTS