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Dengue Virus

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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
пѓ� Dengue induces cytokine production in cells
пѓ� Cytotoxic factor effects endothelial cells
involved in most of the following:
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Heart
Liver
Kidneys
Lungs
Intestines
Spleen
Lymph nodes
Brain
Skin (inflammatory rashes)
Symptoms: DHF
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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)
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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
Relieving symptoms and
complications:
 Plasma volume replacement
 Sedatives for restless patients
 Blood transfusion with
patients with significant blood
loss
 Aspirin should be avoided
 All efforts of control are aimed
against mosquitoes
 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
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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
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"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/>.
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