Dengue research opportunities in the Americas

Abstract

Dengue is a systemic arthropod-borne viral disease of major global public health importance. At least 2.5 billion people who live in areas of the world where dengue occurs are at risk of developing dengue fever (DF) and its severe complications, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Repeated reemergences of dengue in sudden explosive epidemics often cause public alarm and seriously stress healthcare systems. The control of dengue is further challenged by the lack of effective therapies, vaccines, and point-of-care diagnostics. Despite years of study, even its pathogenic mechanisms are poorly understood. This article discusses recent advances in dengue research and identifies challenging gaps in research on dengue clinical evaluation, diagnostics, epidemiology, immunology, therapeutics, vaccinology/clinical trials research, vector biology, and vector ecology. Although dengue is a major global tropical pathogen, epidemiologic and disease control considerations in this article emphasize dengue in the Americas.

Figure 1.

The increasing global dengue problem, 1955–2007. Source: World Health Organization.

Figure 2.

Cocirculation of multiple dengue (DEN) serotypes in the Western Hemisphere, 2006–2010. Source: Pan American Health Organization.

Figure 3.

Sensitivity of dengue diagnostic tests. Based on Centers for Disease Control and Prevention (CDC) surveillance data and validations of commercial kits. Courtesy of Jorge Munoz-Jordan, CDC. Abbreviations: IgM, immunoglobulin M; PCR, polymerase chain reaction.

Figure 4.

Dengue virus life cycle and potential antiviral targets. Courtesy of Richard Kuhn, Purdue University. Adapted from the original image.