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Review
. 2024 Feb 17;403(10427):667-682.
doi: 10.1016/S0140-6736(23)02576-X. Epub 2024 Jan 24.

Dengue

Gabriela Paz-Bailey  1 , Laura E Adams  2 , Jacqueline Deen  3 , Kathryn B Anderson  4 , Leah C Katzelnick  5
Affiliations
Review

Dengue

Gabriela Paz-Bailey et al. Lancet. .

Abstract

Dengue, caused by four closely related viruses, is a growing global public health concern, with outbreaks capable of overwhelming health-care systems and disrupting economies. Dengue is endemic in more than 100 countries across tropical and subtropical regions worldwide, and the expanding range of the mosquito vector, affected in part by climate change, increases risk in new areas such as Spain, Portugal, and the southern USA, while emerging evidence points to silent epidemics in Africa. Substantial advances in our understanding of the virus, immune responses, and disease progression have been made within the past decade. Novel interventions have emerged, including partially effective vaccines and innovative mosquito control strategies, although a reliable immune correlate of protection remains a challenge for the assessment of vaccines. These developments mark the beginning of a new era in dengue prevention and control, offering promise in addressing this pressing global health issue.

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Conflict of interest statement

Declaration of interests No funding was used for this publication. GP-B and LEA are employees of the Centers for Disease Control and Prevention. LCK is supported by the Intramural Research Program of the US National Institute of Allergy and Infectious Diseases. The findings and conclusions in this Seminar are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention. All other authors declare no competing interests.

Figures

Figure 1.
Figure 1.
Predicted global dengue risk. Means (A) and Standard deviations (SDs) (B) of Force of infection (FOI) estimates in dengue endemic countries across 200 geographically stratified bootstrap samples. Average FOI was estimated from age-stratified seroprevalence or case notification date using a set of environmental explanatory variables. Modified from Cattarino L and colleagues (3) Environmental suitability for dengue occurrence in 2080 (C). Adapted from Messina JP and colleagues (5)
Figure 2.
Figure 2.
Dengue clinical course, classification, laboratory abnormalities and management. From WHO Handbook for Clinical Management of Dengue (43).
Figure 3.
Figure 3.
Dengue laboratory findings, virus detection and immune response Data from WHO Dengue Guidelines for Diagnosis, Treatment, Prevention and Control (16), Hunsperger E. and colleagues (210) , Chaloemwong and colleagues (211) and Dussart and colleagues (212).
Figure 4.
Figure 4.
Correlates of dengue pathogenesis and protection. Types of immunological responses associated with increased dengue disease (pathogenic, generally during a secondary infection: ADE of myeloid cells (–102), strong plasmablast response (107, 109, 110), and weak T cell response (114)) or reduced disease (protective, including broadly neutralizing antibodies (135, 136) and effective, cytotoxic CD8+ and CD4+ T cells (–118)).
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