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Regulators of endothelial integrity as severity predictors in dengue.

INTRODUCTION: Dengue is currently among the mosquito-borne diseases of greatest global impact. The clinical course of the disease can be unpredictable, so proper handling in its early stages is critical to ensure optimal outcomes. OBJECTIVE: To evaluate serum regulators of endothelial integrity (VEGF, sICAM-1, sEndoglina, Ang-1, and Ang-2) as predictive markers of dengue severity. MATERIALS AND METHODS: We conducted a case-control study nested in an appropriate cohort. Endothelial regulator levels were first measured by ELISA, after which analysis was performed using logistic regression of c…

Risk factors for shock in children with dengue fever.

OBJECTIVES: To evaluate and analyze the clinical and laboratory parameters that were predictive of the development of shock in children with dengue fever. SUBJECTS AND METHODS: Retrospective study carried out from August 2012 to July 2014 at a tertiary care hospital in Puducherry. RESULTS: Two hundred and fifty-four children were admitted with dengue fever and among them dengue fever without shock was present in 159 children (62.5%) and dengue fever with shock was present in 95 cases (37.4%). Various clinical and laboratory parameters were analyzed using univariate and multivariate logistic …

Animal models for studying dengue pathogenesis and therapy.

Development of a suitable animal model for dengue virus disease is critical for understanding pathogenesis and for preclinical testing of antiviral drugs and vaccines. Many laboratory animal models of dengue virus infection have been investigated, but the challenges of recapitulating the complete disease still remain. In this review, we provide a comprehensive coverage of existing models, from man to mouse, with a specific focus on recent advances in mouse models for addressing the mechanistic aspects of severe dengue in humans. This article forms part of a symposium in Antiviral Research on f…

Epidemiology and Disease Burden of Pediatric Dengue in Venezuela.

Dengue is a mosquito-borne viral disease that has evolved from a sporadic infection to a major public health problem in the Americas, Southeast Asia and the western Pacific, and Africa. Its incidence has increased 30-fold over the past 50 years, and although the true disease burden is not well known, the annual incidence in some areas of the Americas may reach 5%-10% of all children when underreporting is considered. We recently analyzed the disease burden of dengue in Venezuela, and we found an overall decline in case numbers and mortality over the period of 1950-2011. However, there were inc…

Потенциальное воздействие вакцинации на динамику заболеваний денге.

Денге, классифицированный как «неосведомленное тематическое заболевание», в настоящее время рассматривается во всем мире как самая важная вирусная болезнь, переносимая комарами, которая вызывает значительное социально-экономическое и медико-санитарное бремя во многих тропических и субтропических регионах мира. Несмотря на продолжение усилий по разработке и повышению эффективности тетравалентной вакцины для защиты людей от всех серотипов вируса денге, долгосрочные эпидемиологические последствия вакцинации по-прежнему остаются недостижимыми. Мы разрабатываем серотипную, трансмиссивную модель для

Совпадение в аннотации оригинала
Dengue, classified as a 'neglected topical disease', is currently regarded globally as the most important mosquito-borne viral disease, which inflicts substantial socioeconomic and health burden in many tropical and subtropical regions of the world. While efforts continue towards developing and improving the efficacy of a tetravalent vaccine to protect indiv…

Recent Advances in Dengue: Relevance to Puerto Rico.

Dengue represents an increasingly important public health challenge in Puerto Rico, with recent epidemics in 2007, 2010, and 2012-2013. Although recent advances in dengue vaccine development offer hope for primary prevention, the role of health professionals in the diagnosis and management of dengue patients is paramount. Case definitions for dengue, dengue with warning signs, and severe dengue provide a framework to guide clinical decision-making. Furthermore, the differentiation between dengue and other acute febrile illnesses, such as leptospirosis and chikungunya, is necessary for the appr…

Developing a dengue vaccine: progress and future challenges.

Dengue is an expanding public health problem in the tropics and subtropical areas. Millions of people, most from resource-constrained countries, seek treatment every year for dengue-related disease. Despite more than 70 years of effort, a safe and efficacious vaccine remains unavailable. Antidengue antiviral drugs also do not exist despite attempts to develop or repurpose drug compounds. Gaps in the knowledge of dengue immunology, absence of a validated animal or human model of disease, and suboptimal assay platforms to measure immune responses following infection or experimental vaccination a…

Furosemide infusion in children with dengue fever and hypoxemia.

OBJECTIVES: To study the role of furosemide infusion in the management of Acute respiratory distress syndrome (ARDS) associated with dengue fever. METHODS: Children between the ages of 1 month to 18 years, who fulfilled the WHO clinical criteria for dengue infection and American European Consensus Criteria criteria for ARDS with Dengue IgM positivity, were evaluated. Patients were studied as group D (receiving diuretic therapy alone) and group B (both ventilation and diuretics), and compared to a historical control group V (ventilation alone). Furosemide infusion was administered at 0.05-0.1 …

[Rhabdomyolysis associated with dengue fever in a lupic patient].

This report describes the case of a woman with systemic lupus erythematous (SLE) that developed rhabdomyolysis after being infected by dengue virus. There are only a few cases of SLE accompanied by rhabdomyolysis, none of them associated with dengue fever. Initially, the woman presented high fever, myalgia, muscular weakness, mild headache, polyarthralgia and thrombocytopenia reminding a lupus flare, but since the number of people infected by dengue at that time was high and the symptoms from both conditions are similar, a dengue serology was requested. After a few days, the patient developed …

Autoimmune response in children with dengue. Case reports.

Dengue is an infectious disease caused by the dengue virus (DV), which can progress to dengue hemorrhagic fever and dengue shock syndrome. DV causes the production of auto-antibodies against human cells. A variety of factors have been associated with macrophage activation syndrome, including infections, drugs and autoimmune pathologies (systemic lupus erythematosus, systemic onset juvenile idiopathic arthritis). We present three cases of patients that clinically developed an autoimmune response related to a DV infection. Our country currently has endemic cases of dengue, with hyperimmune respo…

Dengue: challenges for policy makers and vaccine developers.

Because of the increasing incidence, geographic expansion and economic burden of dengue transmission, dengue poses major challenges to policy makers. A vaccine against dengue is urgently needed, but vaccine development has been hampered by the lack of an appropriate animal model, poor understanding of correlates of successful human immunity, the fear of immune enhancement, and viral interference in tetravalent combinations. The most suitable target epitopes for vaccines, as well as the role of nonstructural proteins remain elusive. The chimeric yellow fever bone-based live attenuated dengue va…

Analysis of an asymmetric two-strain dengue model.

In this paper we analyse a two-strain compartmental dengue fever model that allows us to study the behaviour of a Dengue fever epidemic. Dengue fever is the most common mosquito-borne viral disease of humans that in recent years has become a major international public health concern. The model is an extension of the classical compartmental susceptible-infected-recovered (SIR) model where the exchange between the compartments is described by ordinary differential equations (ode). Two-strains of the virus exist so that a primary infection with one strain and secondary infection by the other stra…

Dengue fever: theories of immunopathogenesis and challenges for vaccination.

Dengue fever is a mosquito-borne viral disease infecting several hundred million people in tropical and subtropical areas every year. Its clinical manifestations range from mild fever to severe life-threatening shock syndrom. No therapeutics or licensed vaccines are available yet and with half of the world's population already at risk, it represents a major public health concern. The co-existence of four different Dengue virus serotypes renders difficult the obtaining of full protective immunity against each one of them. On the contrary, these serotypes trigger significant cross-reactivities o…

Implications of dengue outbreaks for blood supply, Australia.

Dengue outbreaks have increased in size and frequency in Australia, and transfusion-transmitted dengue poses a risk to transfusion safety. Using whole blood samples collected during the large 2008-2009 dengue epidemic, we estimated the risk for a dengue-infectious blood donation as ≈1 in 7,146 (range 2,218-50,021).

New vaccines for neglected parasitic diseases and dengue.

Neglected tropical diseases (NTDs) are a significant source of morbidity and socioeconomic burden among the world's poor. Virtually all of t … to enter or that are currently in human clinical trials. Specifically, we report on the progress on dengue, hookworm, leishmaniasis, schistosomiasis, Chagas disease, and onchocerciasis vaccines. These products will be some of the first with specific objectives to aid the world's poorest populations.

Changing epidemiology of dengue in South-East Asia.

The burden of dengue and its potential threat to global health are now globally recognized, with 2.5 billion people at risk worldwide. The pathogenesis of severe dengue is particularly intriguing with the involvement of different immune factors. Also, the epidemiology of dengue in South-East Asia is undergoing a change in the human host, the dengue virus and the vector bionomics. Shift in affected age groups, sex differences and expansion to rural areas are evident, while the virulence and genotype of the virus determine the severity and time interval between sequential infections. The Aedes m…

Regular paracetamol in severe dengue: a lethal combination?

An eight-month-old female infant with severe dengue disease, who was repeatedly given therapeutic paracetamol for severe dengue, developed fulminant liver failure with encephalopathy, gastrointestinal haemorrhage and severe coagulopathy. She responded to supportive measures and N-acetylcysteine infusion. This case highlights the potential danger of administering repeated therapeutic doses of paracetamol in childhood severe dengue disease with hepatitis.

Challenges for the formulation of a universal vaccine against dengue.

Dengue is rapidly becoming a disease of an escalating global public health concern. The disease is a vector-borne disease, transmitted by the bite of an Aedes spp. mosquito. Dynamic clinical manifestations, ranging from asymptomatic, flu-like febrile illness, dengue fever (DF) to dengue hemorrhagic fever (DHF) with or without dengue shock syndrome (DSS), make the disease one of the most challenging to diagnose and treat. DF is a self-limited illness, while DHF/DSS, characterized by plasma leakage resulting from an increased vascular permeability, can have severe consequences, including death. …