Related Experiment Video
Updated: Jan 11, 2026
Author Spotlight: Development of a Smartphone-Enhanced Paper-Based Device for Rapid Dengue NS1 Detection
Published on: January 26, 2024
Dengue haemorrhagic fever integral hypothesis: confirming observations, 1987-2007
Maria G Guzman1, Gustavo Kouri
1Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and its Vector, Institute of Tropical Medicine, Pedro Kouri, Habana, Cuba. lupe@ipk.sld.cu
Insights
The integral hypothesis explains dengue haemorrhagic fever (DHF) epidemics by considering host, virus, and vector interactions. Further research is needed to understand these complex relationships within an ecosystem.
Area of Science:
- Epidemiology
- Tropical Medicine
- Ecology
Background:
- The integral hypothesis for dengue haemorrhagic fever (DHF) epidemics was proposed by Kouri et al. in 1987.
- This hypothesis integrated existing knowledge based on the 1981 Cuban DHF epidemic.
- Recent observations support the multifactorial nature of DHF, emphasizing interactions between host, virus, and vector.
Purpose of the Study:
- To review the integral hypothesis for dengue haemorrhagic fever (DHF) development.
- To highlight the importance of a unifying, multifactorial model for understanding DHF epidemics.
- To emphasize the need for ecosystemic investigations into host-virus-vector interactions.
Main Methods:
- Review of the integral hypothesis proposed by Kouri et al. (1987).
- Analysis of observations from the 1981 Cuban DHF epidemic.
- Synthesis of current understanding regarding DHF epidemiology and contributing factors.
Main Results:
- The integral hypothesis provides a unifying framework for understanding DHF epidemics.
- The interaction between host, virus, and vector within an ecosystem is crucial for DHF development.
- Current data supports the multifactorial and integrated view of DHF etiology.
Conclusions:
- The integral hypothesis remains relevant for explaining DHF epidemics.
- Further ecosystemic research is essential to elucidate the complex interactions driving DHF.
- Understanding these interactions is key to controlling dengue haemorrhagic fever.
Abstract:
In 1987, Kouri et al. published in Transactions their integral hypothesis to explain the development of dengue haemorrhagic fever (DHF) epidemics (Kouri, G.P., Guzmán, M.G., Bravo, J.R., 1987. Why dengue haemorrhagic fever in Cuba? 2. An integral analysis. Trans. R. Soc. Trop. Med. Hyg. 81, 821-823). Based on observations carried out during the 1981 Cuban DHF epidemic, the authors integrated in one model the most advanced knowledge at that time. Observations in the last 20 years confirm the importance of this multifactorial and unifying view of the problem, where the interaction between the host, the virus and the vector in an epidemiological and ecosystem setting might determine DHF as a final outcome. Investigations on the interaction among host, virus and mosquito with an ecosystemic view are needed.
