Challenges in the Prevention and Treatment of Dengue Fever: An Emerging Issue

Dengue fever (DF), caused by dengue virus (DENV), is a major global health concern, potentially affecting more than 390 million people annually across more than 100 countries. Despite extensive research, significant challenges persist in both prevention and therapeutic approaches toward dengue. Preventive strategies are mainly focused on vector control through physical, biological, and chemical methods, as well as vaccination efforts in recent years. Existing vaccines, such as Dengvaxia® (Sanofi Pasteur, Paris, France) and Qdenga® (Takeda Pharmaceutical Company, Tokyo, Japan), have demonstrated some efficacy; however, limitations include a lack of efficacy against certain regional DENV strains and the potential for antibody-dependent enhancement (ADE), particularly in individuals without previous DENV exposure. Therapeutic monoclonal antibodies against DENV are potential treatment options, but they are hindered by rapid elimination and ADE risks. The absence of suitable animal models that replicate the symptoms of DF further complicates vaccine and therapeutic development. Emerging strategies, including messenger RNA vaccines and engineered antibodies, show promise but would still require thorough validation for efficacy and safety. To date, therapeutic approaches to DF are predominantly supportive, focusing on symptom management and complication prevention. Although antiviral drugs and immunotherapies are under investigation, none have exhibited clinical success. The intricate pathogenesis of DENV, involving complex virus-host interactions and immune responses, presents additional treatment challenges. In this review, the current challenges and advancements in DF prevention and treatment are examined, emphasizing the limits of existing vaccines and medicines while exploring novel approaches with potential for effectiveness in clinical settings.