Dengue virus infection

Dengue is an acute febrile disease caused by the Aedes mosquito-borne dengue viruses (DENV-1 to DENV-4). Annually, approximately 100 million people fall ill with dengue, which can cause debilitating pain and discomfort, reducing both physical functioning and quality of life. Some patients progress to life-threatening inflammation-driven circulatory failure. Disease burden remains primarily in urban centres; however, factors including increased travel and climate change are rapidly expanding the geographical distribution of dengue to rural and peri-urban environments. Dengue is diagnosed based on compatible clinical features, detection of viral RNA or antigens, or serological testing, depending on the phase of illness. There is no licensed antiviral or host-directed therapy for dengue; management is supportive, with close clinical monitoring and judicious fluid replacement to prevent circulatory failure while avoiding fluid overload. Thus, there is an increasing need for clinicians to be familiar with the clinical features, disease burden and management of dengue, along with the newly recognized post-acute sequelae. Although dengue vaccines have been licensed in several countries, their use has been restricted by uncertainties in dengue pathogenesis. Attention should be focused on how to use currently available vaccines to create the foundation of a larger strategy to mitigate dengue transmission and maximize public health impact.