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Dengue: Dr. Lokesh Reddy PG - Department of Paediatrics

This document provides an overview of dengue virus and disease. It discusses how dengue is caused by four distinct types of dengue virus transmitted by the Aedes aegypti mosquito. Dengue fever causes biphasic fever, myalgia, and rash, while dengue hemorrhagic fever is a more severe form that can lead to dengue shock syndrome. The virus is an enveloped, single-stranded RNA virus. Epidemiology sections explain how dengue incidence has increased globally and is influenced by temperature and extrinsic incubation period in mosquitoes. The entomology section describes the urbanized Aedes aegypti mosquito vector. The pathogenesis section outlines immune mechanisms in primary versus secondary dengue

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Aneesh Myneni
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352 views10 pages

Dengue: Dr. Lokesh Reddy PG - Department of Paediatrics

This document provides an overview of dengue virus and disease. It discusses how dengue is caused by four distinct types of dengue virus transmitted by the Aedes aegypti mosquito. Dengue fever causes biphasic fever, myalgia, and rash, while dengue hemorrhagic fever is a more severe form that can lead to dengue shock syndrome. The virus is an enveloped, single-stranded RNA virus. Epidemiology sections explain how dengue incidence has increased globally and is influenced by temperature and extrinsic incubation period in mosquitoes. The entomology section describes the urbanized Aedes aegypti mosquito vector. The pathogenesis section outlines immune mechanisms in primary versus secondary dengue

Uploaded by

Aneesh Myneni
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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DENGUE

Dr. Lokesh Reddy


PG – Department of paediatrics
CONTENT
1.Introduction
2.Etiology
3.Epidemiology
4.Entomology
5.pathogenesis
Introduction
-Dengue infection is the most rapidly emerging vector borne viral disease
with 30 fold increase in global incidence over the last five decades.

-It is due to four distinct antigenic types of dengue virus ( dengue type
1,2,3,4) transmitted by mosquito named Aedes aegypti.

-Dengue fever is a benign , acute febrile syndrome occurs in tropical and


sub tropical regions characterized by biphasic fever, myalgia , arthralgia ,
macular rash , leukopenia and lymphadenopathy.

-Dengue hemorrhagic fever is sever e and often fatal, febrile disease


caused by one of four dengue viruses. In severe cases it manifest as
dengue shock syndrome.
Etiology
-Dengue virus belongs to flavivirus group,
spherical in shape , measuring 40 – 60 nm.
- single stranded , positive sense RNA virus , 11 kb
in size.
-Enveloped virus comprising of 3 structural
polypeptides namely Capsid protein , E protein ,
M protein.
-Non structural proteins NS 1, NS 2 A/B , NS 3, NS
4 A/B , NS 5.
-NS 1 which can be secreted in patient’s sera has
been used as an earliest diagnostic marker.
Epidemiology
-In 19th and 20th centuries epidemics were common in temperate areas of
America, Europe , Australia and Asia.
-Dengue fever and dengue like diseases ( chikungunya , O’nyong nyong , West
Nile fever) are more common even in travelers to above mentioned areas.
-The extrinsic incubation period (EIP) is the viral incubation period between
the time when a mosquito draws a viremic blood meal and the time when that
mosquito become infectious . This has been recognized as an important factor
in dengue transmission dynamics.
-Many studies have revealed that temperature influences the EIP. At higher
temperatures with in the viable range of survival for vector , the dengue virus
replicates faster which result in shorten EIP there by increasing the chance of
high proportion of mosquitoes becoming infective during their life span.
-Decreasing EIP for 5 days ( normal- 8 to 12 days) can lead to three fold higher
transmission rate of dengue.
-Change of temperature from 17°c – 30°c increases dengue transmission by
fourfold.
ENTOMOLOGY
- Aedes aegypti is highly urbanized mosquito ,
breeding in water stored for drinking or bathing and in
rain water collected in any container.
-A.aegypti is the main vector for yellow fever , dengue ,
chikungunya and zika virus.
-Day time mosquito of short flight range (100 – 500 m )
-Transovarian transmission ( infection carried to next
progeny through eggs ) has made infection more
complicated.
-Life span is 15 days on an average.
-Lay cigar shaped eggs.
Pathophysiology
-The pathogenesis of dengue hemorrhagic fever is incompletely understood.
-Epidemiological studies usually associate this syndrome with secondary
heterotypic infections with dengue types 1 – 4 or infants born to mothers who
had two or more life time dengue infections.
-Infection with one variant of dengue cannot provide protection if secondary
infection due to another variant.
-Absence of cross reactive neutralizing antibodies and presence of enhancing
antibodies are the best correlates of risk for dengue hemorrhagic fever.
-Early in acute stage of secondary dengue infections, there is rapid
activation of complement system . Shortly before or during shock blood
levels of soluble TNF receptor , INF -  , Interleukin – 2 are elevated.

-C1q , C3 , C 4,C 5-8 and C3 proactivators are depressed and C 3 catabolic


rates are activated.

-NS 1 in circulation activates myeloid cells to release cytokines by attaching


to Toll -4 receptors

-NS1 also contributes to increased vascular permeability by activating


complement , interacting with and damaging endothelial cells , blood
clotting factors and platelets.
“If they breed – you will bleed”

THANK YOU

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