Dengue fever
39669
225740209
2008-07-15T04:34:05Z
THEN WHO WAS PHONE?
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Reverted 2 edits by [[Special:Contributions/152.91.9.190|152.91.9.190]] identified as [[WP:VAND|vandalism]] to last revision by [[User:59.189.17.196|59.189.17.196]]. ([[WP:TW|TW]])
{{redirect|Dengue Fever|the band of the same name|Dengue Fever (band)}}
{{Taxobox | color=violet
| name = ''Dengue virus''
| image = Dengue.jpg
| image_caption = A [[Transmission electron microscopy|TEM]] [[micrograph]] showing dengue virus
| virus_group = iv
| familia = ''[[Flaviviridae]]''
| genus = ''[[Flavivirus]]''
| species = '''''Dengue virus'''''
}}
{{DiseaseDisorder infobox |
Name = Dengue fever |
ICD10 = {{ICD10|A|90||a|00}} |
ICD9 = {{ICD9|061}} |
DiseasesDB = 3564 |
MedlinePlus = 001374 |
eMedicineSubj = med |
eMedicineTopic = 528 |
MeshName = Dengue |
MeshNumber = C02.782.417.214 |
}}
'''Dengue fever''' ({{IPAEng|ˈdɛŋgeɪ}}) and '''dengue hemorrhagic fever''' (DHF) are acute [[fever|febrile]] [[disease]]s, found in the [[tropics]] and [[Africa]], and caused by four closely related [[virus]] [[serotype]]s of the genus ''[[Flavivirus]]'', family [[Flaviviridae]].<ref>{{cite web |url= http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=dengue.htm|title=Chapter 4, Prevention of Specific Infectious Diseases|publisher=CDC Traveler's Health: Yellow Book|accessdate=2007-05-20}}</ref> The geographical spread is similar to [[malaria]], but unlike malaria, dengue is often found in urban areas of tropical nations, including [[Puerto Rico]], [[Singapore]], [[Malaysia]], [[Taiwan]], [[Indonesia]], [[Philippines]], [[India]] and [[Brazil]]. Each [[serotype]] is sufficiently different that there is no cross-protection and [[epidemic]]s caused by multiple serotypes (hyperendemicity) can occur. Dengue is transmitted to humans by the ''[[Aedes aegypti]]'' (rarely ''[[Aedes albopictus]]'') [[mosquito]], which feeds during the day.<ref>[http://www.searo.who.int/en/Section10/Section332_12647.htm Dengue Fever – Information Sheet.] [[World Health Organization]], [[October 9]] [[2006]]. Retrieved on [[2007-11-30]].</ref>
==Signs and symptoms==
This [[infectious disease]] is manifested by a sudden onset of [[fever]], with severe headache, muscle and joint pains ([[myalgia]]s and [[arthralgia]]s—severe pain gives it the name ''break-bone fever'' or ''bonecrusher disease'') and [[rash]]es. The dengue rash is characteristically bright red [[petechiae]] and usually appears first on the lower limbs and the chest; in some patients, it spreads to cover most of the body. There may also be [[gastritis]] with some combination of associated [[abdominal pain]], [[nausea]], [[vomiting]] or [[diarrhea]].
Other symptoms include
* fever;
* bladder problems;
* constant headaches;
* severe dizziness; and,
* loss of appetite.
* uncontrollable laughing,
* extreme constipation
Some cases develop much milder symptoms which can, when no rash is present, be misdiagnosed as [[influenza]] or other viral infection. Thus travelers from tropical areas may inadvertently pass on dengue in their home countries, having not been properly diagnosed at the height of their illness. Patients with dengue can pass on the infection only through mosquitoes or blood products and only while they are still [[fever|febrile]].
The classic dengue fever lasts about six to seven days, with a smaller peak of fever at the trailing end of the disease (the so-called "biphasic pattern"). Clinically, the [[platelet]] count will drop until the patient's temperature is normal.
Cases of DHF also show higher fever, [[haemorrhagic phenomena]], [[thrombocytopenia]], and [[haemoconcentration]]. A small proportion of cases lead to [[dengue shock syndrome]] (DSS) which has a high mortality rate.
==Diagnosis==
The diagnosis of dengue is usually made clinically. The classic picture is high fever with no localising source of infection, a [[petechia]]l rash with [[thrombocytopenia]] and relative [[leukopenia]].
The [[World Health Organization|WHO]] definition of dengue [[Viral hemorrhagic fever|haemorrhagic fever]] has been in use since 1975; all four criteria must be fulfilled:<ref>[http://www.who.int/csr/resources/publications/dengue/Denguepublication/en/index.html Dengue haemorrhagic fever: diagnosis, treatment, prevention and control. 2nd edition.] World Health Organization. Retrieved on [[2007-11-30]].</ref>
# Fever, bladder problem, constant headaches, severe dizziness and loss of appetite.
# [[Bleeding|Hemorrhagic]] tendency (positive [[tourniquet test]], spontaneous bruising, bleeding from [[mucosa]], gingiva, injection sites, etc.; vomiting blood, or bloody [[diarrhea]])
# [[Thrombocytopenia]] (<100,000 platelets per mm³ or estimated as less than 3 platelets per high power field)
# Evidence of plasma leakage ([[hematocrit]] more than 20% higher than expected, or drop in haematocrit of 20% or more from baseline following IV fluid, [[pleural effusion]], [[ascites]], hypoproteinemia)
''Dengue shock syndrome'' is defined as dengue hemorrhagic fever plus:
*Weak rapid pulse,
*Narrow pulse pressure (less than 20 mm Hg) or,
*Cold, clammy skin and restlessness.
[[Serology]] and [[polymerase chain reaction]] (PCR) studies are available to confirm the diagnosis of dengue if clinically indicated.
==Treatment==
The mainstay of treatment is supportive therapy. Increased oral fluid intake is recommended to prevent [[dehydration]]. Supplementation with [[Intravenous drip|intravenous fluids]] may be necessary to prevent dehydration and significant concentration of the blood if the patient is unable to maintain oral intake. A [[platelet]] [[blood transfusion|transfusion]] is indicated in rare cases if the platelet level drops significantly (below 20,000) or if there is significant bleeding.
The presence of [[melena]] may indicate internal gastrointestinal bleeding requiring platelet and/or red blood cell transfusion.
[[Aspirin]] and [[non-steroidal anti-inflammatory drug]]s should be avoided as these drugs may worsen the bleeding tendency associated with some of these infections. Patients may receive [[paracetamol]] preparations to deal with these symptoms if dengue is suspected.<ref>[http://www.cdc.gov/NCIDOD/dvbid/dengue/dengue-hcp.htm Dengue and Dengue Hemorrhagic Fever: Information for Health Care Practitioners.] Center for Disease Control. [[October 22]], [[2007]] Retrieved on [[2007-11-30]].</ref>
===Emerging treatments===
Emerging evidence suggests that [[mycophenolic acid]] and [[ribavirin]] inhibit dengue replication. Initial experiments showed a fivefold increase in defective viral RNA production by cells treated with each drug.<ref>{{cite journal |author=Takhampunya R, Ubol S, Houng HS, Cameron CE, Padmanabhan R |title=Inhibition of dengue virus replication by mycophenolic acid and ribavirin |journal=J. Gen. Virol. |volume=87 |issue=Pt 7 |pages=1947–52 |year=2006 |pmid=16760396 |doi=10.1099/vir.0.81655-0|url=http://vir.sgmjournals.org/cgi/content/full/87/7/1947}}</ref> ''In vivo'' studies, however, have not yet been done.
==Epidemiology==
[[Image:Dengue06.png|right|thumb|250px|World-wide dengue distribution, 2006. Red: Epidemic dengue. Blue: ''Aedes aegypti''.]]
[[Image:Dengue distr.gif|right|thumb|250px|World-wide dengue distribution, 2000]]
The first epidemics occurred almost simultaneously in Asia, Africa, and North America in the 1780s. The disease was identified and named in 1779. A global [[pandemic]] began in [[Southeast Asia]] in the 1950s and by 1975 DHF had become a leading cause of death among children in many countries in that region. Epidemic dengue has become more common since the 1980s. By the late 1990s, dengue was the most important mosquito-borne disease affecting humans after malaria, there being around 40 million cases of dengue fever and several hundred thousand cases of dengue [[Viral hemorrhagic fever|hemorrhagic fever]] each year. There was a serious outbreak in [[Rio de Janeiro]] in February 2002 affecting around one million people and killing sixteen.
On March 20, 2008, the secretary of health of the [[state of Rio de Janeiro]], [[Sérgio Côrtes]], announced that 23,555 cases of dengue, including 30 deaths, had been recorded in the state in less than three months. Côrtes said, "I am treating this as an epidemic because the number of cases is extremely high." [[Ministry of Health (Brazil)|Federal Minister of Health]] [[José Gomes Temporão]] also announced that he was forming a panel to respond to the situation. [[Cesar Maia]], mayor of the city of [[Rio de Janeiro]], denied that there was serious cause for concern, saying that the incidence of cases was in fact declining from a peak at the beginning of February. <ref>{{Citation
| author=Fernanda Pontes
| title=Secretário estadual de Saúde Sérgio Côrtes admite que estado vive epidemia de dengue
| newspaper=O Globo Online
| year=2008
| date=20 March 2008
| url=http://oglobo.globo.com/rio/mat/2008/03/20/secretario_estadual_de_saude_sergio_cortes_admite_que_estado_vive_epidemia_de_dengue-426368388.asp
| language=Portuguese}}.</ref> By April 3, 2008, the number of cases reported rose to 55,000 <ref>{{Citation
|author=CNN
|title=Thousands hit by Brazil outbreak of dengue
|newspaper=CNN
|year=2008
|date=3 April 2008
|url=http://www.cnn.com/2008/HEALTH/conditions/04/03/brazil.dengue/index.html
|language=English}}.</ref>
Significant outbreaks of dengue fever tend to occur every five or six months. The cyclicity in numbers of dengue cases is thought to be the result of seasonal cycles interacting with a short-lived cross-immunity for all four strains, in people who have had dengue (Wearing and Rohani 2006). When the cross-immunity wears off, the population is then more susceptible to transmission whenever the next seasonal peak occurs. Thus in the longer term of several years, there tend to remain large numbers of susceptible people in the population despite previous outbreaks because there are four different strains of the dengue virus and because of new susceptible individuals entering the target population, either through childbirth or immigration.
There is significant evidence, originally suggested by [[S.B. Halstead]] in the 1970s, that dengue hemorrhagic fever is more likely to occur in patients who have secondary infections by [[serotype]]s different from the primary infection. One model to explain this process is known as [[antibody-dependent enhancement]] (ADE), which allows for increased uptake and [[virion]] replication during a secondary infection with a different strain. Through an immunological phenomenon, known as [[original antigenic sin]], the [[immune system]] is not able to adequately respond to the stronger infection, and the secondary infection becomes far more serious.<ref>{{cite journal |author=Rothman AL |title=Dengue: defining protective versus pathologic immunity |journal=J. Clin. Invest. |volume=113 |issue=7 |pages=946–51 |year=2004 |pmid=15057297 |doi=10.1172/JCI200421512|url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=379334}}</ref> This process is also known as superinfection (Nowak and May 1994; Levin and Pimentel 1981).
In [[Singapore]], there are about 4,000–5,000 reported cases of dengue fever or dengue haemorrhagic fever every year. In the year 2003, there were six deaths from dengue shock syndrome.{{Fact|date=June 2007}} It is believed that the reported cases of dengue are an underrepresentation of all the cases of dengue as it would ignore subclinical cases and cases where the patient did not present for medical treatment. With proper medical treatment, the mortality rate for dengue can therefore be brought down to less than 1 in 1000.{{Fact|date=December 2007}}
==Prevention==
===Vaccine development===
There is no commercially available [[vaccine]] for the dengue [[flavivirus]]. However, one of the many ongoing vaccine development programs is the Pediatric Dengue Vaccine Initiative which was set up in 2003 with the aim of accelerating the development and introduction of dengue vaccine(s) that are affordable and accessible to poor children in endemic countries.<ref>{{cite web|url=http://www.pdvi.org/|title=Pediatric Dengue Vaccine Initiative website|publisher=International Vaccine Institute|accessdate=2007-11-30}}</ref> [[Thailand|Thai]] researchers are testing a dengue fever vaccine on 3,000–5,000 human volunteers after having successfully conducted tests on animals and a small group of human volunteers.<ref>{{cite web|url=http://english.people.com.cn/200509/05/eng20050905_206569.html|publisher=People's Daily Online|title=Thailand to test Mahidol-developed dengue vaccine prototype|date=[[2005-09-05]]|accessdate=2006-10-08}}</ref> A number of other vaccine candidates are entering [[Clinical trial#Phase I|phase I]] or [[Clinical trial#Phase II|II testing]].<ref>{{cite journal |author=Edelman R |title=Dengue vaccines approach the finish line |journal=Clin. Infect. Dis. |volume=45 Suppl 1 |issue= |pages=S56–60 |year=2007 |pmid=17582571 |doi=10.1086/518148}}</ref>
===Mosquito control===
[[Image:A aegypti eradication.jpg|right|thumb|A field technician looking for [[larva]]e in standing water containers during the 1965 ''[[Aedes aegypti]]'' eradication program in Miami, Florida. In the 1960s, a major effort was made to eradicate the principal urban vector mosquito of dengue and yellow fever viruses, ''Aedes aegypti'', from southeast United States.
<small>Courtesy: Centers for Disease Control and Prevention Public Health Image Library</small>]]
Primary prevention of dengue mainly resides in [[mosquito control]]. There are two primary methods: larval control and adult mosquito control. In urban areas, ''Aedes'' mosquitos breed on water collections in artificial containers such as plastic cups, used tires, broken bottles, flower pots, etc. Continued and sustained artificial container reduction or periodic draining of artificial containers is the most effective way of reducing the larva and thereby the ''aedes'' mosquito load in the community. Larvicide treatment is another effective way of control the vector larvae but the larvicide chosen should be long lasting and preferably have World Health Organization clearance for use in drinking water. There are some very effective insect growth regulators (IGR`s) available which are both safe and long alasting e.g. pyriproxyfen. For reducing the adult mosquito load, fogging with insecticide is somewhat effective.
Prevention of mosquito bites is another way of preventing disease. This can be achieved either by personal protection or by using mosquito nets.
In 1998, scientists from the Queensland Institute of Research in [[Australia]] and [[Vietnam]]'s Ministry of Health introduced a scheme that encouraged children to place a water bug, the crustacean ''[[Mesocyclops]]'', in water tanks and discarded containers where the ''Aedes aegypti'' mosquito was known to thrive. This method is viewed as being more cost-effective and more environmentally friendly than pesticides, though not as effective, and requires the ongoing participation of the community.<ref>{{cite news|url=http://news.bbc.co.uk/1/hi/health/4257935.stm|title=Water bug aids dengue fever fight|publisher=BBC News|date=[[February 11]] [[2005]]|accessdate=2007-11-30}}</ref>
===Personal protection===
Personal prevention consists of the use of [[mosquito net]]s, [[Insect repellent|repellents]] containing NNDB or [[DEET]], covering exposed skin, use of DEET-impregnated bednets, and avoiding endemic areas.
=== Potential antiviral approaches ===
In cell culture experiments<ref>{{cite journal |author=Kinney RM, Huang CY, Rose BC, ''et al'' |title=Inhibition of dengue virus serotypes 1 to 4 in vero cell cultures with morpholino oligomers |journal=J. Virol. |volume=79 |issue=8 |pages=5116–28 |year=2005 |pmid=15795296 |doi=10.1128/JVI.79.8.5116-5128.2005}}</ref> and mice <ref>{{cite journal |author=Burrer R, Neuman BW, Ting JP, ''et al'' |title=Antiviral effects of antisense morpholino oligomers in murine coronavirus infection models |journal=J. Virol. |volume=81 |issue=11 |pages=5637–48 |year=2007 |pmid=17344287 |doi=10.1128/JVI.02360-06}}</ref> [[Morpholino]] antisense oligos have shown specific activity against Dengue virus.
The [[yellow fever]] [[vaccine]] (YF-17D) is a related Flavivirus,{{Clarifyme|date=March 2008}}<!-- this section makes no sense, needs translation to English --> thus the [[Chimera (virus)|chimeric]] replacement of yellow fever vaccine with dengue has been often suggested{{Clarifyme|date=March 2008}} but no full scale studies have been conducted to date.<ref>{{cite journal |author=Querec T, Bennouna S, Alkan S, ''et al'' |title=Yellow fever vaccine YF-17D activates multiple dendritic cell subsets via TLR2, 7, 8, and 9 to stimulate polyvalent immunity |journal=J. Exp. Med. |volume=203 |issue=2 |pages=413–24 |year=2006 |pmid=16461338 |doi=10.1084/jem.20051720}}</ref>
In 2006, a group of Argentine scientists discovered the molecular replication mechanism of the virus, which could be attacked by disruption of the [[RNA polymerase|polymerase]]'s work.<ref>{{cite journal |author=Filomatori CV, Lodeiro MF, Alvarez DE, Samsa MM, Pietrasanta L, Gamarnik AV |title=A 5' RNA element promotes dengue virus RNA synthesis on a circular genome |journal=Genes Dev. |volume=20 |issue=16 |pages=2238–49 |year=2006 |pmid=16882970 |doi=10.1101/gad.1444206}}</ref>
== Recent outbreaks ==
[[Image:Luchemos todos contra el dengue.jpg|thumb|right|A public service ad teaching people how to prevent dengue and yellow fever in [[Encarnación, Paraguay]] (2007)]]
{{2005 dengue outbreak tally}}
During the first months of 2007, over 16,000 cases have been reported in [[Paraguay]] and in the end of the year, more than 100.000, of which around 300 or 400 have been detected as DHF cases. Ten deaths have also been reported, including a high ranking member of the Ministry of Health. One Department of Health official resigned because he had approved the use of expired batches of insecticide to control the mosquito vectors of dengue.<ref>{{cite web|date=[[2 March]] [[2007]]|url=http://news.bbc.co.uk/2/hi/americas/6407287.stm|title=Dengue sparks Paraguay emergency|publisher=BBC News|accessdate=2007-06-19}}</ref><ref name="Paraguay2007">{{cite web|url=http://news.bbc.co.uk/2/hi/americas/6422319.stm|publisher=BBC News|date=[[6 March]] [[2007]]|accessdate=2007-06-19|title=Paraguay dengue official sacked}}</ref> The disease has propagated to Argentina (where it is not considered endemic) by people who recently arrived from Paraguay.<ref>{{es icon}} {{cite news|publisher=Clarín|date=[[22 February]] [[2007]]|url=http://www.clarin.com/diario/2007/02/22/sociedad/s-02906.htm|title=Hay 93 casos de dengue}}</ref> In the Brazilian state of [[Mato Grosso do Sul]], which borders on Paraguay, the number of cases in March 2007 is estimated to be more than 45,000.<ref name="Paraguay2007"/> Epidemics in the states of Ceará, Pará, São Paulo, and Rio de Janeiro have taken the Brazilian national tally of cases to over 70,000, with upwards of 80 deaths.<ref>{{es icon}} {{cite news|publisher=New York Times|date=[[15 April]] [[2008]]|url=http://www.nytimes.com/2008/04/15/world/americas/15dengue.html|title=Dengue Outbreak Sweeps Through Rio}}</ref> Larvae have also been found in Parana state. The proportion of cases registered as DHF is reported to be higher than in previous years.{{Fact|date=December 2007}}
=== Americas ===
* [[Puerto Rico]]: <ref name=PRoutbreak>{{cite news
| title = Dengue fever surging in Puerto Rico
| publisher = MSNBC, Telemundo
| date = [[August 08]], [[2007]]
| url = http://www.msnbc.msn.com/id/20181559/
| accessdate = 2007-13-09}}</ref>(August 2007) 2,343 confirmed cases of dengue in 2007.
* [[Dominican Republic]]: {{Failed verification|date=December 2007}}<ref name=DRoutbreak>{{es icon}} {{cite news
| last = Batista
| first = L.
| coauthors = A Santiago Díaz
| title = Más de 4,968 afectados por dengue
| publisher = Diario Libre
| date =
| url = http://www.diariolibre.com/app/article.aspx?id=82889
| accessdate = 2006-10-19}}</ref>(August – October 2006) 4,968 cases with 44 dead
* [[Cuba]]: Media reports <ref name=cubaoutbreak1>{{cite news
| title = Protecting the Revolution
| publisher = Strategypage.com
| date = [[September 17]], [[2006]]
| url = http://www.strategypage.com/htmw/htiw/articles/20060917.aspx
| accessdate = 2006-10-07}}</ref><ref name=cubaoutbreak2>{{cite news
| last = Acosta
| first = Dalia
| title = War on Mosquitoes Continues During Global Summit
| publisher = Inter Press Service
| date = [[2006-09-12]]
| url = http://www.ipsnews.net/news.asp?idnews=34694
| accessdate = 2006-10-07}}</ref><ref name=cubaoutbreak3>{{cite news
| title = Cuba wages war on tiny enemy
| publisher = Independent Online, South Africa
| date = [[September 25]], [[2006]]
| url = http://www.int.iol.co.za/index.php?set_id=1&click_id=31&art_id=qw1159129981777B214
| accessdate = 2006-10-07 }}</ref><ref name=cubaoutbreak4>{{cite news
| title = Cuba waging war against dengue fever
| publisher = Miami Herald
| date = [[October 7]], [[2006]]
| url = http://www.miami.com/mld/miamiherald/news/world/cuba/15700825.htm
| accessdate = 2006-10-07 }}</ref> (dated September and October 2006) speculate on an outbreak although there is no official report
* [[Brazil]]: 2008 Health officials say an outbreak of dengue fever has infected more than 110,000 people in Rio de Janeiro state and claimed at least 95 lives since [[January 1]]. An outbreak of Dengue in the first seven months of 2007 reported more than 438,000 cases of dengue fever, with 97 deaths.<ref>{{cite web | url = http://www.saude.rj.gov.br/Docs/Acoes/Dengue/Relat%F3rio%20de%20Casos%20de%20Dengue%20(25-04-2008%20-%2019h10m).pdf | title = State secretary of Health}} <!-- dead link... --></ref>
* [[Mexico]]: As of October 2007 there is a serious problem in [[Monterrey]], [[Nuevo Leon]] almost reaching epidemic proportions.{{Fact|date=March 2008}}
=== Asia Pacific ===
{{seealso|2006 dengue outbreak in Pakistan|2005 dengue outbreak in Singapore|2006 dengue outbreak in India}}
* [[Australia]]: [[2006]] [[March 15]], 2 confirmed cases at Gordonvale, [[Cairns, Queensland]].
* [[China]]: September 2006, 70 cases since June in [[Guangzhou]],[[Guangdong]].<ref>[http://www.taipeitimes.com/News/world/archives/2006/08/29/2003325364 China, Dengue Fever Cases Jump.] ''[[Taipei Times]]'', [[29 August]], 2006.</ref>
* [[Cook Islands]]: <ref name=cookislandsoutbreak>{{cite news
| title = 460 people in Cook Islands affected by Dengue Fever outbreak
| publisher = Radio New Zealand International
| date = [[15 January]], [[2007]]
| url = http://www.rnzi.com/pages/news.php?op=read&id=29493
| accessdate = 2007-01-15 }}</ref>(October 2006 – January 2007) 460 cases.
* [[India]]: 2006 September, more than 400 cases and 22 deaths were reported due to dengue fever in [[New Delhi]].<ref>{{cite news|url=http://www.iht.com/articles/ap/2006/10/02/asia/AS_GEN_India_Dengue_Outbreak.php|title=Dengue fever kills 14 in India, affects more than 400 |publisher=International Herald Tribune, Associated Press News|date=[[October 2]], [[2006]]|accessdate=2006-10-02]}}</ref> By [[October 7]], [[2006]], reports were of 3,331 cases of the mosquito-borne virus and a death toll of 49.<ref>[http://news.yahoo.com/s/afp/20061007/wl_asia_afp/indiahealthdengue_061007200413 India says dengue outbreak serious as death toll rises] Pratap Chakravarty, news.yahoo.com, [[7 October]] [[2006]]. Retrieved [[8 October]] [[2006]]. </ref>
* [[Indonesia]]: 2004 80,000 infected with 800 deaths.
* [[Malaysia]]: January 2005 33,203 cases.
* [[Pakistan]]: 2006 Over 3,230 cases, 50 deaths.
** [[Karachi]] 2006 October, the number of infected patients rose to 1,836 of which 30 had died.
** [[Lahore]], [[2006]] [[October 23]], the disease shifted to Lahore during the holidays with the luggage of some people travelling to their homes to celebrate [[Eid ul-Fitr|Eid]]. The number of infected patients is 400 by [[October 31]], of which 4 had died.
* [[Philippines]]: <ref name=philippinesoutbreak>{{cite news
| last = Santos
| first = Tina
| title = DOH names dengue-hit areas in metropolis
| publisher = Philippine Daily Inquirer
| date = [[September 10]], [[2006]]
| url = http://newsinfo.inq7.net/inquirerheadlines/metro/view_article.php?article_id=20064
| accessdate = 2006-10-07 }}</ref>(January – August 2006) 13,468 cases with 167 dead.
* [[Singapore]]: 2007 - more than 4029 cases, 8 deaths; [[29 September]] [[2005]] at least 13 deaths; 2004 - 9,460 cases; 2003 - 4,788 cases.
* [[Thailand]]: May 2005 , 7,200 infected. At least 12 dead.
==History==
The origins of the word ''dengue'' are not clear, but one theory is that it is derived from the [[Swahili]] phrase "Ka-dinga pepo", which describes the disease as being caused by an [[evil spirit]].<ref>[http://www.cbwinfo.com/Biological/Pathogens/DENV.html Dengue fever: Essential data.] Chemical and Biological Warfare Agents. Retrieved on [[2007-11-30]]</ref> The Swahili word "dinga" may possibly have its origin in the Spanish word "dengue" (fastidious or careful), describing the gait of a person suffering dengue fever<ref>[http://www.etymonline.com/index.php?term=dengue Dengue.] Online Etymology Dictionary. Retrieved on [[2007-11-30]]</ref> or, alternatively, the Spanish word may derive from the Swahili.<ref>{{cite journal|title = etymologia: dengue|journal = Emerging Infectious Diseases|year = 2006|volume = 12|number= 6| pages = 893|url=http://www.cdc.gov/ncidod/eid/vol12no06/pdfs/etymology.pdf|format=PDF}}</ref> It may also be attributed to the phrase meaning "Break bone fever", referencing the fact that pain in the bones is a common symptom.
Outbreaks ''resembling'' dengue fever have been reported throughout history.<ref name=Gubler_1998>{{cite journal |author=Gubler DJ |title=Dengue and dengue hemorrhagic fever |journal=Clin. Microbiol. Rev. |volume=11 |issue=3 |pages=480–96 |year=1998 |pmid=9665979 |doi=}}</ref> The first definitive case report dates from 1789 and is attributed to [[Benjamin Rush]], who coined the term "breakbone fever" (because of the symptoms of [[myalgia]] and [[arthralgia]]). The viral [[etiology]] and the transmission by mosquitoes were deciphered only in the 20th century. Population movements during World War II spread the disease globally.
In 2007 replication mechanism of the virus was interrupted by interception of the viral protease [http://www.utmb.edu/discoveringdenguedrugs%2Dtogether/], and currently a project to identify new protease interception mechanisms of the whole familly of the virus has been launched ([[Dengue]] virus belong to the familly [[Flaviviridae]], which includes among others [[Hepatitis C virus|HCV]], [[West Nile virus|West Nile]] and [[Yellow fever]] viruses). The software and information about the project can be found at the World Community Grid web site.[http://www.worldcommunitygrid.org]
==Footnotes==
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==References==
* [http://www.elsevier-international.com/catalogue/title.cfm?ISBN=0702026409 Manson's Tropical Diseases]
* [http://www.ppidonline.com/ Mandell's Principles and Practices of Infection Diseases]
* [http://www.cecilmedicine.com/buy.cfm?book=goldman Cecil Textbook of Medicine]
* [http://www.oup.com/us/catalog/general/subject/Medicine/PrimaryCare/?ci=0192629220&view=usa The Oxford Textbook of Medicine]
* [http://books.mcgraw-hill.com/medical/harrisons/ Harrison's Principles of Internal Medicine]
* Theiler, Max and Downs, W. G. 1973. ''The Arthropod-Borne Viruses of Vertebrates: An Account of The Rockefeller Foundation Virus Program 1951-1970''. Yale University Press.
* Downs, Wilbur H., et al. 1965. ''Virus diseases in the West Indies''. Special edition of the ''Caribbean Medical Journal'', Vol. XXVI, Nos. 1-4, 1965.
* Earle, k. Vigors. 1965. "Notes on the Dengue epidemic at Point Fortin." The ''Caribbean Medical Journal'', Vol. XXVI, Nos. 1-4, pp. 157-164.
* Hill, A. Edward. 1965. "Isolation of Dengue Virus from a Human Being in Trinidad." ''Virus diseases in the West Indies''. The ''Caribbean Medical Journal'', Vol. XXVI, Nos. 1-4, pp. 83-84; "Dengue and Related Fevers in Trinidad and Tobago." ''Ibid'', pp. 91-96.
==External links==
*[http://www.cdc.gov/ncidod/dvbid/dengue/index.htm CDC site on Dengue Fever].
*[http://www.dengueinfo.org/ Dengueinfo.org] - Resources & depository of Dengue Virus genomic sequences for biomedical researchers.
*[http://news.ninemsn.com.au/article.aspx?id=345161].
*[http://www.gmanews.tv/story/77792/Valenzuela-troubled-by-steep-rise-in-dengue-cases gmanews.tv/story,Valenzuela troubled by steep rise in dengue cases]
*[http://www.gmanews.tv/largevideo/latest/17243/Can-camote-tops-cure-dengue www.gmanews.tv/largevideo, Can camote tops cure dengue? - 01/25/2008]
*[http://www.rcsb.org/pdb/static.do?p=education_discussion/molecule_of_the_month/pdb103_1.html - RCSB Protein Data Bank] Protein of the month: Dengue virus
{{Viral diseases}}
[[Category:Viral diseases]]
[[Category:Flaviviruses]]
[[Category:Tropical diseases]]
[[Category:Hemorrhagic fevers]]
[[Category:Insect-borne diseases]]
[[Category:Biological weapons]]
[[Category:Health problems in India]]
[[Category:Neglected diseases]]
[[ar:حمى الدنك]]
[[bn:ডেঙ্গু]]
[[zh-min-nan:Thian-káu-jia̍t]]
[[bg:Денга]]
[[ca:Dengue]]
[[cs:Dengue]]
[[da:Denguefeber]]
[[de:Dengue-Fieber]]
[[dv:ޑެންގީ ހުން]]
[[es:Dengue]]
[[eo:Dengo]]
[[fr:Dengue]]
[[hi:डेंगू]]
[[hr:Dengue groznica]]
[[id:Demam berdarah]]
[[ia:Dengue]]
[[it:Dengue]]
[[hu:Dengue-láz]]
[[ms:Demam Denggi]]
[[nl:Dengue]]
[[ja:デング熱]]
[[no:Dengue]]
[[pl:Denga]]
[[pt:Dengue]]
[[ru:Лихорадка денге]]
[[scn:Tirzana]]
[[si:ඩෙංගි උණ]]
[[sk:Horúčka dengue]]
[[sr:Денга грозница]]
[[fi:Denguekuume]]
[[sv:Denguefeber]]
[[ta:டெங்கு காய்ச்சல்]]
[[th:โรคไข้เลือดออก]]
[[vi:Sốt xuất huyết Dengue]]
[[ur:ڈینگو بخار]]
[[zh:骨痛熱症]]