Dengue As An Emerging Infectious Disease: A Mini-Review

Emerging infectious diseases are diseases that are newly or relatively ‘recently’ discovered. Manyemerging infectious diseases are caused by viruses that are either zoonotic or vector-borne. Select on viral emerging infectious disease and write a mini-review on that disease and the pathogen(s) that cause it. You may select a pathogen that primarily infects humans or other animals (or both).

In your mini-review you should discuss the following:

• The host range of the pathogen that causes the disease, and the impact it has on all of its hosts;
  
  
• The burden of the disease (have there been numerous outbreaks across multiple continents, or has the disease been limited in geography and number of outbreaks);

• Factors contributing to the emergence of the disease; and
  
  
• Measures that can be taken to tackle the disease.

The Pathogen(s) that Cause Dengue

One of the main concerns of the health system across the world is the outbreak of infectious disease. The emerging infectious disease are defined as the disease that are discovered recently or found to be high prevalence in the worldwide. Such emerging infectious disease caused by viruses that are vector borne or zoonotic (Kimberlin et al. 2015). One of such emerging infectious disease that has created a life threatening situation in the globe is dengue. The infectious disease is carried by the vector mosquitoes and caused by four specified dengue viruses. Flavivirus is one of the most known virus that causes dengue. The dengue fever is also known as break-bone fever as it causes severe muscle pain and joint pain that leads to the pain like bones are breaking (World Health Organization 2014). Around 50 million severe incident of dengue fever occur per year across the world along with 22000 deaths (Bhatt et al. 2013). Thus, it is important to provide information regarding dengue in order to create awareness within the people and take proper interventions to prevent and cure the illness in an effective manner. In this regards the following paper will provide a brief discussion about the host of flavivirus and its impact on host, prevalence of dengue worldwide, factors that contributes to the consequence of dengue and effective measures that could be taken in order prevent and treat dengue in an effective manner.

As mentioned before, Flavivirus is one of the most commonly known virus that is responsible for the transmission of the infectious disease. The virus is included in the family of Flaviviridae, group IV (Pierson and Diamond 2013). The most common vector of dengue is the Aedes aegypti mosquito. It helps the virus to transmit to the hosts through the bites of female mosquitoes (Reiter 2014). After an incubation period of 4 to 10 days the virus become capable of transmitting the illness for the rest of its life. The host range of the virus includes vertebrates and the insect specific viruses (ISV) as well (Blitvich and Firth 2015).  The virus utilizes the cytoplasmic cellular machinery in order to propagate the infectious progeny virions. After that the virus engages in various biochemical processes to transmit the infection. The host body initiates some antiviral strategies in order to counteract the invasion, however, the virus also uses some alternative strategies in order to defence the response of the host (Pierson and Kielian 2013). It has been found that the ribosomal protein such as RPLP 1 and RPLP 2 are the most crucial host factors that help the virus to replicate in the host body (Ye et al. 2013).

Prevalence of Dengue Worldwide

After the successful transmission of the infection it impacts the host body in an effective manner. The impact ranges from mild to severe infection. Most of the hosts suffer from high fever, headache, fatigue, nausea, vomiting, pain behind the eyes, severe muscle and joint pain, skin rashes and mild bleeding from nose and gums (Murray, Quam and Wilder-Smith 2013). In some severe cases the host may suffer from haemorrhagic fever, enlargement of liver, damage of lymph and blood vessels and dysfunction of circulatory system. Such severe condition sometimes lead to the dengue shock syndrome and death as well (Sam et al. 2013).

There is a dramatic increase in the prevalence of dengue in the recent years. It has been reported the approx. 390 million dengue infection occur per year from which 50 million cases are reported as severe case and around 22000 deaths occur per year due the infectious disease (Bhatt et al. 2013). The WHO has reported that the incident of dengue has increased from 2010 to 2015 and the rate of increase is from 2.2 million to 3.2 million (World Health Organization 2018). The infections of dengue is prevalent across the tropics and subtropics. Recent outbreak has been reported in the areas of Caribbean along with Puerto Rico, virgin Island of U.S, Central America and Cuba. It has been found that tourists returning from some areas that are reported with widespread dengue such as Singapore, Africa, South Pacific, West Indies, Southeast Asia, India and Middle East (Diethelm 2013). In America, 2.35 million cases of dengue has been reported in the year 2015, from which 10200 cases were identified as severe illness and 1181 deaths has been reported (Sanchez?Vegas et al. 2013). In 2013, severe cases of dengue has been reported in Florida and china. Worst outbreak of dengue has been reported in Thailand in the last 20 years with 135344 cases of dengue fever and 126 deaths (Bhatt et al. 2013). In India, 18isk factors in an effective manner72 positive cases of dengue has been reported only in New Delhi in the year 2015 (Palaniyandi 2014). Recently in 2017, 80732 incidents of dengue infection along with 205 deaths has been reported in Sri Lanka (Sirisena and Noordeen 2014). Such outbreak of the infectious disease has become one of the main threat for the health system worldwide.  Thus, it is important to introduce adequate research in order to identify the potential factors contributing to the consequence of dengue and introduce effective measure of prevention and treatment to address the risk factors in an effective manner.

Factors Contributing to Dengue

Research has been indicated that there are some potential factors that contribute to the development of the infectious disease. For example environmental factor such as climate contributes effectively to the increasing incidence of dengue. The viruses responsible for dengue and the vector mosquitoes are found to be sensitive to the environmental conditions such as rainfall, temperature and humidity. Such environmental factors play a vital role in the life cycle and transmission of the disease. Hence, adequate changes in the environmental conditions could lead to the consequence of dengue. For example, high temperature helps to accelerate the stages of development of the mosquitoes, effective rainfall lead to the increase in the standing water thus, helps to produce proper breeding sites and it has been found that humidity is a substantial factor that facilitate the condition of growth of the vectors (Nkya et al. 2013). On the other hand social factors such as unplanned urbanization, increasing population and increasing trade and travel also contributes to the consequence of dengue (Li et al. 2014). In addition lack of awareness in the society lead to the incident of unclean surroundings that facilitate the breeding condition of mosquitoes (Al-Dubai et al. 22013). Such factors all together responsible for the high prevalence of dengue throughout the world.

As per the previous discussion it has been found that there are many contributing factors that influence the high prevalence of dengue. Due to this the infectious disease has become one of the life threatening case in the world. With increasing prevalence death rate is also increasing in an effective manner. Thus, it is important to take proper measures in order to tackle the disease and provide healthy environment to the population of the world to improve the health status (Chandren, Wong and AbuBakar 2015). Unfortunately there are no specific medication or vaccine for dengue, hence the most effective way to tackle the disease is introducing effective prevention process to control the transmission of the disease. The most effective prevention method is mosquito control. Eliminating the places that are appropriate for the mosquitoes for laying egg has been identified as the best method for controlling mosquitoes. The breeding grounds of the mosquitoes include water collections in some artificial containers such as plastic cups, tires, bottles, flower pots and the garbage areas. Thus. It is important to draining water from such place, eliminating containers and cover the garbage area in order to control the breeding of mosquitoes (Yboa and Labrague 2013). In order to drain the standing water it is important to empty the wading pool of the children, unclog the roof of the gutters, change the water of the bird’s birth and collected water from containers such as flower pots. Proper pesticides could be used to kill the mosquitoes. Mosquito nets, traps, and insect repellent ointments could be used in order to prevent he mosquito bites (Chandren, Wong and AbuBakar 2015). Natural control could be used such as placing water bug and Mesocyclopes in water could be helpful. Such process is cost effective and ecofriendly but not effective enough and requires continuous social participation (Yboa and Labrague 2013).

Effective Measures to Prevent and Treat Dengue

In order to manage dengue fever, it is important to introduce proper diagnosis to identify the illness at early stage. It would help to manage the infectious disease before reaching the state of severity. In this regards proper blood test need to be done in order to check the availability of the virus or antibodies to it in the blood sample. It is important to inform the doctor about travelling ti some tropical areas. It would help the doctor in order to evaluate the possibility that the patient is suffering from dengue fever. If a person feels worse within 24 hours after the fever goes down, the person should visit a doctor immediately and should be checked for serious complications (Murray, Quam and Wilder-Smith 2013). As mentioned before, there is no vaccine for the prevention of dengue and specific medicine is also unavailable, thus, health professionals face difficulties in the treatment of dengue, especially in case of severe illness. It is important to take rest and drink plenty of water and other fluids such as juice and soup. Doctors recommend to avoid medication with aspirin as it could affect the bleeding and make it worse. However, medicines for reducing pain could be taken along with acetaminophen (Herrero et al. 2013). Such process of prevention, diagnosis and treatment would help to control the transmission of dengue in an effective manner.

Conclusion:

From the above discussion it can be concluded that, dengue is one of the most commonly known emerging infectious disease that has created life threatening condition across the world. It has been found that approx. 390 million cases of dengue occurs per year from which 50 million cases are related to severe dengue along with 22000 cases of deaths worldwide. The tropical and subtropical areas vulnerable to the infectious disease. The Flavivirus is one of the most commonly known dengue virus that is responsible for the outbreak of the disease. Aedes aegypti mosquito is the vector of dengue and the host range of the virus include vertebrates and insect specific viruses. There are some effective factors that contributes to the consequence of dengue, for example climate, social factor and lack of awareness. There are no vaccine and specific medication for dengue, however, with proper prevention, early diagnosis and effective treatment the prevalence of dengue could be controlled.

References:

Al-Dubai, S.A., Ganasegeran, K., Mohanad Rahman, A., Alshagga, M.A. and Saif-Ali, R., 2013. Factors affecting dengue fever knowledge, attitudes and practices among selected urban, semi-urban and rural communities in Malaysia. Southeast Asian J Trop Med Public Health, 44(1), pp.37-49.

Bhatt, S., Gething, P.W., Brady, O.J., Messina, J.P., Farlow, A.W., Moyes, C.L., Drake, J.M., Brownstein, J.S., Hoen, A.G., Sankoh, O. and Myers, M.F., 2013. The global distribution and burden of dengue. Nature, 496(7446), p.504.

Blitvich, B.J. and Firth, A.E., 2015. Insect-specific flaviviruses: a systematic review of their discovery, host range, mode of transmission, superinfection exclusion potential and genomic organization. Viruses, 7(4), pp.1927-1959.

Chandren, J.R., Wong, L.P. and AbuBakar, S., 2015. Practices of dengue fever prevention and the associated factors among the Orang Asli in Peninsular Malaysia. PLoS neglected tropical diseases, 9(8), p.e0003954.

Diethelm, K., 2013. A fractional calculus based model for the simulation of an outbreak of dengue fever. Nonlinear Dynamics, 71(4), pp.613-619.

Herrero, L.J., Zakhary, A., Gahan, M.E., Nelson, M.A., Herring, B.L., Hapel, A.J., Keller, P.A., Obeysekera, M., Chen, W., Sheng, K.C. and Taylor, A., 2013. Dengue virus therapeutic intervention strategies based on viral, vector and host factors involved in disease pathogenesis. Pharmacology & therapeutics, 137(2), pp.266-282.

Kimberlin, D.W., Brady, M.T., Jackson, M.A. and Long, S.S., 2015. Red Book, (2015): 2015 Report of the Committee on Infectious Diseases. American academy of pediatrics.

Li, Y., Kamara, F., Zhou, G., Puthiyakunnon, S., Li, C., Liu, Y., Zhou, Y., Yao, L., Yan, G. and Chen, X.G., 2014. Urbanization increases Aedes albopictus larval habitats and accelerates mosquito development and survivorship. PLoS neglected tropical diseases, 8(11), p.e3301.

Murray, N.E.A., Quam, M.B. and Wilder-Smith, A., 2013. Epidemiology of dengue: past, present and future prospects. Clinical epidemiology, 5, p.299.

Nkya, T.E., Akhouayri, I., Kisinza, W. and David, J.P., 2013. Impact of environment on mosquito response to pyrethroid insecticides: facts, evidences and prospects. Insect biochemistry and molecular biology, 43(4), pp.407-416.

Palaniyandi, M., 2014. The environmental aspects of dengue and chikungunya outbreaks in India: GIS for epidemic control. International Journal of Mosquito Research, 1(2), pp.38-44.

Pierson, T.C. and Diamond, M.S., 2013. Flaviviruses. Fields virology, 6, pp.747-94.

Pierson, T.C. and Kielian, M., 2013. Flaviviruses: braking the entering. Current opinion in virology, 3(1), pp.3-12.

Reiter, P., 2014. 25 Surveillance and Control of Urban Dengue Vectors. Dengue and dengue hemorrhagic fever, p.481.

Sam, S.S., Omar, S.F.S., Teoh, B.T., Abd-Jamil, J. and AbuBakar, S., 2013. Review of dengue hemorrhagic fever fatal cases seen among adults: a retrospective study. PLoS neglected tropical diseases, 7(5), p.e2194.

Sanchez?Vegas, C., Hamer, D.H., Chen, L.H., Wilson, M.E., Benoit, C., Hunsperger, E., MacLeod, W.B., Jentes, E.S., Ooi, W.W., Karchmer, A.W. and Kogelman, L., 2013. Prevalence of Dengue Virus Infection in US Travelers Who Have Lived in or Traveled to Dengue?Endemic Countries. Journal of travel medicine, 20(6), pp.352-360.

Sirisena, P.D.N.N. and Noordeen, F., 2014. Evolution of dengue in Sri Lanka—changes in the virus, vector, and climate. International Journal of Infectious Diseases, 19, pp.6-12.

World Health Organization, 2014. Dengue and severe dengue.

World Health Organization. 2018. Dengue. [online] Available at: https://www.who.int/denguecontrol/en/ [Accessed 18 Aug. 2018].

Yboa, B.C. and Labrague, L.J., 2013. Dengue knowledge and preventive practices among rural residents in Samar province, Philippines. American Journal of Public Health Research, 1(2), pp.47-52.

Ye, J., Zhu, B., Fu, Z.F., Chen, H. and Cao, S., 2013. Immune evasion strategies of flaviviruses. Vaccine, 31(3), pp.461-471.