Dengue virus
A TEM micrograph showing dengue virus
Virus classification
Group: Group IV ((+)ssRNA) Family: Flaviviridae Genus: Flavivirus Species: Dengue virus

Dengue fever (IPA: /ˈdɛŋgeɪ/) and dengue hemorrhagic fever (DHF) are acute febrile diseases, found in the tropics and Africa, and caused by four closely related virus serotypes of the genus Flavivirus, family Flaviviridae. A micrograph, microphotograph or photomicrograph is a Photograph or similar image taken through a Microscope or similar device to show Virus classification involves naming and placing Viruses into a taxonomic system An RNA virus is a Virus that has RNA (ribonucleic acid as its Genetic material. The Flaviviridae are a family of Viruses that are primarily spread through arthropod vectors (mainly ticks and mosquitoes Flavivirus is a genus of the family Flaviviridae. This genus includes the West Nile virus, Dengue virus The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings A00-A79 - Bacterial infections and other intestinal infectious diseases and STDs (A00-A09 Intestinal Infectious diseases ( The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Fever (also known as pyrexia, from the Greek pyretos meaning fire or a febrile response, from the Latin word Febris A disease is an abnormal condition of an organism that impairs bodily functions and can be deadly The Tropics are centered on the Equator and limited in Latitude by the Tropic of Cancer in the northern hemisphere at approximately 23°26' (23 A virus (from the Latin virus meaning Toxin or Poison) is a sub-microscopic infectious agent that is unable For the term's use in bacteriology see Serovar. Transplants between genetically non-identical humans induce the creation of antibodies in the recipient Flavivirus is a genus of the family Flaviviridae. This genus includes the West Nile virus, Dengue virus The Flaviviridae are a family of Viruses that are primarily spread through arthropod vectors (mainly ticks and mosquitoes ^[1] The geographical spread is similar to malaria, but unlike malaria, dengue is often found in urban areas of tropical nations, including Puerto Rico,Singapore, Taiwan, Indonesia, Philippines, India and Brazil. Malaria is a vector -borne Infectious disease caused by Protozoan Parasites It is widespread in tropical and subtropical regions including Puerto Rico (ˌpwertoˈriko officially the Commonwealth of Puerto Rico ("Estado Libre Asociado de Puerto Rico" {{lang-en|"Associated Free State of Puerto Rico"}} Singapore Taiwan ( Taiwanese: Tâi-oân/Tāi-oân (historically 大灣/台員/大員/台圓/大圓/台窩灣 is an Island in East Asia. The Republic of Indonesia ( (Republik Indonesia is a Country in Southeast Asia. The Philippines ( Filipino: Pilipinas, officially known as the Republic of the Philippines (fil ''Republika ng Pilipinas'' RP India, officially the Republic of India (भारत गणराज्य inc-Latn Bhārat Gaṇarājya; see also other Indian languages) is a country |utc_offset = -2 to -4 |time_zone_DST = BRST |utc_offset_DST = -2 to -5 |cctld Each serotype is sufficiently different that there is no cross-protection and epidemics caused by multiple serotypes (hyperendemicity) can occur. For the term's use in bacteriology see Serovar. Transplants between genetically non-identical humans induce the creation of antibodies in the recipient In Epidemiology, an epidemic (from Greek epi- upon + demos people is a classification of a disease that appears as new cases in a Dengue is transmitted to humans by the Aedes aegypti (rarely Aedes albopictus) mosquito, which feeds during the day. The yellow fever mosquito, Stegomyia aegypti (= Aedes aegypti, = Aedes (Stegomyia aegypti) is a Mosquito The Asian tiger mosquito or forest day mosquito ( Aedes albopictus) from the Mosquito family Culicidae, is characterized by its Mosquitoes are insects in the family Culicidae. They have a pair of scaled wings a pair of Halteres, a slender body and long legs ^[2]

Signs and symptoms

This infectious disease is manifested by a sudden onset of fever, with severe headache, muscle and joint pains (myalgias and arthralgias—severe pain gives it the name break-bone fever or bonecrusher disease) and rashes. An infectious disease is a clinically evident Disease resulting from the presence of Pathogenic microbial agents including Pathogenic viruses Pathogenic Fever (also known as pyrexia, from the Greek pyretos meaning fire or a febrile response, from the Latin word Febris Myalgia means " Muscle Pain " and is a symptom of many diseases and disorders Arthralgia (from Greek arthro-, joint + -algos, pain literally means joint pain; it is a symptom of injury infection illnesses -- in particular A rash is a change of the Skin which affects its color appearance or Texture. 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. A petechia (pɨˈtiːkiə plural petechiae (pɨˈtiːkɪiː is a small (1-2mm red or purple spot on the body caused by a minor Hemorrhage (broken Capillary There may also be gastritis with some combination of associated abdominal pain, nausea, vomiting or diarrhea. Gastritis is an inflammation of the lining of the stomach There are many possible causes Abdominal pain can be one of the Symptoms associated with transient disorders or serious disease Nausea ( Latin: Nausea, Greek:, " Sea-sickness " also called wamble) is the sensation of unease and discomfort Vomiting (also called throwing up, emesis) is the forceful expulsion of the contents of one's Stomach through the Mouth and sometimes the In Medicine, diarrhea, also spelled diarrhoea (see spelling differences) is frequent loose or liquid Bowel movements Acute diarrhea

Other symptoms include:

• fever;
• bladder problems;
• constant headaches;
• severe dizziness; and,
• loss of appetite.

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 febrile. Fever (also known as pyrexia, from the Greek pyretos meaning fire or a febrile response, from the Latin word Febris

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. Platelets, or Thrombocytes, are small cytoplasmic bodies derived from cells They circulate in the Blood of Mammals and are involved

Cases of DHF also show higher fever, haemorrhagic phenomena, thrombocytopenia, and haemoconcentration. Thrombocytopenia (or -paenia, or thrombopenia in short is the presence of relatively few Platelets in Blood. 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 petechial rash with thrombocytopenia and relative leukopenia. A petechia (pɨˈtiːkiə plural petechiae (pɨˈtiːkɪiː is a small (1-2mm red or purple spot on the body caused by a minor Hemorrhage (broken Capillary Thrombocytopenia (or -paenia, or thrombopenia in short is the presence of relatively few Platelets in Blood. Leukopenia (or leukocytopenia, or leucopenia, from Greek λευκό -white and πενία -deficiency is a decrease in the number of

The WHO definition of dengue haemorrhagic fever has been in use since 1975; all four criteria must be fulfilled:^[3]

1. Fever, bladder problem, constant headaches, severe dizziness and loss of appetite. The viral hemorrhagic Fevers ( VHFs') are a diverse group of animal and human illnesses that are caused by five distinct families of
2. Hemorrhagic tendency (positive tourniquet test, spontaneous bruising, bleeding from mucosa, gingiva, injection sites, etc. Bleeding, technically known as hemorrhaging / haemorrhaging (see American and British spelling differences) is the loss of Blood from For Tourniquet, see that article A tourniquet test (also known as a Rumpel-Leede Capillary-Fragility Test or simply a capillary fragility test The mucous membranes (or mucosae; singular mucosa) are linings of mostly endodermal origin covered in Epithelium, which are involved in ; vomiting blood, or bloody diarrhea)
3. Thrombocytopenia (<100,000 platelets per mm³ or estimated as less than 3 platelets per high power field)
4. 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. In Medicine, diarrhea, also spelled diarrhoea (see spelling differences) is frequent loose or liquid Bowel movements Acute diarrhea Thrombocytopenia (or -paenia, or thrombopenia in short is the presence of relatively few Platelets in Blood. The hematocrit ( Ht or HCT) or packed cell volume ( PCV) or erythrocyte volume fraction (EVF is the proportion of Blood Pleural effusion is excess fluid that accumulates in the Pleural cavity, the fluid-filled space that surrounds the Lungs Excessive amounts of such fluid can impair In Medicine ( Gastroenterology) ascites (also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more

Serology and polymerase chain reaction (PCR) studies are available to confirm the diagnosis of dengue if clinically indicated. Serology is the scientific study of blood serum. In practice the term usually refers to the Diagnostic identification of antibodies in the serum

Treatment

The mainstay of treatment is supportive therapy. Increased oral fluid intake is recommended to prevent dehydration. Dehydration ( hypohydration) is the removal of Water ( hydro in ancient Greek) from an object Supplementation with intravenous fluids may be necessary to prevent dehydration and significant concentration of the blood if the patient is unable to maintain oral intake. Intravenous therapy or IV therapy is the giving of Liquid substances directly into a Vein. A platelet transfusion is indicated in rare cases if the platelet level drops significantly (below 20,000) or if there is significant bleeding. Platelets, or Thrombocytes, are small cytoplasmic bodies derived from cells They circulate in the Blood of Mammals and are involved Blood transfusion is the process of transferring Blood or blood-based products from one person into the Circulatory system of another

The presence of melena may indicate internal gastrointestinal bleeding requiring platelet and/or red blood cell transfusion. In Medicine, melena or melaena refers to the black "tarry" Feces that are associated with gastrointestinal Hemorrhage.

It is very important to avoid aspirin and non-steroidal anti-inflammatory drugs; these drugs may aggravate the bleeding tendency associated with some of these infections. Aspirin, or acetylsalicylic acid (ASA (əˌsɛtɨlsælɨˌsɪlɨk ˈæsɨd is a Salicylate drug, often used as an Analgesic to relieve Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAID s or NAID s, are drugs with Analgesic, Antipyretic and in higher Patients should receive instead paracetamol preparations to deal with these symptoms if dengue is suspected. Paracetamol ( INN) (ˌpærəˈsiːtəmɒl -ˈsɛtə- or acetaminophen ( USAN) is a widely-used Analgesic and Antipyretic Medication ^[4]

Emerging treatments

Emerging evidence suggests that mycophenolic acid and ribavirin inhibit dengue replication. Mycophenolic acid ( INN) (ˌmaɪkoʊˈfɛnɒlɪk or mycophenolate is an immunosuppressant drug used to prevent rejection in Organ transplantation Ribavirin (Copegus Rebetol Ribasphere VilonaVirazole also generics from Sandoz Teva Warrick is an Anti-viral drug which is active against a number of DNA and Initial experiments showed a fivefold increase in defective viral RNA production by cells treated with each drug. ^[5] In vivo studies, however, have not yet been done.

Epidemiology

World-wide dengue distribution, 2006. Red: Epidemic dengue. Blue: Aedes aegypti.

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. A pandemic (from Greek παν pan all + δήμος demos people is an Epidemic of Infectious disease that spreads through 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 hemorrhagic fever each year. The viral hemorrhagic Fevers ( VHFs') are a diverse group of animal and human illnesses that are caused by five distinct families of There was a serious outbreak in Rio de Janeiro in February 2002 affecting around one million people and killing sixteen. Rio de Janeiro ("River of January" ˈhiw dʒi ʒʌˈnejɾu in Brazilian Portuguese, /ˈriːoʊ di ʒəˈnɛroʊ/ in English is the second largest city of Brazil

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. Rio de Janeiro ( pron ˈhiu dʒi ʒʌˈnejɾu) is one of the 26 states of Brazil. Côrtes said, "I am treating this as an epidemic because the number of cases is extremely high. " 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. César Epitácio Maia (born July 18, 1945) is the current mayor of Rio de Janeiro. Rio de Janeiro ("River of January" ˈhiw dʒi ʒʌˈnejɾu in Brazilian Portuguese, /ˈriːoʊ di ʒəˈnɛroʊ/ in English is the second largest city of Brazil ^[6] By April 3, 2008, the number of cases reported rose to 55,000 ^[7]

Significant outbreaks of dengue fever tend to occur every five or six years. 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 serotypes different from the primary infection. For the term's use in bacteriology see Serovar. Transplants between genetically non-identical humans induce the creation of antibodies in the recipient 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. A virus (from the Latin virus meaning Toxin or Poison) is a sub-microscopic infectious agent that is unable 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. Original antigenic sin (first described in 1960 by Thomas Francis Jr An immune system is a collection of mechanisms within an Organism that protects against Disease by identifying and killing Pathogens and Tumor ^[8] 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. Singapore In the year 2003, there were six deaths from dengue shock syndrome. 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.

Prevention

Vaccine development

There is no commercially available vaccine for the dengue flavivirus. A vaccine is a biological preparation which is used to establish or improve immunity to a particular disease Flavivirus is a genus of the family Flaviviridae. This genus includes the West Nile virus, Dengue virus 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. ^[9] 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. The Kingdom of Thailand (ˈtaɪlænd ราชอาณาจักรไทย, râːtɕʰa-ʔaːnaːtɕɑ̀k-tʰɑj ^[10] A number of other vaccine candidates are entering phase I or II testing. In health care clinical trials are conducted to allow safety and Efficacy data to be collected for new drugs or devices In health care clinical trials are conducted to allow safety and Efficacy data to be collected for new drugs or devices ^[11]

Mosquito control

A field technician looking for larvae in standing water containers during the 1965 Aedes aegypti eradication program in Miami, Florida. A larva ( Latin; plural larvae) is a juvenile form of Animal with indirect development, undergoing Metamorphosis (for example The yellow fever mosquito, Stegomyia aegypti (= Aedes aegypti, = Aedes (Stegomyia aegypti) is a Mosquito 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. Courtesy: Centers for Disease Control and Prevention Public Health Image Library

Primary prevention of dengue mainly resides in mosquito control. The Mosquito Control EP is the first studio release by American Post-metal band Isis, released in 1998 by Escape Artist 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. 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. For a topic outline on this subject see List of basic Australia topics. Vietnam (ˌviːɛtˈnɑːm Việt Nam) officially UserPolbot. --> Mesocyclops is a genus of Crustacean in family Cyclopidae. 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. ^[12]

Personal protection

Personal prevention consists of the use of mosquito nets, repellents containing NNDB or DEET, covering exposed skin, use of DEET-impregnated bednets, and avoiding endemic areas. A mosquito net offers Protection against Mosquitos flies, and other Insects and thus against diseases such as Malaria. An insect repellent is a substance applied to skin clothing or other surfaces which discourages Insects (and Arthropods in general from landing or climbing on that N, N -Diethyl- meta -toluamide, abbreviated DEET, is the most common active Ingredient in Insect repellents It is intended

Potential antiviral approaches

In cell culture experiments^[13] and mice ^[14] Morpholino antisense oligos have shown specific activity against Dengue virus. In Molecular biology, a Morpholino is a Molecule used to modify Gene expression.

The yellow fever vaccine (YF-17D) is a related Flavivirus, thus the chimeric replacement of yellow fever vaccine with dengue has been often suggested but no full scale studies have been conducted to date. Yellow fever (also called yellow jack, black vomit or sometimes American Plague) is an acute viral disease A vaccine is a biological preparation which is used to establish or improve immunity to a particular disease A chimera virus is defined by the United States Department of Agriculture Center for Veterinary Biologics as a "new hybrid microorganism created by joining ^[15]

In 2006, a group of Argentine scientists discovered the molecular replication mechanism of the virus, which could be attacked by disruption of the polymerase's work. RNA polymerase ( RNAP or RNApol) is an Enzyme that produces RNA. ^[16]

Recent outbreaks

A public service ad teaching people how to prevent dengue and yellow fever in Encarnación, Paraguay (2007)

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. Paraguay, officially the Republic of Paraguay ( Spanish: República del Paraguay; Guaraní: Tetã Paraguái) is one of the only 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. ^[17][18] The disease has propagated to Argentina (where it is not considered endemic) by people who recently arrived from Paraguay. ^[19] 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. Mato Grosso do Sul (ˈmatu ˈgɾosu du ˈsuw is one of the states of Brazil. ^[18] 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. ^[20] Larvae have also been found in Parana state. The proportion of cases registered as DHF is reported to be higher than in previous years.

Americas

• Puerto Rico: ^[21](August 2007) 2,343 confirmed cases of dengue in 2007. Puerto Rico (ˌpwertoˈriko officially the Commonwealth of Puerto Rico ("Estado Libre Asociado de Puerto Rico" {{lang-en|"Associated Free State of Puerto Rico"}}
• Dominican Republic:^[22](August – October 2006) 4,968 cases with 44 dead
• Cuba: Media reports ^{[23][24][25][26]} (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 1st. The Dominican Republic ( Spanish: República Dominicana;) is a nation located in the Caribbean region and shares the island of Hispaniola with The Republic of Cuba (ˈkjuːbə or) consists of the island of Cuba (the largest and second-most populous island of the Greater Antilles) Isla de la |utc_offset = -2 to -4 |time_zone_DST = BRST |utc_offset_DST = -2 to -5 |cctld An outbreak of Dengue in the first seven months of 2007 reported more than 438,000 cases of dengue fever, with 97 deaths. ^[27]
• Mexico: As of October 2007 there is a serious problem in Monterrey, Nuevo Leon almost reaching epidemic proportions. The United Mexican States ( or commonly Mexico (ˈmɛksɪkoʊ () is a federal constitutional Republic in North America. This article is about the Mexican city for other uses see Monterrey (disambiguation. Nuevo León ( Spanish for "New León " after the former kingdom in Spain) is a state located in northeastern Mexico.

Asia Pacific

See also: 2006 dengue outbreak in Pakistan, 2005 dengue outbreak in Singapore, and 2006 dengue outbreak in India

• Australia: 2006 March 15, 2 confirmed cases at Gordonvale, Cairns, Queensland. In the 2006 dengue outbreak in Pakistan, a significant rise in the number of Dengue fever cases was reported in Pakistan, becoming the country's worst health In the 2005 dengue outbreak in Singapore, a significant rise in the number of Dengue fever cases was reported in Singapore, becoming the country's worst health Cases of dengue fever were reported first from New Delhi in early September and by end of September other states in India also started to report deaths due to Dengue fever. For a topic outline on this subject see List of basic Australia topics. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 44 BC - Julius Caesar, Dictator of the Roman Republic, is stabbed to death by Marcus Junius Brutus,
• China: September 2006, 70 cases since June in Guangzhou,Guangdong. China ( Wade-Giles ( Mandarin) Chung¹kuo² is a cultural region, an ancient Civilization, and depending on perspective a National Guangzhou ( Jyutping: Gwong²zau¹; Yale: Gwóngjàu) is the Capital and a Sub-provincial city Guangdong ( EFEO: Kouangtong; Pinyin Guǎngdōng; Postal map spelling: Kwangtung) is a province on the ^[28]
• Cook Islands: ^[29](October 2006 – January 2007) 460 cases. The Cook Islands ( Cook Islands Māori: Kūki 'Āirani) are a self-governing parliamentary democracy in free association with New Zealand.
• India: 2006 September, more than 400 cases and 22 deaths were reported due to dengue fever in New Delhi. India, officially the Republic of India (भारत गणराज्य inc-Latn Bhārat Gaṇarājya; see also other Indian languages) is a country New Delhi (नई दिल्ली ਨਵੀਂ ਦਿੱਲੀ نئی دلی is the Capital city of India. ^[30] By October 7, 2006, reports were of 3,331 cases of the mosquito-borne virus and a death toll of 49. Events 3761 BC - The epoch (origin of the modern Hebrew calendar ( Proleptic Julian calendar) Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. ^[31]
• Indonesia: 2004 80,000 infected with 800 deaths. The Republic of Indonesia ( (Republik Indonesia is a Country in Southeast Asia.
• Malaysia: January 2005 33,203 cases. For the biogeographical region see Malesia Malaysia (məˈleɪʒə or /məˈleɪziə/ is a country that consists of thirteen states and
• Pakistan: 2006 Over 3,230 cases, 50 deaths. Pakistan () officially the Islamic Republic of Pakistan, is a country located in South Asia, Southwest Asia, Middle East and
  • Karachi 2006 October, the number of infected patients rose to 1,836 of which 30 had died. (ڪراچي) is the largest city in Pakistan. It is the world's second largest city proper behind Mumbai in terms of population which exceeds 10 million
  • 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. ( lahor is the capital of the Pakistani province of Punjab and is the second largest city in Pakistan after Karachi. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 4004 BC - Creation of the world begins according to the calculations of Archbishop James Ussher 42 BC - Eid ul-Fitr or Id-ul-Fitr (عيد الفطر ‘Īdu l-Fiṭr) often abbreviated to Eid, is a Muslim Holiday that marks the end of The number of infected patients is 400 by October 31, of which 4 had died. Events 445 BC – Ezra reads the Book of the Law to the Israelites in Jerusalem (see Nehemiah 91 NLTse
• Philippines: ^[32](January – August 2006) 13,468 cases with 167 dead. The Philippines ( Filipino: Pilipinas, officially known as the Republic of the Philippines (fil ''Republika ng Pilipinas'' RP
• Singapore: 2007 more than 4029 cases, 8 deaths at 29 September 2005 at least 13 deaths. Singapore Events 522 BC - Darius I of Persia kills the Magian usurper Gaumâta securing his hold as king of the Persian Empire. Year 2005 ( MMV) was a Common year starting on Saturday (link displays full calendar of the Gregorian calendar. 2004 9,460 cases. 2003, 4,788 cases.
• Thailand: May 2005 , 7,200 infected. The Kingdom of Thailand (ˈtaɪlænd ราชอาณาจักรไทย, râːtɕʰa-ʔaːnaːtɕɑ̀k-tʰɑj 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. Swahili (called Kiswahili in the language itself is the First language of the Swahili people (Waswahili who inhabit several large stretches ^[33] 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^[34] or, alternatively, the Spanish word may derive from the Swahili. ^[35] 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. ^[36] 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). Benjamin Rush ( December 24 1745 &ndash April 19 1813) was a Founding Father of the United States. Myalgia means " Muscle Pain " and is a symptom of many diseases and disorders Arthralgia (from Greek arthro-, joint + -algos, pain literally means joint pain; it is a symptom of injury infection illnesses -- in particular The viral etiology and the transmission by mosquitoes were deciphered only in the 20th century. Etiology (alternatively aetiology, aitiology) is the study of causation. 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 [14], 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 HCV, West Nile and Yellow fever viruses). The Flaviviridae are a family of Viruses that are primarily spread through arthropod vectors (mainly ticks and mosquitoes This page is for the virus For the disease see Hepatitis C. Hepatitis C virus ( HCV) is a small (50 nm in size West Nile virus (or WNV is a Virus of the family Flaviviridae; part of the Japanese encephalitis (JE antigenic complex of viruses it is found in Yellow fever (also called yellow jack, black vomit or sometimes American Plague) is an acute viral disease The software and information about the project can be found at the World Community Grid web site. [15]

Footnotes

References

• Manson's Tropical Diseases
• Mandell's Principles and Practices of Infection Diseases
• Cecil Textbook of Medicine
• The Oxford Textbook of Medicine
• 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

• CDC site on Dengue Fever.
• Dengueinfo.org - Resources & depository of Dengue Virus genomic sequences for biomedical researchers.
• [16].
• gmanews.tv/story,Valenzuela troubled by steep rise in dengue cases
• www.gmanews.tv/largevideo, Can camote tops cure dengue? - 01/25/2008