Dengue Virus Research Articles

Serotypic and genotypic profile of dengue virus outbreaks in India between 2011 and 2017.

The epidemiology of dengue has been demonstrating significant changes in recent years, with rising incidence of infection in countries with known endemicity and occurrence of fresh outbreaks in previously unaffected territories. India, which has been a traditional hotspot dengue virus (DENV) transmission in the endemic south-east Asian region, has also been affected by the sweeping changes in dengue epidemiology. Two remarkable developments characterize the alterations witnessed by India 2011-2017. Firstly, all parts of the country have witnessed abrupt replacement of existing DENV lineages with emerging novel strains. Secondly, co-circulation of multiple serotypes of DENV have been reported from all across the country 2011-2017; thereby hinting at the transition of the country towards hyper-endemicity. Considering the potential clinical implications of such epidemiological transformation in terms increasing involvement of pediatric patients and growing predisposition to serious complications, the present review provides an update on the serotypic and genotypic profile of dengue outbreaks that have been witnessed by different zones of India between 2011 and 2017. Dividing the country into northern, southern, eastern, western, central and north-eastern zones, we describe discrete zone-specific distribution patterns of DENV serotypes and genotypes and observe simultaneous circulation of different DENV strains in different parts of the country. Random shifts in the genetic characteristics of the circulating strains and the widespread co- circulation of all four serotypes underscore the need for undertaking continuous and representative molecular surveillance of the circulating DENV strains across the country for prompt identification of emerging strains and novel mutants; gain insights into the formulation of Dengue vaccines and develop a clearer understanding of the molecular basis of immune evasion, disease epidemiology and pathogenesis.

Assessment of larvicidal, growth-suppressing, and developmentaltering bioefficacy of Ageratum houstonianum against Aedes aegypti (L.).

Aedes aegypti is a major vector responsible for spreading dengue, chikungunya, yellow fever, and Zika viruses worldwide. These illnesses have increased globally due to climate and environmental changes. Vector control and management are the principal tactics for combating mosquitoes-borne diseases in the absence of an effective vaccine. The study aimed to ascertain bioactivities of Ageratum houstonianum leaf acetone extract (AhLAE) against Aedes aegypti. Bioefficacy of AhLAE was tested against fourth instar larvae (L4) of Ae. aegypti using standard WHO protocol. The mortality, growth, and development of larvae, pupae and adults were recorded after exposure to the extract. The AhLAE showed larvicidal activity against L4 with LC50 and LC90 values of 401.88 and 691.24 mg/L, respectively. The mortality of the larvae further increased on subsequent days. The AhLAE caused a significant reduction in pupae formation and adult emergence. It also increased the larval duration of L4 and development duration of the pupa formed from the treated L4, indicating its growth-suppressing effects. The impact of the AhLAE was dose-dependent; high concentrations caused reduction in survival and growth of L4. Consequently, the L4-pupal and L4-adult growth indexes decreased. Additionally, the AhLAE induced developmental anomalies in the form of larva-pupa (L-P) intermediates. The study found that the AhLAE exhibited larvicidal, growth-suppressing, and development-altering activities against Ae. aegypti. The findings suggest the potential of AhALE as a natural insecticidal agent for controlling mosquitoes.

Embryonic dormancy in Aedes aegypti and Aedes albopictus (Diptera: Culicidae): a survival and dispersal mechanism

Aedes aegypti and Aedes albopictus are the main vectors of arboviruses such as dengue, Zika virus, and chikungunya. Ae. aegypti is a widely spread mosquito in tropical and subtropical regions, whereas Ae. albopictus is a culicid of Asian origin that shows exophilic behavior and can be found in subtropical and temperate areas. Climatic factors could influence the distribution of both species, making them use genetic and environmental resources to adapt to the environment, activating survival mechanisms (embryonic dormancy) that increase the developmental period and keep their offspring in the environment. From this perspective, this review aimed to compare the different physiological mechanisms of embryonic dormancy between Ae. aegypti and Ae. albopictus and their impact on the development and environmental adaptability of these two species. A total of 62 articles were identified in the PubMed, Scopus, and Web of Science databases corresponding to the period from 1981 to 2021. In diapause, the results mentioned above are indirectly linked to temperature and directly linked to photoperiod variations. With regard to quiescence, temperature and humidity are directly related to the activation of this mechanism. In conclusion, it is essential to highlight the expansion of arboviruses such as dengue, chikungunya, yellow fever, and Zika virus and their relationship with embryonic dormancy, diapause and quiescence, extremely important strategies for Ae. aegypti and Ae. albopictus to keep their offspring in the environment under adverse conditions.

B-215 Evaluating RT-qPCR for Dengue Virus Detection: Outcomes of a Brazilian External Quality Assessment Program

Abstract Background Dengue virus (DENV), responsible for a prevalent arthropod-borne viral illness, poses a substantial public health challenge worldwide. Clinically, DENV's manifestation often resembles that of other arboviruses, resulting in frequent healthcare visits and complicating the early diagnosis, which is critical for patient management. While virus isolation is a viable method, RT-qPCR assays yield significantly quicker results. Rapid immunochromatographic tests are available; yet, RT-qPCR not only matches their sensitivity but also provides distinct advantages in clinical laboratory settings. These include higher throughput and integrated, traceable quality control within each routine, offering less subjective and more dependable results. Maintaining high diagnostic standards for DENV is imperative. External quality assessment programs (EQAP) play a key role in enhancing laboratory diagnostic capabilities by monitoring and assessing diagnostic methods. This study evaluates the diagnostic efficacy of RT-qPCR for DENV using data from an EQAP conducted by a Brazilian provider, accredited by ABNT NBR ISO/IEC 17043:2011. Methods The quality control samples comprised lyophilized suspensions containing viable DENV particles, grown on vero cells (BCRJ 0245/ATCC CCL-81) under BSL-3 conditions. From February 2017 to November 2022, twenty-four EQAP survey rounds were carried out, each encompassing three samples, culminating in 1,153 data points. The evaluation metrics included participant numbers, adequacy percentage, sensitivity, specificity, and the incidence of false positives and negatives. The Mann-Kendall test assessed trends in these metrics over the survey rounds. The RT-qPCR kits employed by participants were classified either as in-vitro diagnostic (IVD) or as laboratory-developed tests (LDT). Kits that demonstrated high performance in terms of adequacy, sensitivity, and specificity were identified and listed. Results The number of laboratories participating has increased. Starting with four in 2017, the program expanded to 28 by 2022. Laboratory accuracy was high during the evaluation period, with a median of 99% (97.8% in 2017 and 99.2% in 2022). The Mann-Kendall test indicated a significant trend of increased accuracy (p<0.001). Specificity remained stable at 98.8%, while sensitivity improved, with a median of 99.4%—rising from 93.3% in 2017 to 100% in 2022 (p<0.001). Only three false negatives were reported over three separate rounds, and six false positives were reported across four rounds. Both LDT and IVD RT-qPCR kits demonstrated high accuracy (99.4% and 98.4%, respectively). Biomanguinhos ZDC, Viasure ZDC, and ZDC Multiplex kits all showed 100% adequacy, sensitivity, and specificity. Conclusions This study highlights the increasing adoption of RT-qPCR for DENV detection, as evidenced by the growing number of laboratories in the EQAP program and the consistently high adequacy rates from 2017 to 2022. Nonetheless, the number of participating laboratories remains relatively small for a vast tropical country like Brazil. The high sensitivity and specificity, along with the infrequency of false results, underscore its effectiveness. The superior performance of certain kits suggests possible advancements in DENV diagnosis, contributing to global public health initiatives against this arboviral disease.

The Angiopoietin-Tie-2 Axis in Children and Young Adults with Dengue Virus Infection in the Philippines.

Dengue virus (DENV) infection is associated with plasma leakage, which may progress to shock. The angiopoietin (Ang)-tyrosine kinase with immunoglobulin and epidermal growth factor homology domain 2 (Tie-2) axis regulates endothelial permeability. We examined the clinical utility of Ang-1, Ang-2, and the Ang-2-to-Ang-1 ratio for prediction of progression to severe DENV in a prospective cohort study of children and young adults (age 1 to <26 years) with DENV infection. Ang-1, Ang-2, Tie-2 were measured at presentation to an outpatient clinic in the Philippines from stored plasma by multiplex Luminex® assay. Patients were followed prospectively to document the clinical course (hospitalization, length of stay, intravenous fluid resuscitation, and transfer to a higher level facility). We included 244 patients (median age 9 years, 40% female). At presentation, 63 patients (26%) had uncomplicated dengue, 179 (73%) had dengue with warning signs, and 2 (0.82%) had severe dengue. One hundred eighty-one patients (74%) were hospitalized. Ang-1 levels were lower and Ang-2 higher in patients who required hospitalization. Ang-2-to-Ang-1 ratio >1 was associated with a relative risk of hospitalization of 1.20 (95% CI: 1.03-1.36, P = 0.016). A higher Ang-2-to-Ang-1 ratio was associated with longer length of hospital stay, higher frequency of transfer to a higher level facility, larger intravenous fluid requirement, hemoconcentration, and thrombocytopenia. Angiopoietin-2 was correlated with procalcitonin (Kendall's τ = 0.17, P = 0.00012), a marker of systemic inflammation, as well as soluble vascular cell adhesion molecule-1 (τ = 0.22, P <0.0001) and Endoglin (τ = 0.14, P = 0.0017), markers of endothelial activation. In conclusion, altered Ang-2-to-Ang-1 ratio can be detected early in the course of DENV infection and predicts clinically meaningful events (hospitalization, length of stay, and fluid resuscitation).

Evaluation of Wolbachia infection in Aedes aegypti suggests low prevalence and highly heterogeneous distribution in Medellín, Colombia

Dengue virus, transmitted mainly by Aedes aegypti mosquitoes, is a significant public health challenge in tropical and subtropical countries, with an incidence that is growing at an alarming rate. The release of Wolbachia-carrying mosquitoes has been suggested as a strategy to reduce the incidence of multiple arboviruses. In Medellín, Colombia, large-scale releases of Wolbachia-infected Ae. aegypti mosquitoes were performed between 2017 and 2022 by the World Mosquito Program to facilitate population replacement. In this study, we evaluated the prevalence and distribution of Wolbachia-infected Ae. aegypti two years after completion of these releases. We conducted the sampling across 19 communes in Medellín, using 416 ovitraps to collect Ae. aegypti eggs from epidemiological weeks 26 to 41 in 2023. Upon hatching the collected eggs, we identified and pooled adult female Ae. aegypti for DNA extraction. Subsequently, we conducted PCR assays for the detection of Wolbachia infection in these mosquitoes. We used maximum likelihood estimation (MLE) and Bayesian methods to estimate the prevalence of Wolbachia infection, while using QGIS to analyze spatial distribution of infection in the region. A total of 774 female Ae. aegypti mosquitoes from 182 pools were evaluated. We detected Wolbachia in 33.5 % of pools, with an estimated individual minimum infection rate of 9.5 % and a maximum of 33.2 %. The prevalence varied significantly across communes, with the highest rates observed in the northeastern and southwestern areas. Spatial analysis revealed a highly heterogeneous island-like distribution of Wolbachia across Medellín with a few hotspots. The observed Wolbachia prevalence in this work was lower than previously reported. We suspect a decline in the prevalence of Wolbachia-infected Ae. aegypti mosquitoes in Medellín following the completion of their release.

A-261 Outcome of a survey on dengue lateral flow immunoassay test kit reading and interpretation by medical laboratory staff in a hospital laboratory

Abstract Background Lateral flow immunoassay (LFIA) tests, first introduced in 1959, are now the mainstay of clinical laboratories. Khoo Teck Puat Hospital (KTPH) is a 795-bed acute care general hospital located in the north of Singapore. The Department of Laboratory Medicine has been using dengue LFIA test kits for the detection of dengue NS1 antigen, IgM antibodies and IgG antibodies. While kits are cost-effective, user-friendly and provide rapid results, there is subjectivity in reading and interpretation of results. Methods We conducted a survey to assess test reading and interpretation by medical laboratory staff. Six serum and plasma specimens were analysed using Bioline™ Dengue IgG/IgM WB test device. Test kits at the end-point of sample incubation were photographed in both well-lit and dim conditions. A survey questionnaire was prepared using an online form builder tool using the photographs. Staff were invited to participate in the survey. They were allowed to report the result as ‘Positive’, ‘Negative’ or ‘Equivocal’. Results A total of sixteen responses were received. Results were 100% concordant for all 6 specimens in both well-lit and dim conditions. For one case, under a well-lit condition, 15 staff reported the result as ‘Positive’ while one staff reported ‘Equivocal’. Most of the reported results for samples with no consensus is split between ‘Positive’ and ‘Equivocal’. Conclusions Dengue viruses of all 4 known serotypes are endemic in Singapore. Positive results are tracked on a national level to identify areas of high dengue infection for intensive environmental and vector control measures. Hence, accurate reporting and identification of patients with dengue infection is important. Our survey shows that lighting conditions do not affect the interpretation of LFIA results. Reading and interpretation of dengue LFIA test kits however, remain dependent on user interpretation and newer test kits with optical readers may be useful in mitigating this.

Harnessing high potential benzothiazole chalcones against dengue virus NS5 protein: A multi-faceted theoretical study through molecular docking, ADME, and DFT

Chalcones bearing tetralone, indanone and benzothiazole cores were synthesized successfully using a general Claisen-Schmidt condensation protocol. The prepared compounds were purified and structurally analyzed by 1H, 13C NMR, and FT-IR techniques. A multi-faceted theoretical approach, combining Density Functional Theory (DFT), molecular docking, and ADME predictions, was employed to evaluate their therapeutic potential. DFT calculations at the B3LYP/def2-TZVP level revealed key electronic properties, with TD3 compound demonstrating the highest chemical reactivity. Molecular Electrostatic Potential (MEP) and Reduced Density Gradient (RDG) analyses provided insights into the compounds' non-covalent interactions and charge distributions. Molecular docking studies against the NS5 protein (PDB: 6KR2) showed superior binding affinities for all three compounds compared to the control ligand SAH, with TD3 exhibiting the lowest binding energy (−8.41 kcal/mol) and theoretical inhibition constant (689.31 nM). ADME predictions indicated favorable drug-like properties with concerns regarding aqueous solubility and potential P-glycoprotein interactions. Toxicity evaluations highlighted challenges, particularly in hepatotoxicity and carcinogenicity. The study identified TD3 as a promising lead compound for Dengue Virus NS5 inhibition, while also emphasizing the need for targeted modifications to address toxicity concerns. This research not only contributes to anti-dengue drug discovery efforts but also provides a robust methodological framework for the theoretical evaluation of similar small compounds in future investigations.

Lithospermic acid inhibits dengue virus infection through binding with envelope proteins

The dengue virus has emerged as a global pandemic, highlighting the urgent need for the immediate development of antiviral therapeutics. Lithospermum erythrorhizon, a medicinal plant commonly used in China for various ailments including viral infections, inflammation, rheumatism, and cancer, showed promising antiviral properties in our research. Specifically, both the ethanol extract of Lithospermum erythrorhizon and its active component, lithospermic acid, demonstrated significant inhibitory effects on Dengue virus (DENV) replication in Vero cells, with EC50 values of 6.50 μg/mL(95% CI: 2.25 to 18.98)and 15.00 μM(95% CI: 12.13 to 18.07), respectively. Notably, lithospermic acid exhibited potent antiviral activity across multiple cell lines against DENV, impeding virus replication and specifically impeding the expression of viral E and NS3 proteins during the early stages of DENV infection. Experimental assays involving RNase digestion and sucrose density gradient analysis confirmed that lithospermic acid did not directly inactivate DENV but rather interfered with viral processes. Furthermore, the compound was found to bind to the E protein of DENV, effectively inhibiting viral infection and mitigating the cytopathic effects induced by DENV. Collectively, these findings underscore the potential of lithospermic acid as a promising candidate for the development of therapeutic strategies targeting DENV infection.

Dengue fever complicated by abscess formation: An atypical presentation

Abstract: Dengue fever is a mosquito-borne disease with a wide clinical spectrum, ranging from self-limiting mild sickness to expanded dengue syndrome (EDS). Despite extensive investigation into the immunological pathogenesis of dengue virus (DENV) infection, the precise mechanism remains unclear. DENV’s transitory reduction of host innate immunity could be the most likely cause of dengue-associated coinfections and/or superinfections. Furthermore, the dual infection can aggravate the clinical course of dengue fever. We document an unusual case of dengue fever in a 27-year-old healthy male, exacerbated by cellulitis and myositis involving the posterolateral compartment of the proximal and midcalf, which was later discovered to be an abscess. Blood culture showed methicillin-sensitive Staphylococcus aureus. This case shows the possibility of bacterial coinfections in dengue patients, especially in the context of immunosuppression, as well as the need for early recognition of atypical characteristics and the novel entity known as EDS.

Seroprevalence and hematological profile of dengue among healthy inhabitants of Mayo Kebbi province: South of Tchad

ABSTRACT Introduction: Dengue is one of the most serious and rapidly spreading major mosquito borne diseases in the world. Despite many acute febrile illnesses in Tchad, the burden of illness due to dengue in the country is largely unknown. Hence, the present study aimed to determine the seroprevalence of dengue viral (DENV) infection and its association with hematological parameters. Method: A cross sectional study was carried out in Bongor Provincial Hospital. Blood samples were collected from each participant and were used to determine the hematological profile and to diagnose the presence of DENV infection. A total of 130 participants were enrolled in the study. Among these, 114 (87.7%) were diagnosed positive for DENV infection. Results: The majority of the positive cases were of the age group 21 to 40 years old. Leukocytosis was the most common hematological parameter affecting 120 (92.3%) of them followed by anemia and thrombocytopenia affecting 69 (53.1%) and 16 (12.3%) of them, respectively, and then lymphocytosis affecting 5 (3.8%) of them. No case of leukopenia was recorded. Discussion: The seroprevalence rate among participants suggests that the dengue virus is in circulation in Mayo Kebbi province: south of Tchad. The abnormal hematological parameters may contribute to the severity of the infection like the incidence of bleeding in the case of thrombocytopenia.

Emerging Infectious Diseases and the Eye: Ophthalmic Manifestations, Pathogenesis, and One Health Perspectives.

Infectious diseases may lead to ocular complications including uveitis, an ocular inflammatory condition with potentially sight-threatening sequelae, and conjunctivitis, inflammation of the conjunctiva. Emerging infectious pathogens with known ocular findings include Ebola virus, Zika virus, Avian influenza virus, Nipah virus, severe acute respiratory syndrome coronaviruses, and Dengue virus. Re-emerging pathogens with ocular findings include Toxoplasma gondii and Plasmodium species that lead to malaria. The concept of One Health involves a collaborative and interdisciplinary approach to achieve optimal health outcomes by combining human, animal, and environmental health factors. This approach examines the interconnected and often complex human-pathogen-intermediate host interactions in infectious diseases that may also result in ocular disease, including uveitis and conjunctivitis. Through a comprehensive review of the literature, we review the ophthalmic findings of emerging infectious diseases, pathogenesis, and One Health perspectives that provide further insight into the disease state. While eye care providers and vision researchers may often focus on key local aspects of disease process and management, additional perspective on host-pathogen-reservoir life cycles and transmission considerations, including environmental factors, may offer greater insight to improve outcomes for affected individuals and stakeholders.

Detection of dengue virus serotype 4 in Panama after 23 years without circulation.

Panama is a country with endemic Dengue virus (DENV) transmission since its reintroduction in 1993. The four serotypes have circulated in the country and the region of the Americas, however, DENV-4 confirmed autochthonous cases have not been identified since 2000, despite its circulation in neighboring countries. Here, we report DENV-4 detection in Panama in the last four-month period of 2023 with co-circulation of the other serotypes, this was associated with a peak of dengue cases during the dry season even though most dengue outbreaks are described in the rainy season. Complete genomes of DENV-4 allowed us to determine that cases were caused by DENV-4 genotype IIb, the same genotype as 23 years ago, with high similarity to DENV-4 sequences circulating in Nicaragua and El Salvador during 2023. This report shows the importance of maintaining serotype and genotype surveillance for early detection of new variants circulating in the country.

Bimetallic Au-Ag Reduced Graphene Oxide Nanostructures for Enhanced Detection of Dengue Virus E Protein

The development of highly sensitive and specific diagnostic tools for early-stage detection of dengue virus (DENV) is critical for effective outbreak management, particularly in resource-limited settings. In this study, we report a novel electrochemical immunosensor based on bimetallic gold silver (Au-Ag) nanoparticles integrated with reduced graphene oxide (rGO) for the detection of dengue virus envelope (E) protein. The Au-Ag bimetallic nanostructures exhibit superior electron transfer kinetics and enhanced electrocatalytic activity, while rGO serves as an excellent platform due to its large surface area and high conductivity. This synergistic combination improves antigen-antibody interactions and significantly boosts sensor performance. The immunosensor demonstrated a broad linear detection range of 100 ag ml−1 to 10 ng ml−1, with a high correlation coefficient (R2 = 0.98519). It achieved an ultra-low limit of detection (LOD) of 4.959 ag ml−1 for DENV E protein, outperforming existing detection methods. These findings highlight the potential of the Au-Ag- rGO-based immunosensor as a promising tool for point-of-care diagnosis, enabling rapid and cost-effective disease management and control.

Spatio-temporal distribution of Dengue, Zika and Chikungunya in Cali, Colombia: 2014-2016

Introduction: Emerging and re-emerging arboviral infections have become a public health challenge in the Americas due to their epidemic potential. Objective: To determine the spatio-temporal distribution of the dengue, Zika, and chikungunya viruses during an epidemic period in Cali, Colombia. Materials and methods: Multi-method descriptive ecological and exploratory study of confirmed and suspected cases reported to the epidemiological surveillance system between 2014 and 2016. Results: 40,168 cases were analyzed, and it was found that dengue was the most frequent arboviral infection (59.2 %). The most affected individuals were women (65 %) and those with a mean age of 34.5 years. Although arboviral infections spread out throughout the city, the three diseases were concentrated in significant groups located at the center-east and northeast areas of Cali (p&lt;0.01; z=-203.7). Conclusions: This study identified critical zones for the three arboviral infections, which are located in areas with low socioeconomic status. Likewise, the results suggest that in addition to eco-epidemiological and bio-psychosocial factors, temperature, precipitation, and the aedic index may play an important role in the spatio-temporal behavior of these diseases. A multidisciplinary and collaborative approach is necessary, which must involve communities and authorities to implement effective control strategies, especially during epidemic periods.

Deciphering the Molecular Landscape of Dengue Infection: Insights from gene expression profiling and Protein Interactions

Dengue fever (DF) is a viral infection recognized as one of the most rapidly spreading vector-borne diseases among humans. However, the molecular mechanisms underlying disease aetiology and potential therapeutic targets remain unclear. This study presents a thorough examination of differentially expressed genes (DEGs) throughout the spectrum of Dengue infection stages, offering insights into disease mechanisms and therapeutic targets. Through meticulous analysis of DEGs within each infection stage, key genes pertinent to disease progression are identified, highlighting their roles in host-virus interactions. Noteworthy discoveries include the upregulation of IFI27 and USP18 in mild infection, suggesting involvement in viral replication inhibition and host defence, alongside the downregulation of CMTM2, indicating alterations in immune-related functions. Similarly, in severe infection, upregulated genes like IGHV1-69 are linked to illness severity, while downregulated IL-13RA1 signifies disruptions in cytokine signaling. Overlapping DEGs between infection groups unveil shared biological processes, further elucidated through functional enrichment analysis, showcasing coordinated regulation of cellular processes and pathways. Integration of Dengue virus and human interaction network analysis reveals crucial insights into the mechanisms by which the virus mediates the disease progression and offers potential therapeutic opportunities for disease management.

Dengue fever in hyperglycemic patients: an emerging public health concern demanding eyes on the effective management strategies.

Hyperglycemia, also known as diabetes, is a metabolic disorder characterized by elevated levels of glucose in the bloodstream. It can lead to the prolonged dysfunction, injury, and deterioration of several organs. In addition, dengue is a viral illness transmitted by mosquitoes that has reached epidemic proportions worldwide. In this article, we focused on the severity of comorbidities, difficulties in managing them, and preventive measures meant to lessen the risks associated with comorbidities in diabetic patients with dengue infection. We explored a number of databases, including PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library, for this review article using various related keywords. The findings of this review article indicate that elderly dengue patients with diabetes should be admitted to the hospital for close observation and early management using fluid therapy. An observed association exists between dengue hemorrhagic fever (DHF) and diabetes, indicating a possible consequence in this specific group. Additionally, patients with diabetes who contract dengue show elevated levels of inflammatory markers. Diabetes mellitus deteriorates the immune system, which exacerbates the progression of dengue fever. Cutting-edge technology and scientific research may assist in addressing the challenges that diabetes and dengue viruses pose in low- and middle-income countries. Implementing innovative diabetic care management is essential to ensuring consistency of care, improving a healthy lifestyle, and lowering patient risk factors and comorbidities. Dengue fever has spread to epidemic levels throughout the world. Inflammatory markers increase and the prevalence of DHF is greater in diabetes individuals with dengue infection. Given the continued growth of dengue in Asian nations, it is imperative that we concentrate our efforts and resources on providing more precise and effective treatment for this emerging issue.

The dengue vaccine: a major scientific challenge and a public health issue

Almost half of the world's population is exposed to the risk of transmission of the four dengue virus serotypes (DENV 1-4), by mosquitoes of the genus Aedes. A dengue vaccine is effective if it induces prolonged protective immunity against all circulating viral strains, irrespective of the age and infection history of the vaccinated subject. An effective vaccine strategy against dengue is based on the injection of live attenuated viruses in a tetravalent formulation. In this review, we present the most promising candidate vaccines against dengue, their successes and also the questions raised by the correlates of protection that have been adopted to assess their level of effectiveness against the disease.

Dengue Virus Serotype 3 Origins and Genetic Dynamics, Jamaica.

We identified 3 clades of dengue virus serotype 3 belonging to genotype III isolated during 2019-2020 in Jamaica by using whole-genome sequencing and phylogenomic and phylogeographic analyses. The viruses likely originated from Asia in 2014. Newly expanded molecular surveillance efforts in Jamaica will guide appropriate public health responses.

Neonatal ascites, leading to the diagnosis of congenital dengue with plasma leakage.

Although Cambodia is a dengue-endemic country, mother-to-child transmission of dengue virus has yet to be documented. We report a rare case for congenital dengue diagnosed by RT-PCR in a 4-day-old neonate with ascites. The neonate was initially treated for suspected perinatal infection. The management was supportive.