UNIVERSITY OF SANTO TOMAS

Senior High School

JOURNAL REPORT

GROUP NO. 5 SECTION 12 HA-11 Date Submitted

Journal Title Dengue

Dengue is a self-restricted, fundamental viral disease transmitted between people by mosquitoes. The
quickly growing worldwide impression of dengue is a general wellbeing challenge with a monetary burden
that is presently neglected by authorized immunizations, explicit remedial specialists, or proficient vector-
control methodologies. This survey features our present comprehension of dengue, including its clinical
indications, pathogenesis, tests that are utilized to analyze it, and its administration and counteractive
action.

The worldwide burden of dengue is enormous; an expected 50 million contaminations for each year
happen all over around 100 nations, with potential for further spread. Integral to the development of
dengue as a public medical issue has been the dispersal of effective mosquito vectors over a great part of
the tropical and subtropical countries. The essential vector, the urban-adjusted Aedes aegypti mosquito,
has turned out to be broadly dispersed all over tropical and subtropical areas. Dengue rose up out of Africa
during the slave exchange in the fifteenth through nineteenth century, spread into Asia through business
trades, and has been distributed with the approach of expanded travel and exchange in the previous 50
years. Globalization of trade, specifically the trade of tires from used vehicles, is believed to elucidate the
dissemination of eggs and immature sorts of these arboviral vectors into new territories. The unfold of
infectious disease illustrates the international trade (and the transport of the dipterous insect vectors),
increasing travel among and between countries (and the movement of viremic people), urban state of
affairs (which is tributary to multiple infections from an infected mosquito), and ineffective vector-control
methods have supported a scourge within the epoch.

Dengue is caused by one of four single-stranded, positive-sense RNA viruses (dengue virus type 1 through
dengue virus type 4), also referred to as serotypes) of the genus flavivirus (family Flaviviridae). Infectious
virus and the virus-encoded NS1 are present in blood during the acute phase, and high-level early viremia
and NS1 antigenemia have been associated with more severe clinical presentations. It exists in both urban
and endemic setting, where humans and mosquitos are the only known hosts, and sylvan areas, where
mosquito-borne transmissions happen between nonhuman species. Multiple genotypes consist of
phylogenetically associated sequences within each dengue virus serotype. There are subtle antigenic
variations between genotypes of the same serotype, but these may not be clinically important as one
serotype human infection is thought to confer long-lived serotype-specific immunity, but only short-lived
cross-immunity between serotypes.

In urban and endemic communities, the dynamics of dengue viruses are complicated, involving the birth
and death of viral lines. Although dengue has appeared over the previous 40 years in various new regions,
the viruses themselves are paradoxically "local" in their developmental history, indicating that the
worldwide spread of dengue virus has happened in comparatively rare "jumps," most probably due to the

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JOURNAL REPORT

motion of viremic beings to new geographical environments with an appropriate vector and vulnerable
population.

Although most infections with dengue viruses are asymptomatic, there may be a broad range of clinical
manifestations from mild febrile disease to serious and fatal disease. Differential diagnosis is wide and
varies with the development of the disease. Other arboviral infections include measles, rubella, enterovirus
infections, adenovirus infections, and influenza during the febrile phase. Other illnesses that should be
regarded as part of the differential diagnosis are typhoid, malaria, leptospirosis, viral hepatitis, rickettsial
illnesses, and bacterial sepsis, based on the clinical image and the incidence of local disease.

In clinical manifestations, symptoms suddenly begin and follow three stages after an incubation period of 3
to 7 days — an original febrile stage, a critical phase around the moment of defervescence, and a stage of
spontaneous regeneration.

FEBRILE PHASE
Typically, the initial phase is characterized by high temperatures (around 38.5 ° C) with headache, vomiting,
myalgia, and joint pain, sometimes with a temporary macular rash.

CRITICAL PHASE
A systemic vascular leak syndrome becomes evident around the moment of defervescence in a tiny
percentage of patients, typically in kids and young adults, as demonstrated by increased
hemoconcentration, hypoproteinemia, pleural effusions, and ascites.

RECOVERY PHASE
The modified vascular permeability is short-lived, spontaneously returning to ordinary level after roughly
48 to 72 hours, and is consistent with the patient's symptoms rapidly improving.

There are currently no efficient antiviral agents available to treat dengue infection, and therapy remains
supportive, with special emphasis on thorough fluid management. Patients without complications and able
to tolerate oral liquids may stay at home with orders to return to the hospital instantly if there are
indications of vascular leakage suggestive of bleeding or warning. However, in a medical clinic with a
complete blood count, our practice is to assess these patients daily to monitor hematocrit and platelet
values. Blood transfusion may be life-saving for patients with serious bleeding that affects cardiovascular
function, but due to the danger of fluid overload it should be done with care. There is currently no proof,
however, that prophylactic platelet transfusions are of any importance in patients with no clinically
important bleeding, even if thrombocytopenia is deep.

New approaches to vector control include releasing genetically modified male mosquitoes that sterilize the
female wild-type population, decreasing egg production and next-generation population size that would be
accessible for future dengue virus transmission. An alternative strategy involves embryonic introduction of
strains of the obligate intracellular bacterium wolbachia into A. aegypti. Strikingly, wolbachia-infected A.
aegypti are partially resistant to dengue virus infection and can invade natural A.
aegypti populations, suggesting the possibility of induction of widespread biologic resistance to dengue
viruses in A. aegypti populations. ChimeriVax (Sanofi Pasteur), the leading dengue vaccine candidate, is a
tetravalent formulation of attenuated 17D vaccine strains of yellow fever expressing the prM and E
proteins of the dengue virus. It has been difficult to develop a vaccine for dengue that is safe and elicits
balanced neutralizing antibody responses to all four serotypes. However, notable progress has been

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produced over the previous 5 years and clinical studies in multicenter stage 2–3 are underway to determine
the effectiveness of this three-dose vaccine. There is a shortage of data on immune correlates. Long-term
vaccine follow-up will be the key to understanding whether waning immunity from the vaccine predisposes
recipients to more serious results on subsequent natural infection. Other candidates in early clinical
development include vaccines with live attenuated dengue viruses and recombinant subunit vaccines.

Over the previous century, the field of dengue studies has been strengthened, fueled by the increasing
awareness of the disease burden combined with the prospect of a dengue vaccine. No vaccine, however,
can be an instant worldwide panacea, and attempts must continue to enhance therapy by applying current
best practices in triage and fluid management, along with attempts to create fresh antiviral or other
therapeutic drugs. Similarly, it is necessary to foster innovative methods to prevent virus transmission, such
as by modifying mosquito populations. An improved understanding of the current epidemiology of the
disease and the potential for its future spread would also assist policymakers in allocating resources to
combat this global public health challenge.

Remarks:

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