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      Dengue y fiebre hemorrágica del dengue: un problema de salud mundial Translated title: Dengue and dengue hemorrhagic fever: a worldwide health problem

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          Abstract

          Desde épocas tan remotas como 1635 y 1699, el dengue ha sido considerado la enfermedad viral transmitida por mosquitos de mayor importancia médica. Dada la importancia de esta entidad al nivel mundial y particularmente para la región de las Américas, se hizo necesaria la búsqueda de una solución inmediata para abortar el desarrollo de la forma grave de la enfermedad. En este estudio se presentó una actualización del tema en aspectos tan importantes como: el espectro clínico de la enfermedad, las características del agente etiológico y los mecanismos inmunopatogénicos que tienen lugar en su interacción con el hospedero.

          Translated abstract

          Since remote times as early as 1635 and 1699, dengue has been considered as the most important mosquito-borne viral disease. Given the significance of this disease worldwide, particularly in the Americas, it was necessary to look for an immediate solution to hinder the development of the most serious dengue variant. This study covered a review about some important aspects like clinical spectrum of the disease, the characteristics of the etiologic agent, and the immunopathogenic mechanisms that interact with the host.

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          Most cited references94

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          Early clinical and laboratory indicators of acute dengue illness.

          A prospective observational study was conducted to identify early indicators of acute dengue virus infection. Children with fever for <72 h without obvious cause were studied at hospitals in Bangkok and Kamphaeng Phet, Thailand, until resolution of fever. Of 172 evaluable subjects (91% of enrollees), 60 (35%) had dengue, including 32 with dengue fever (DF) and 28 with dengue hemorrhagic fever (DHF). At enrollment, children with dengue were more likely than children with other febrile illnesses (OFI) to report anorexia, nausea, and vomiting and to have a positive tourniquet test, and they had lower total white blood cell counts, absolute neutrophil and absolute monocyte counts, and higher plasma alanine and aspartate (AST) aminotransferase levels than children with OFI. Plasma AST levels were higher in children who developed DHF than in those with DF. These data identify simple clinical and laboratory parameters that help to identify children with DF or DHF.
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            Observations related to pathogenesis of dengue hemorrhagic fever. IV. Relation of disease severity to antibody response and virus recovered.

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              Dengue virus structural differences that correlate with pathogenesis.

              The understanding of dengue virus pathogenesis has been hampered by the lack of in vitro and in vivo models of disease. The study of viral factors involved in the production of severe dengue, dengue hemorrhagic fever (DHF), versus the more common dengue fever (DF), have been limited to indirect clinical and epidemiologic associations. In an effort to identify viral determinants of DHF, we have developed a method for comparing dengue type 2 genomes (reverse transcriptase PCR in six fragments) directly from patient plasma. Samples for comparison were selected from two previously described dengue type 2 genotypes which had been shown to be the cause of DF or DHF. When full genome sequences of 11 dengue viruses were analyzed, several structural differences were seen consistently between those associated with DF only and those with the potential to cause DHF: a total of six encoded amino acid charge differences were seen in the prM, E, NS4b, and NS5 genes, while sequence differences observed within the 5' nontranslated region (NTR) and 3' NTR were predicted to change RNA secondary structures. We hypothesize that the primary determinants of DHF reside in (i) amino acid 390 of the E protein, which purportedly alters virion binding to host cells; (ii) in the downstream loop (nucleotides 68 to 80) of the 5' NTR, which may be involved in translation initiation; and (iii) in the upstream 300 nucleotides of the 3' NTR, which may regulate viral replication via the formation of replicative intermediates. The significance of four amino acid differences in the nonstructural proteins NS4b and NS5, a presumed transport protein and the viral RNA polymerase, respectively, remains unknown. This new approach to the study of dengue virus genome differences should better reflect the true composition of viral RNA populations in the natural host and permit their association with pathogenesis.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                mtr
                Revista Cubana de Medicina Tropical
                Rev Cubana Med Trop
                Centro Nacional de Información de Ciencias Médicas (Ciudad de la Habana )
                1561-3054
                April 2008
                : 60
                : 1
                : 0
                Affiliations
                [1 ] Departamento de Virología. Centro Colaborador OPS/OMS para el Estudio del Dengue y su Vector. Instituto de Medicina Tropical Pedro Kourí Cuba
                Article
                S0375-07602008000100001
                b16ccdcd-3994-46e5-b451-f47335d92d97

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=0375-0760&lng=en
                Categories
                TROPICAL MEDICINE

                Infectious disease & Microbiology
                Dengue,disease,pathogenesis,remission,enfermedad,patogénesis,remisión
                Infectious disease & Microbiology
                Dengue, disease, pathogenesis, remission, enfermedad, patogénesis, remisión

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