Dengue is a disease that that came from the Spanish word at the Swahili phrase «ki denga pepo», which means «cramp-like seizure caused by an evil spirit». During an outbreak in a Caribbean in 1827-1828, dengue fever emerged. The outbreaks of dengue fever have been reported throughout history. The very first case was reported from 1789 and was attributed to Benjamin Rush, who invented the term «break bone fever» because of the symptoms of myalgia and arthralgia. The transmission by mosquitoes were only known.
SIGNS AND SYMPTOMS
This infectious disease is manifested by a sudden inception 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; the dengue rash is characteristically bright red petechia and usually appears first on the lower limbs and the chest — in some patients, it spreads to cover most of the body. There may also be gastritis with some combination of associated abdominal pain, nausea, vomiting or diarrhea.
Some cases develop much milder symptoms, which can, when no rash is present, be misdiagnosed as a flu 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 only pass on the infection through mosquitoes or blood products while they are still febrile.
The classic dengue fever lasts about six to seven days, with a smaller peak of fever at the trailing end of the fever (the so-called «biphasic pattern»). Clinically, the platelet count will drop until the patient’s temperature is normal.
Cases of DHF also show higher fever, haemorrhagic phenomena, thrombocytopenia and haemoconcentration. A small proportion of cases lead to dengue shock syndrome (DSS) which has a high mortality rate.
There is no commercially available vaccine for the dengue flavivirus. However, one of the many ongoing vaccine development programs is the Pediatric Dengue Vaccine Initiative (PDVI) 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.
Thai researchers, in phase III testing, have planned to test a dengue fever vaccine on 3,000-5,000 human volunteers within the next three years after having successfully conducted tests on animals and a small group of human volunteers.