Dengue Disease Transmission and Clinical Manifestations

Introduction to Dengue Transmission

Dengue virus is transmitted primarily through the bite of infected Aedes mosquitoes, particularly Aedes aegypti, in a cycle that involves humans and mosquitoes with distinct phases of infection, viremia, and transmission 1, 2
Dengue virus is transmitted by Aedes species mosquitoes, primarily Aedes aegypti, which are present throughout tropical and subtropical regions worldwide 1, 2
Day-biting mosquitoes of the genus Aedes act as the primary vector of dengue 3, 4
Dengue has been reported in more than 100 countries with an annual global incidence of 50-100 million patients per year 3, 4

The spectrum of illness associated with dengue varies from mild febrile illness to dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS) 3, 4
Classic dengue fever is characterized by fever, headache, retro-orbital pain, myalgia, arthralgia (particularly back pain), and rash 3, 4
For symptomatic patients, nucleic acid amplification tests (NAATs) are the preferred method of diagnosis when performed on serum collected ≤7 days after symptom onset 7
Acute dengue can be confirmed with a positive PCR or, if symptoms have been present for over 5-7 days, with a positive IgM capture ELISA 3, 4

Dengue has an incubation period of 4-8 days (range: 3-14 days) from infection until disease onset 3, 4
Among symptomatic persons, the incubation period is typically a few days to 2 weeks 1, 2
IgM antibodies directed against dengue virus typically develop during the first week of illness 1, 2
IgM antibodies may persist for extended periods - studies show 71% of patients had detectable IgM antibodies at 6 months and 46% at 12 months after infection 1, 2

The incidence of dengue has doubled each decade since 1990, with an estimated 58 million symptomatic infections and 13,000 deaths worldwide in 2013 1, 2
Dengue is the most common arbovirus encountered in returning travelers and a common cause of fever in those returning from Asia 3, 4
Appropriate clinical management of severe dengue can reduce the case-fatality rate among hospitalized patients to <0.5% 1, 2