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Chapter 1 : Epidemic Dengue and Dengue Hemorrhagic Fever: a Global Public Health Problem in the 21st Century

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Epidemic Dengue and Dengue Hemorrhagic Fever: a Global Public Health Problem in the 21st Century, Page 1 of 2

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Abstract:

Dengue fever and dengue hemorrhagic fever (DHF) are caused by infection with four dengue virus serotypes, dengue-1 (DEN-1), DEN-2, DEN-3 and DEN-4, which are closely related to each other antigenically. This chapter reviews the changing epidemiology associated with dengue viruses and attempts to explain why changes have occurred in the waning years of the 20th century. The reasons for the dramatic resurgence of epidemic dengue/DHF in the waning years of the 20th century are complex and not fully understood but are most likely associated with demographic and societal changes that have occurred over the past 50 years. The emphasis has thus been on implementing emergency control methods in response to epidemics rather than on developing programs to prevent epidemic transmission. This approach has been particularly detrimental to dengue prevention and control because in most countries surveillance is very poor; the passive surveillance systems relied on to detect increased transmission are dependent on reports by local physicians, who often have a low index of suspicion and do not consider dengue in their differential diagnosis of dengue-like illness. As a result, the epidemic has often reached or passed peak transmission before it is detected, and emergency control measures are nearly always implemented too late to have any impact on the course of the epidemic. Only with an improved public health infrastructure to support community-based prevention programs will we be able to reverse the trend of emergent epidemic dengue/DHF.

Citation: Gubler D. 1998. Epidemic Dengue and Dengue Hemorrhagic Fever: a Global Public Health Problem in the 21st Century, p 1-14. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch1

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Chagas' Disease
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Dengue virus
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Infectious Diseases
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Dengue Fever
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Figures

Image of Figure 1.
Figure 1.

World distribution of epidemic dengue and the principal vector mosquito, , in 1997.

Citation: Gubler D. 1998. Epidemic Dengue and Dengue Hemorrhagic Fever: a Global Public Health Problem in the 21st Century, p 1-14. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch1
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Image of Figure 2.
Figure 2.

Known global distribution of the four dengue virus serotypes, showing areas of hyperendemicity, in 1997.

Citation: Gubler D. 1998. Epidemic Dengue and Dengue Hemorrhagic Fever: a Global Public Health Problem in the 21st Century, p 1-14. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch1
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Image of Figure 3.
Figure 3.

Global emergence of DHF. The numbers of cases reported to the World Health Organization from 1950 10 1980 and 1981 to 1995 are shown.

Citation: Gubler D. 1998. Epidemic Dengue and Dengue Hemorrhagic Fever: a Global Public Health Problem in the 21st Century, p 1-14. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch1
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Image of Figure 4.
Figure 4.

Reinfestation of the Americas by . The ranges of the species in 1970 and 1997 are shown.

Citation: Gubler D. 1998. Epidemic Dengue and Dengue Hemorrhagic Fever: a Global Public Health Problem in the 21st Century, p 1-14. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch1
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Image of Figure 5.
Figure 5.

Emergence of DHF in the Americas. The number of cases reported to PAHO each year from 1980 to 1995 is shown. The 1981 data reflect the Cuban epidemic. (Data reprinted with permission from PAHO.)

Citation: Gubler D. 1998. Epidemic Dengue and Dengue Hemorrhagic Fever: a Global Public Health Problem in the 21st Century, p 1-14. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch1
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Image of Figure 6.
Figure 6.

Geographic expansion of epidemic dengue in Africa and the Middle East from 1980 to 1997.

Citation: Gubler D. 1998. Epidemic Dengue and Dengue Hemorrhagic Fever: a Global Public Health Problem in the 21st Century, p 1-14. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch1
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References

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