DENGUE IN PAKISTAN: Journey from a Disease free to a Hyper Endemic Nation
Abstract
Dengue fever (DF), Dengue Hemorrhagic fever (DHF) and Dengue Shock syndrome have been causing significant and incremental morbidity and mortality in various parts of the world. It was characterized a viral infection in 1906. The earliest known
documentation of symptoms resembling dengue fever was recorded during the Chin Dynasty (AD 265-420) in the Chinese Encyclopedia of Symptoms. The illness was associated with flying insects near water and labeled as “The water poison”.1
Dengue virus is an enveloped positive single strand 11 kilo bases long RNA virus belonging to the Flaviviridae family.2
Four serotypes, Den 1, 2, 3 and 4 are responsible for Dengue viral infection in different regions of the globe and their relative prevalence varies temporally. Clinicopathological events in Dengue viral infection are poorly understood due to its unique
features as all the four serotypes behaved differently in various regions as well as chronological order in which the infection is introduced into a community. Primary infection by any one type leads to mild to moderate disease and confer short-term (approximately 6 months) immunity against all the four types and lifelong immunity to the specific infecting type. However, subsequent ‘secondary’ infection by any other type may cause mild to severe disease which may prove fatal. Several manifestations of dengue viral infection are due to immunologically mediated tissue damage causing thrombocytopenia, leucopenia, increase capillary permeability, multi-organ dysfunction etc. Infection during early pregnancy usually does not
cause any damage to fetus but in later term it infects the infant.3-5
Downloads
References
History of Dengue (http://www.denguevirusnet.com /history-of-dengue.html).
Rodenhuis-Zybert IA, Wilschut J, Smit JM. Dengue virus life cycle: viral and host factors modulating infectivity. Cell Mol Life Sci 2010; 67:2773-86.
Kariyawasam S, Senanayake H. Dengue infections during pregnancy: case series from a tertiary care hospital in Sri Lanka. J Infect Dev Ctries 2010; 4:767- 75
.4 Capeding RZ, Brion JD, Caponpon MM, Gibbons RV, Jarman RG, Yoon IK, et al. The incidence, characteristics, and presentation of dengue virus infections during infancy. Am J Trop Med Hyg 2010; 82:330-6.
Tsai HC, Lin CC, Hong NS, Kuo TN, Huang YY, Lin MY, et al. Dengue virus infection in early gestation with delivery of an unaffected fetus and no vertical transmission. Taiwan J Obstet Gynecol 2010; 49:112-4.
Monath TP. Dengue: the risk to developed and developing countries. Proceedings of the National
Academy of Sciences 1994; 91:2395.
Chaturvedi U, Shrivastava R, Nagar R. Dengue vaccines: Problems & prospects. Indian J Med Res 2005; 121:639.
Dengue Fever World Health Organization Fact Sheet No.117. 2009 [http://www.who.int/mediacentre/factsheets/fs117/en/].
Jahan F. Dengue Fever (DF) in Pakistan. Asia Pac Fam Med 2011;10:1.
Akram DS, Igarashi A, Takasu T. Dengue virus infection among children with undifferentiated fever in Karachi. Indian J Pediatr 1998; 65:735-40.
Paul RE, Patel AY, Mirza S, Fisher-Hoch SP, Luby SP. Expansion of epidemic dengue viral infections to Pakistan* 1. Int J Infect Dis 1998; 2:197-201.
Tang JW, Khanani MR, Zubairi AM, Lam WY, Lai F, Hashmi K, et al. A wide spectrum of dengue IgM and PCR positivity post-onset of illness found in a large dengue 3 outbreak in Pakistan. J Med Virol 2008; 80:2113-21.
Khan E, Siddiqui J, Shakoor S, Mehraj V, Jamil B, Hasan R. Dengue outbreak in Karachi, Pakistan, 2006: experience at a tertiary care center. Trans R Soc Trop Med Hyg 2007; 101:1114-9.
Khan E, Hasan R, Mehraj V, Nasir A, Siddiqui J, Hewson R. Co-circulations of two genotypes of dengue virus in 2006 out-break of dengue hemorrhagic fever in Karachi, Pakistan. J Clin Virol 2008; 43:176-9.
Ahmed S, Arif F, Yahya Y, Rehman A, Abbas K, Ashraf S, et al. Dengue fever outbreak in Karachi 2006-a study of profile and outcome of children under 15 years of age. J Pak Med Assoc 2008; 58:4-8.
Humayoun MA, Waseem T, Jawa AA, Hashmi MS, Akram J. Multiple dengue serotypes and high frequency of dengue hemorrhagic fever at two tertiary care hospitals in Lahore during the 2008 dengue virus outbreak in Punjab, Pakistan. Int J Infect Dis 2010; 14 Suppl 3:e54-9.
Humayoun MA, Waseem T, Jawa AA, Hashmi MS, Akram J. Multiple dengue serotypes and high frequency of dengue hemorrhagic fever at two tertiary care hospitals in Lahore during the 2008 dengue virus outbreak in Punjab, Pakistan. Int J Infect Dis 2010.
Fatima Z, Idrees M, Bajwa MA, Tahir Z, Ullah O, Zia MQ, et al. Serotype and genotype analysis of dengue virus by sequencing followed by phylogenetic analysis using samples from three mini outbreaks-2007-2009 in Pakistan. BMC Microbiol 2011; 11:200.
Mahmood N, Rana MY, Qureshi Z, Mujtaba G, Shaukat U. Prevalence and molecular characterization of dengue viruses serotypes in 2010 epidemic. Am J Med Sci 2012; 343:61-4.
Health. http://www.thenews.com.pk/NewsDetail.aspx?ID=23989.
2011 Dengue outbreak in Pakistan. http://en.wikipedia.org/wiki/2011_ dengue_outbreak_in_Pakistan.
Parkash O, Almas A, Jafri SMW, Hamid S, Akhtar J, Alishah H. Severity of acute hepatitis and its outcome in patients with dengue fever in a tertiary care hospital Karachi, Pakistan (South Asia). BMC Gastroenterol 2010; 10:43.
Bhalla A, Sharma N, Sharma A, Suri V. Concurrent infection with dengue and malaria. Indian J Med Sci 2006; 60:330-1.
Kroeger A, Lenhart A, Ochoa M, Villegas E, Levy M, Alexander N et al. Effective control of dengue vectors with curtains and water container covers treated with insecticide in Mexico and Venezuela: Cluster randomised trials. BMJ 2006; 332:1247-52.
Lenhart A, Orelus N, Maskill R, Alexander N, Streit T, McCall PJ. Insecticide-treated bednets to control dengue vectors: Preliminary evidence from a controlled trial in Haiti. Trop Med Int Health 2008; 13:56-67.
Morrison AC, Zielinski-Gutierrez E, Scott TW, Rosenberg R Defining Challenges and Proposing Solutions for Control of the Virus Vector Aedes aegypti. PLoS Med 2008; 5:68.
Teng TB. New initiatives in dengue control in Singapore. Dengue Bulletin 2001; 25:1-6.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Rafiq Muhammad Khanani
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Articles published in the Journal of Dow University of Health Sciences are distributed under the terms of the Creative Commons Attribution Non-Commercial License https://creativecommons.org/ licenses/by-nc/4.0/. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. 
