DENGUE HAEMORRHAGIC FEVER:
CURRENT ISSUES AND FUTURE RESEARCH
Suchitra Nimmannitya, MD MPH
ABSTRACT
Dengue illness caused by any of the four dengue serotypes is
currently the most important mosquito-borne viral disease in the
tropical areas of the world. Dengue Fever (DF) is known for over 200
years as a mild disease in children and more severe in adults with
fever, headache, myalgia, bone and joint pain and rash; occasionally
unusual haemorrhage may occur. Dengue haemorrhagic fever (DHF) has
first emerged to become one of the major public health problems as
an epidemic disease of children in Southeast Asia in 1954. The
pathophysiologic hallmarks that differentiate DHF from DF are plasma
leakage due to increased vascular permeability and abnormal
haemostasis. Management of the life threatening, dengue shock
syndrome (DSS) that occurs as a result of critical plasma loss and
occasionally with additional blood loss is one major medical
problem.
Extensive research studies during the past four decades revealed the
involvement of both immune systems and almost all haematologic
components in pathogenesis of DHF. The complexity of this
immunopathogenesis, which remains unclear, adds a challenging
dimension to medical research scientists in various fields.
Key words: dengue haemorrhagic fever, dengue shock syndrome,
vascular
permeability, plasma leakage, haemostasis
Correspondence to: Prof. Suchitra Nimmannitya, Senior
Consultant Queen Sirikit National Institute of Child Health,
Rajvithee Road, Bangkok 10500 Thailand
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