Infecting over 390 million individuals worldwide, dengue remains a persistent threat to deploying Service Members. As a mosquito-borne disease, spread by the same vector as chikungunya and Zika, increased global temperatures combined with continued urbanization and travel serve to increase the likelihood of exposure to dengue's four serotypes. Uniquely, when an individual is previously infected by one serotype of dengue is re-infected by new serotype, they can experience antibody-dependent enhancement, resulting in more severe disease; this phenomenon significantly complicates disease management and vaccine development. Dengue fever can present with vague, non-specific symptoms including fever, headache, joint pain and rash, making it difficult to distinguish between other viruses like chikungunya or Zika without specific diagnostics. Dengue is particularly dangerous, due to the potential for ADE and severe dengue (previously termed dengue shock syndrome or dengue hemorrhagic fever by the World Health Organization's 1997) which can be associated with mortality rates of 1% with proper care but up to 26% without. Current treatments address symptoms and disease management primarily focuses on prevention through vector control. However, vector control is increasingly complicated by insecticide-resistance in mosquitoes and the lack of a safe vaccine.
Since 1994, AFRIMS, along with local partners in Thailand's
Kamphaeng Phet province, has developed one of the largest dengue cohort studies worldwide to provide detailed information on the incidence, spatial distribution, diagnosis and complications of dengue in Thailand. Similar studies have also been implemented in the Philippines, including
Cebu City and Manila. These data and study sites enable AFRIMS to work with pharmaceutical partners to develop and evaluate dengue vaccine candidates.
The primary departments at AFRIMS involved with this research are
Entomology,
Veterinary Medicine and
Virology.
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