dengue virus DENV DENV-1 DENV-2 DENV-3 DENV-4 NS1 Non-structural protein 1 NS1 DENV antibody-dependent enhancement ADE DENV

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1 Journal of Traditional Chinese Medicine 2018 Vol. 59 No DOI /j /r dengue virus DENV A B C 2009 WHO DENV 1 antibody-dependent enhancement ADE DENV imported case A B C GRADE 1 2 DENV ZX A A Y * john131212@ sina. com 1 2 DENV-1 DENV-2 DENV-3 DENV-4 NS1 Non-structural protein 1 NS endemic DENV DENV warning signs

2 Journal of Traditional Chinese Medicine 2018 Vol. 59 No severe dengue tourniquet test cm cm 1. 3 / min > haematocrit HCT fluid overload DENV DENV DENV 1 antibody dependent enhancement ADE B C WHO 25 DENV WHO DENV-1 DENV-2 DENV DENV-4 DENV 1 DENV Flavivirade Flavivirus DENV 11kb RNA ~ 50 DENV C prm /M E 7 NS1

3 Journal of Traditional Chinese Medicine 2018 Vol. 59 No NS2A NS2B NS3 NS4A NS4B NS5 DENV C RNA prm E 45 ~ 55nm 20 NS1 DENV DENV NS DENV 0. 05% ph7 ~ 9-70 DENV 6 20 HCT 4 DENV DENV ADE ~ ~ 3 HCT ~14 5 ~9 3 3 ~ 7 3 ~ DENV DENV ~ 8 3

4 Journal of Traditional Chinese Medicine 2018 Vol. 59 No ml HCT CT X HCT 28 2 B B ALT CT AST AST ALT B BNP 28 ST T ~ 5 DENV NS1 IgM /IgG 2 ELISA DENV IgM DENV 3 DENV NS1 A1 1-3 DENV FA /IFA DENV IgG DENV 1 80 DENV DENV 5 TaqMan PCR DENV RNA DENV RNA DENV IgM DENV 6 NS1 DENV RT - PCR DENV RNA 7. 2 DENV 7 C6 /36 DENV 2 ~ DENV 30 NS1 DENV A1 1 IgM 4 IgM Mac - ELISA DENV IgM B1 29 IgM DENV 5 1 IgG B CT B DENV DENV > 3

5 Journal of Traditional Chinese Medicine 2018 Vol. 59 No < 90 /60 mmhg 1 mmhg = kpa 20% % acute respiratory distress syndrome ARDS ALT AST 1000U /L 7. 3 DENV NS1 DENV IgG 4 B1 7 B2 12 A1 DENV IgM NS1 DENV IgG 14 4 A1 8 A1 16 B ARDS ALT AST > 1000 IU /L A HCT HCT A A2 B1 15 ICU ARDS 0. 5ml / kg h % NSAIDs

6 Journal of Traditional Chinese Medicine 2018 Vol. 59 No ~ X B 2 7 g /L 3 < /L ~ 0. 5 mg / kg 2 ~ 3 / 17 HCT A B2 19 A ml ~ 800 ml 90 /60 mmhg A1 21 B g /L B B B1 25 B ARDS MODS ICU A2 ARDS

7 Journal of Traditional Chinese Medicine 2018 Vol. 59 No World Health Organization. Dengue Guidelines for diagnosis treatment prevention and control EB /OL http / /www. who. int /tdr /publications / documents / dengue - diagnosis. pdf KULARATNE SA. Dengue fever J. BMJ DENV EB/OL http / /www. nhfpc. gov. cn / yzygj / s3593g / / d417aa2e783949e48f8a7366d7f dfacc. shtml S Z. h4661. doi /bmj. h M. The global economic burden of dengue a systematic analysis J. Lancet Infect Dis CASTRO MC WILSON ME BLOOM DE. Disease and economic burdens of dengue J. Lancet Infect Dis e70 e J J MURPHY BR WHITEHEAD SS. Immune response to dengue virus and prospects for a vaccine J. Annu Rev Immunol doi /annurevimmunol BHATT S GETHING PW BRADY OJ et al. The global distribution and burden of dengue J. Nature SHEPARD DS UNDURRAGA EA HALASA YA et al.

8 Journal of Traditional Chinese Medicine 2018 Vol. 59 No ZHANG FC ZHAO H LI LH et al. Severe dengue outbreak in Yunnan China 2013 J. Int J Infect Dis doi /j. ijid LAI S HUANG Z ZHOU H et al. The changing epidemiology of dengue in China a descriptive analysis of 25 years of nationwide surveillance data J. BMC Med doi /s SHEN SQ WEI HX FU YH et al. Multiple Sources of Infection and Potential Endemic Characteristics of the Large Outbreak of Dengue in Guangdong in 2014 J. Sci Rep doi /srep HUANG XY MA HX WANG HF et al. Outbreak of dengue Fever in central China 2013 J. Biomed Environ Sci SHARP TM TOMASHEK KM READ JS et al. A New Look at an Old Disease Recent Insights into the Global Epidemiology of Dengue J. Curr Epidemiol Rep ZHANG F TANG X HU X et al. A clinical epidemiology and virological study of a dengue fever outbreak in Guangzhou China J. Dengue Bulletin Global strategy for dengue prevention and control WHO MULLER DA YOUNG PR. The flavivirus NS1 protein molecular and structural biology immunology role in pathogenesis and application as a diagnostic biomarker J. Antiviral Res ROTHMAN AL. Immunity to dengue virus a tale of original antigenic sin and tropical cytokine storms J. Nat Rev Immunol HALSTEAD SB Dengue J. Lancet GUZMAN MG HARRIS E. Dengue J. Lancet ST JA ABRAHAM SN GUBLER DJ. Barriers to preclinical investigations of anti-dengue immunity and dengue pathogenesis J. Nat Rev Microbiol SCREATON G MONGKOLSAPAYA J YACOUB S et al. New insights into the immunopathology and control of dengue virus infection J. Nat Rev Immunol M KALAYANAROOJ S VAUGHN DW NIMMANNITYA S et al. Early clinical and laboratory indicators of acute dengue illness J. J Infect Dis SIMMONS CP FARRAR JJ NGUYEN V et al. Dengue J. N Engl J Med HUNSPERGER EA YOKSAN S BUCHY P et al. Evaluation of commercially available diagnostic tests for the detection of dengue virus NS1 antigen and anti-dengue virus IgM antibody J. PLoS Negl Trop Dis e MULLER DA DEPELSENAIRE AC YOUNG PR. Clinical and Laboratory Diagnosis of Dengue Virus Infection J. J Infect Dis suppl_2 S89 S Handbook for clinical management of dengue WHO 33 LYE DC ARCHULETA S SYED-OMAR SF et al. Prophylactic platelet transfusion plus supportive care versus supportive care alone in adults with dengue and thrombocytopenia a multicentre open-label randomised superiority trial J. Lancet J J M J J J J J J KATZELNICK LC COLOMA J HARRIS E. Dengue knowledge gaps unmet needs and research priorities J. Lancet Infect Dis e88 e LOW JG OOI EE VASUDEVAN SG. Current Status of Dengue Therapeutics Research and Development J. J Infect Dis suppl_2 S96 S HALSTEAD SB. Critique of World Health Organization Recommendation of a Dengue Vaccine J. J Infect Dis