Dengue Update. Actualització sobre dengue
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1 Leading research at: Dengue Update Click to edit Master subtitle style Actualització sobre dengue Ned Hayes, MD
2 Dengue Leading research at: Caused by infection with one of 4 viruses DEN-1, DEN-2, DEN-3, DEN-4 Characterized by fever, headache, myalgia, thrombocytopenia, sometimes bleeding Severe forms can have severe bleeding and/or shock Transmitted primarily through bite of Aedes aegypti, Aedes albopictus, other Aedes species Prevention is through vector control, personal protection against mosquito bites
3 Leading research at: How much dengue is there? Click to edit Master subtitle style Quant dengue hi és?
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5 Leading research at: Estimated Burden of Dengue 3,970,000,000 people living in areas of risk 36,000,000 dengue cases each year 21,000 dengue deaths each year
6 Lancet: December, 2012 Institute of Health Metrics
7 Estimated Burden of Dengue Institute of Health Metrics 11,400 dengue deaths in ,700 dengue deaths in 2010
8 Estimated Burden of Dengue Institute of Health Metrics 11,400 dengue deaths in 1990 (0.215 per 100K) 14,700 dengue deaths in 2010 (0.214 per 100K)
9 Estimated Burden of Dengue Institute of Health Metrics 11,400 dengue deaths in 1990 (0.215 per 100K) 14,700 dengue deaths in 2010 (0.214 per 100K) (Malaria: 1,169,500 deaths in 2010) (Chagas: 10,300 deaths in 2010)
10 Estimated Burden of Dengue Institute of Health Metrics 11,400 dengue deaths in 1990 (0.215 per 100K) 14,700 dengue deaths in 2010 (0.214 per 100K) (Malaria: 1,169,500 deaths in 2010) (Chagas: 10,300 deaths in 2010) 712,000 DALYS in ,000 DALYS in 2010
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13 Leading research at: Where is there dengue? Click to edit Master subtitle style On hi ha dengue?
14 Global Distribution of Dengue and Risk of Dengue, 2011 Gubler DJ. Trop Med and Health, 2011
15 Refining the Global Spatial Limits of Dengue Virus Transmission by Evidence-Based Consensus Oliver J. Brady 1,2 *, Peter W. Gething 1, Samir Bhatt 1, Jane P. Messina 1, John S. Brownstein 3, Anne G. Hoen 4, Catherine L. Moyes 1, Andrew W. Farlow 1, Thomas W. Scott 5,6, Simon I. Hay 1,6 * 1 Spatial Ecology and Epidemiology Group, Department of Zoology, University of Oxford, Oxford, United Kingdom, 2 Oxitec Ltd., Abingdon, United Kingdom, 3 Department of Pediatrics, Harvard Medical School and Children s Hospital Informatics Program, Boston Children s Hospital, Boston, Massachusetts, United States of America, 4 Department of Community and Family Medicine, Dartmouth College, Hanover, New Hampshire, United States of America, 5 Department of Entomology, University of California Davis, Davis, California, United States of America, 6 Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
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22 Leading research at: How is dengue changing? Click to edit Master subtitle style Com es canvia el dengue?
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24 Distribution of Aedes aegypti in the Americas Gubler DJ. Trop Med and Health, 2011
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26 Reported Cases of Dengue: Thailand Indonesia Vietnam Gubler DJ. Trop Med and Health, 2011
27 Distribution of Dengue Serotypes in 1970 Guzman et al. Nature Reviews 2010, after Gubler DEN-1 DEN-2 DEN-1 DEN-2 DEN-1 DEN-2 DEN-3 DEN-4
28 b Distribution of Dengue Serotypes in 2004 Guzman et al. Nature Reviews 2010, after Gubler DEN-1 DEN-2 DEN-3 DEN-4 DEN-1 DEN-2 DEN-3 DEN-4 DEN-1 DEN-2 DEN-3 DEN-4 DEN-1 DEN-2 DEN-3 DEN-4 DEN-1 DEN-2 DEN-1 DEN-2 DEN-3 DEN-4 DEN-1 DEN-2 DEN-3 DEN-4 DEN-1 DEN-2 DEN-3 DEN-4 DEN-1 DEN-2 DEN-3 DEN-4
29 Leading research at: Why is dengue occurrence changing? Click to edit Master subtitle style Per què està canviant l'aparició del dengue?
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31 Mean Annual Number of Global Airline Passengers Gubler DJ. Trop Med and Health, 2011
32 Porcentaje de la población mundial residente en zonas urbanas, 1950 y 2010 Click to edit Master subtitle style United Nations, Dept of Economic and Social Affairs.
33 Leading research at: Can we control dengue? Click to edit Master subtitle style Podem controlar el dengue?
34 The Lancet, Sept 2012 Primary objective: To assess efficacy of the vaccine against virologically confirmed, symptomatic dengue occurring one month or more after complete vaccination.
35 Methods 2452 vaccinated children aged 4 to 11 years, compared (ATP) to 1221 controls who received rabies vaccine or placebo Active surveillance for febrile illness PCR and NS1 antigen testing on acute serum Case of dengue defined as febrile illness with positive dengue PCR or positive NS1 antigen Second serum to assess immune response
36 Results Vaccine efficacy against virologically confirmed dengue was 30% (-13%-57%) DEN-1 efficacy: 56% (-22%-84%) DEN-2 efficacy: 9% (-75%-51%) DEN-3 efficacy: 75% (-375%-100%) DEN-4 efficacy: 100% (25%-100%) DEN-2 accounted for 59% of all 134 cases Immunogenic against all serotypes, including DEN-2
37 Possible Reasons for Limited Vaccine Efficacy Neutralizing antibody as assayed not sufficient to provide good protection? Antigenic mismatch between vaccine epitopes and the pathogenic DEN-2 virus strain? Need for nonstructural genes in vaccine?
38 Leading research at: Is dengue a threat to Europe? Click to edit Master subtitle style És el dengue una amenaça per a Europa?
39 Recent Outbreaks of Particular Interest to Europe 2009: Cape Verde Islands: 17,000 cases 2010: France: 2 cases Hundreds of imported cases each year 2010: Croatia: 2 cases (15 infections?) <10? imported cases each year : Madeira Island, Portugal
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41 Dengue on Madeira 3 October: Dengue confirmed in two cases with no relevant travel history Virus identified as DEN-1 25 November: cumulative total 1891 cases 111 patients hospitalized, no fatalities Majority had fever, headache, myalgia, arthralgia 77 cases of dengue in travelers to mainland Europe/UK from Madeira Apparent vector: Aedes aegypti (2005)
42 Reported Dengue by Age Group, Madeira Oct 3- Nov 25, 2012
43 Reported Dengue by Age Group, Madeira Oct 3- Nov 25, 2012
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45 Nº de casos de novos casos de dengue notificados por semana na Ilha da Madeira, Nº de casos Semanas de 2012 e 2013 Fonte: IASaúde, IP-RAM
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48 Leading research at: Gracies! Click to edit Master subtitle style
Thomas Jaenisch MD PhD Section Clinical Tropical Medicine Department for Infectious Diseases Heidelberg University Hospital 1 st of June 2017
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