The History and Natural History of Dengue Fever

The exact origins of the disease are not clear and arguments have been made that it
originated in Africa and was spread worldwide with the slave trade. The most convincing
explanation for the name dengue is that it is derived from the Swahili "Ka-Dinga pepo" that
describes the disease as a sudden cramp like disease caused by an evil spirit. It has also
been argued that it originated in the Malay Peninsula of Indochina. Regardless, in the wild
the virus has a life cycle very similar to that of yellow fever involving passing between
primates living in the jungle canopy and mosquitoes that feed on them. It is believed that
the virus was transferred to man by the bite of the tiger-striped mosquito (Aedes albopticus)
as man began clearing the jungle and building settlements. The commonest vector is now
the closely-related mosquito Aedes aegypti which is African in origin but has spread
throughout the tropics in the Old and New Worlds.

The earliest reports of a dengue-like disease are from Chin Dynasty China (265-420 AD).
The first rigorously documented outbreaks occurred almost simultaneously in:

 Cairo and Alexandria (Egypt, 1799);

 Jakarta (the called Batavia, Indonesia, 1799);
 Philadelphia (United States, 1780);
 Madras (India, 1780).

Outbreaks have occurred throughout the temperate and tropical climes since then.

The virus was identified in the 1940's when it became a concern to the armies fighting in
Pacific and Asia as it was causing a large number of non-combat casualties to Allied and
Japanese forces. Japanese scientists first identified the virus in 1943 and were quickly
followed by U.S. researchers. By 1956 the four serotypes of the virus were identified and
every outbreak of the disease since has been due to a virus belonging to one of the four
serotypes.

Work is being done on the development of vaccines against the disease but there are
currently none proven safe and effective for human use. The primary method of preventing
the spread of the disease is by controlling the mosquito vectors and this has proven
effective and the disease appeared to be on the decline for many years, however it had a
resurgence in the 1990's and remains a major public health problem in many areas and the
current situation has been designated a global pandemic.

The most worrisome aspect of the resurgence is that it has come with an increase in the
frequency and severity of dengue hemorrhagic syndrome, a severe complication of the
disease normally only arising upon re-infection. Typically, when diseases first crossover to
man they are at their most severe (syphilis is the prime example of this) and over the years
they become less severe as they adapt themselves to a new host. Dengue appears to be
running against the stream, making it a greater public health and weapons threat.

Take of: http://www.cbwinfo.com/Biological/Pathogens/DENV.html