Dengue Vaccines: A Potential Solution to Curb the Spread of a Deadly Disease

Dengue is a mosquito-borne viral disease that infects up to 400 million people every year according to the World Health Organization (WHO). While most cases result in mild fever, some can progress to develop severe dengue which is a leading cause of serious illness and death among children and adults living in endemic countries. With rising global temperatures and increased urbanization, the spread of the Aedes aegypti and albopictus mosquitoes that transmit the dengue virus has expanded geographically. This has major health and economic consequences as dengue surveillance and clinical management places a huge strain on already overburdened public health systems in developing nations where it is most prevalent. Vaccination has the potential to provide broad, long-lasting protection against all four viral serotypes and help curb transmission. Several dengue vaccine candidates are in development.
Challenges of developing a dengue vaccine
The dengue virus exists as four closely related but antigenically distinct serotypes (DENV-1, DENV-2, DENV-3 and DENV-4). A successful Dengue Vaccines must provide balanced, lifelong protection against all four to avoid increased disease severity from antibody-dependent enhancement after a secondary infection with a different serotype. Additionally, as dengue disease symptoms mimic other febrile illnesses like chikungunya, Zika etc., it is difficult to obtain an immune response that precisely targets all four serotypes without cross-reacting with other flaviviruses. The complex pathogenesis, absence of an established non-human primate model and lack of validated immune correlates of protection further complicate vaccine design. Manufacturers face obstacles in developing a formulation that is safe, effective, heat stable, easy to administer and affordable enough for widespread use in tropical countries where the burden is highest.
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