Dengue fever - A review

Introduction. - Transmitted by Aedes mosquitoes all over the inter-tropical area, Dengue fever is the leading arboviral disease in humans. It is also an emerging disease. Current knowledge and key points. - Increasing morbidity-mortality, and geo graphical expansion are the drastic changes noted in the recent epidemiolog y of the disease. They are related to those occurring at the bio-climatic, socio-demographic and behavioural levels, which in turn may have led to enh anced viral circulation and virulence, and also vectorial resistance. The v arious clinical patterns (undifferentiated febrile episode of children, acu te and algid classic form, the potentially fatal dengue hemorrhagic fever/d engue shock syndrome, and the atypical forms) are reviewed, as well as the diagnostic methods, and the pathogenesis (sequential infections, facilitati ng antibodies, capillary leakage). Future prospects and projects. - Dengue fever is actually much more than a travellers fever or an exotic curiosity. It presently threatens half the wo rld's population, and remains a puzzling disease in many aspects, such as t he virus-vector and host-virus relationships, and clinical expression varia bility. In this respect, dengue fever appears as a model of viral disease. The current molecular approach is expected to provide us with new insights into pathophysiology, more efficient tools for disease control, and also an efficient vaccine in the near future. (C) 2001 Editions scientifiques et m edicales Elsevier SAS.