title: Recent advances in understanding dengue.
abstract: Dengue is an emerging threat to billions of people worldwide. In the last 20 years, the incidence has increased four-fold and this trend appears to be continuing. Caused by one of four viral serotypes, dengue can present as a wide range of clinical phenotypes with the severe end of the spectrum being defined by a syndrome of capillary leak, coagulopathy, and organ impairment. The pathogenesis of severe disease is thought to be in part immune mediated, but the exact mechanisms remain to be defined. The current treatment of dengue relies on supportive measures with no licensed therapeutics available to date. There have been recent advances in our understanding of a number of areas of dengue research, of which the following will be discussed in this review: the drivers behind the global dengue pandemic, viral structure and epitope binding, risk factors for severe disease and its pathogenesis, as well as the findings of recent clinical trials including therapeutics and vaccines. We conclude with current and future dengue control measures and key areas for future research.
authors.affiliation: Department of medicine, Imperial College London, London, UK; Oxford University Clinical research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.
authors.forename: Sophie
authors.initials: S
authors.lastname: Yacoub
authors.affiliation: Department of medicine, Imperial College London, London, UK; Dengue Hemorrhagic Fever Research Unit, Office for Research and Development, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Juthathip
authors.initials: J
authors.lastname: Mongkolsapaya
authors.affiliation: Department of medicine, Imperial College London, London, UK.
authors.forename: Gavin
authors.initials: G
authors.lastname: Screaton
keywords: Flavivirus; dengue; dengue virus