A historical Perspective of Dengue
The story of dengue in many ways starts in the Americas.
Dr. Benjamin Rush made the first good clinical description of dengue.
He was in charge of hospitals under General George Washington in the Oriental Army and described for dengue outbreak in Philadelphia in 1780:
“This fever generally came on with rigor, but seldom with a regularly chilly fit. The pains which accompanied this fever were exquisitely severe in the head, back and limbs.
The pains in the head were sometimes in the back parts of it, and at other times they occupied only the eyeballs.
A few complained of their flesh being sore to the touch, in very part of the body. Its general name among all classes of people was the break-bone fever.”
Dengue today presents with the same fever, headache, eye pain, myalgia and arthralgia.
The US military’s dengue research efforts started just after the Spanish-America War, sparked by the very many dengue causalities in the Philippines.
A dengue commission was established in 1900, and Ashburn and Craig were sent to the Philippines to determine the etiology of dengue and to devise countermeasures.
Although a series of experiments they deduced that dengue was caused by “an ultra microscopic and non-filterable agent,” or a virus.
Ashburn and Craig confirmed that virus could be transmitted from person to person by both mosquito and by syringe; they made careful description of the disease to include leucopenia.
Important for vaccine development, they demonstrated that immunity following infection was absolute; they could only make healthy volunteers with dengue one time.
During World War II, Japan and the United States of America had large dengue research programs.
Dr. Hotta and Dr. Kimura in Japan isolated the dengue serotype 1 virus (DENV-1) shortly before Dr. Sabin and Dr. Schlesinger did so in Hawaii.
In the 1950s, the face of dengue changed dramatically with the widespread recognition of DHF. The army and the Air Force sent Dr. Bill Hammond to investigate the 1956 outbreak of hemorrhagic fever in the Philippines.
He worked with Philippines and Thai scientist to isolate DENV-3 and DENV-4.
The most important pathological process that distinguished DHF from dengue is plasma leakages that can lead to shock and death.
Untreated, DHF has a mortality rate of around 10%. With careful fluid management, however, mortality rates drop to below 1%.
DHF can occur in any age group, but it is most common among children living in dengue hyperendemic areas.
A historical Perspective of Dengue
