Dengue: A Global and Emerging Health Challenge

Dengue virus, a rapidly expanding tropical arbovirus with four distinct serotypes, poses a growing global public health threat—particularly in regions where healthcare systems are ill-equipped to diagnose, treat, and manage its severe manifestations. Transmitted primarily by Aedes mosquitoes, dengue typically manifests as an acute febrile illness characterized by severe myalgias ("bone-breaking fever"), arthralgias, gastrointestinal distress, and hemorrhagic tendencies. In severe cases, the infection can progress to life-threatening dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Because definitive antiviral therapeutics remain in development, supportive clinical care, with a critical focus on timely intravenous fluid resuscitation, is the cornerstone of management. Prevention relies predominantly on vector control and personal protective measures. Vaccine development is complicated by antibody-dependent enhancement (ADE), a phenomenon in which heterologous secondary infections or non-protective vaccine-induced immunity can worsen disease severity, as observed with Dengvaxia; researchers are currently evaluating novel tetravalent candidates to mitigate this risk. Accurate diagnosis depends on identifying specific time-dependent diagnostic windows using clinical findings, complete blood counts, and targeted laboratory assays. This review synthesizes dengue management, severe complications, diagnostic strategies, and ongoing challenges in vaccine and therapeutic development.