Logo
homeHome
toggle_offCompany ProfilegroupsBoards & Staffsworkspace_premiumMemberships & PartnersschoolAcademy of Journalismperson_addCareerslinkBlog(EN)emailContact Us
list_altOur JournalslightbulbInstruction for AuthorsbookmarkBrieflands PolicieshandshakePublish My Researchplay_circleJournal Management Systemcredit_cardArticle Processing Chargeszoom_inOpen Peer ReviewimagePublishing Services
menu_bookPublish My Book

Koomesh

Journal of Semnan University of Medical Sciences

homeHome
listAll Issuesplay_arrowIn Presscheck_circleAccepted ManuscriptssearchSearch
lightbulbInstructions
infoJournal InformationgroupsEditors & BoardspublicIndexing and Listing Sourcesquery_statsJournal Metricszoom_inOpen Peer Review (OPR)balancePublication Ethics and Publication Malpractice Statementassignment_indReviewer and AE Registration FormchatSupportphone_in_talkContact Us
euroAPC
Authors GuideSubmit Manuscript
koomesh

Image Credit:koomesh

Outlines

https://doi.org/10.69107/koomesh-158138

Clinical Manifestations, Transmission, Pathogenesis, Diagnosis, and Management of Dengue Fever: A Comprehensive Review

Author(s):
Ramtin NaderianRamtin NaderianRamtin Naderian ORCID1, 2, Fateme KhariFateme Khari3, Shaghayegh PazokiShaghayegh PazokiShaghayegh Pazoki ORCID3, Samira SanamiSamira SanamiSamira Sanami ORCID3,*, Elham SaffariehElham SaffariehElham Saffarieh ORCID3,**
1Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran
2Health Policy Research Center, Institute of Health, Shiraz, Iran
3Abnormal Uterine Bleeding Research Center, Semnan University of Medical Sciences, Semnan, Iran
Corresponding Authors:
Koomesh:Vol. 27, issue 5; e158138
Published online:Aug 19, 2025
Article type:Review Article
How to Cite:Naderian R, Khari F, Pazoki S, Sanami S, Saffarieh E. Clinical Manifestations, Transmission, Pathogenesis, Diagnosis, and Management of Dengue Fever: A Comprehensive Review. koomesh. 2025;27(5):e158138. doi: https://doi.org/10.69107/koomesh-158138

Abstract

Keywords
Dengue virus
Dengue
Fever
Dengue Vaccines
prevention and control
Aedes
Mosquito-Borne Diseases

References

  • 1.
    Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran.
  • 2.
    Health Policy Research Center, Institute of Health, Shiraz, Iran.
  • 3.
    Kuo CY, Yang WW, Su EC. Improving dengue fever predictions in Taiwan based on feature selection and random forests. BMC Infect Dis. 2024;24(Suppl 2):334. [PubMed ID:38509486]. [PubMed Central ID:PMC10953060]. https://doi.org/10.1186/s12879-024-09220-4.
  • 4.
    World Health Organization. Dengue - Bangladesh. Geneva, Switzerland: World Health Organization; 2023. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON481.
  • 5.
    Chiu NC, Chi H, Weng SL, Lin CY. Unprecedented dengue outbreak in Taiwan following COVID-19. J Travel Med. 2024;31(2). [PubMed ID:38246750]. [PubMed Central ID:PMC10911057]. https://doi.org/10.1093/jtm/taae015.
  • 6.
    Nyenke CU, Nnokam BA, Esiere RK, Nwalozie R. Dengue Fever: Etiology, Diagnosis, Prevention and Treatment. Asian J Res Infect Dis. 2023;14(1):26-33. https://doi.org/10.9734/ajrid/2023/v14i1279.
  • 7.
    World Health Organization. Dengue and severe dengue. Geneva, Switzerland: World Health Organization; 2021. [Cited:2021]. Available from: https://www.who.int/health-topics/dengue-and-severe-dengue#tab=tab_1.
  • 8.
    Yang X, Quam MBM, Zhang T, Sang S. Global burden for dengue and the evolving pattern in the past 30 years. J Travel Med. 2021;28(8). [PubMed ID:34510205]. https://doi.org/10.1093/jtm/taab146.
  • 9.
    Vasilakis N, Weaver SC. The history and evolution of human dengue emergence. Adv Virus Res. 2008;72:1-76. [PubMed ID:19081488]. https://doi.org/10.1016/S0065-3527(08)00401-6.
  • 10.
    Cologna R, Armstrong PM, Rico-Hesse R. Selection for virulent dengue viruses occurs in humans and mosquitoes. J Virol. 2005;79(2):853-9. [PubMed ID:15613313]. [PubMed Central ID:PMC538581]. https://doi.org/10.1128/JVI.79.2.853-859.2005.
  • 11.
    Rothman AL. Immunity to dengue virus: a tale of original antigenic sin and tropical cytokine storms. Nat Rev Immunol. 2011;11(8):532-43. [PubMed ID:21760609]. https://doi.org/10.1038/nri3014.
  • 12.
    Simmons CP, Farrar JJ, Nguyen v V, Wills B. Dengue. N Engl J Med. 2012;366(15):1423-32. [PubMed ID:22494122]. https://doi.org/10.1056/NEJMra1110265.
  • 13.
    Laureti M, Narayanan D, Rodriguez-Andres J, Fazakerley JK, Kedzierski L. Flavivirus Receptors: Diversity, Identity, and Cell Entry. Front Immunol. 2018;9:2180. [PubMed ID:30319635]. [PubMed Central ID:PMC6168832]. https://doi.org/10.3389/fimmu.2018.02180.
  • 14.
    Harrison SC. Viral membrane fusion. Virology. 2015;479-480:498-507. [PubMed ID:25866377]. [PubMed Central ID:PMC4424100]. https://doi.org/10.1016/j.virol.2015.03.043.
  • 15.
    Guardado-Calvo P, Atkovska K, Jeffers SA, Grau N, Backovic M, Perez-Vargas J, et al. A glycerophospholipid-specific pocket in the RVFV class II fusion protein drives target membrane insertion. Science. 2017;358(6363):663-7. [PubMed ID:29097548]. https://doi.org/10.1126/science.aal2712.
  • 16.
    Villalain J. Membrane fusion by dengue virus: The first step. Biochim Biophys Acta Biomembr. 2025;1867(1):184400. [PubMed ID:39522596]. https://doi.org/10.1016/j.bbamem.2024.184400.
  • 17.
    Wiwanitkit V. Unusual mode of transmission of dengue. J Infect Dev Ctries. 2009;4(1):51-4. [PubMed ID:20130380]. https://doi.org/10.3855/jidc.145.
  • 18.
    Gaikwad S, Sawant SS, Shastri JS. Comparison of nonstructural protein-1 antigen detection by rapid and enzyme-linked immunosorbent assay test and its correlation with polymerase chain reaction for early diagnosis of dengue. J Lab Physicians. 2017;9(3):177-81. [PubMed ID:28706387]. [PubMed Central ID:PMC5496295]. https://doi.org/10.4103/0974-2727.208265.
  • 19.
    Hegde SS, Bhat BR. Dengue detection: Advances and challenges in diagnostic technology. Biosensors Bioelectronics. 2022;10:100100. https://doi.org/https://doi.org/10.1016/j.biosx.2021.100100.
  • 20.
    Pierson TC, Kielian M. Flaviviruses: braking the entering. Curr Opin Virol. 2013;3(1):3-12. [PubMed ID:23352692]. [PubMed Central ID:PMC3601797]. https://doi.org/10.1016/j.coviro.2012.12.001.
  • 21.
    Rawlinson SM, Pryor MJ, Wright PJ, Jans DA. Dengue virus RNA polymerase NS5: a potential therapeutic target? Curr Drug Targets. 2006;7(12):1623-38. [PubMed ID:17168837]. https://doi.org/10.2174/138945006779025383.
  • 22.
    Yon C, Teramoto T, Mueller N, Phelan J, Ganesh VK, Murthy KH, et al. Modulation of the nucleoside triphosphatase/RNA helicase and 5'-RNA triphosphatase activities of Dengue virus type 2 nonstructural protein 3 (NS3) by interaction with NS5, the RNA-dependent RNA polymerase. J Biol Chem. 2005;280(29):27412-9. [PubMed ID:15917225]. https://doi.org/10.1074/jbc.M501393200.
  • 23.
    Barnard TR, Abram QH, Lin QF, Wang AB, Sagan SM. Molecular Determinants of Flavivirus Virion Assembly. Trends Biochem Sci. 2021;46(5):378-90. [PubMed ID:33423940]. https://doi.org/10.1016/j.tibs.2020.12.007.
  • 24.
    Lim SP, Wen D, Yap TL, Yan CK, Lescar J, Vasudevan SG. A scintillation proximity assay for dengue virus NS5 2'-O-methyltransferase-kinetic and inhibition analyses. Antiviral Res. 2008;80(3):360-9. [PubMed ID:18809436]. https://doi.org/10.1016/j.antiviral.2008.08.005.
  • 25.
    Hasan S, Jamdar SF, Alalowi M, Al Ageel Al Beaiji SM. Dengue virus: A global human threat: Review of literature. J Int Soc Prev Community Dent. 2016;6(1):1-6. [PubMed ID:27011925]. [PubMed Central ID:PMC4784057]. https://doi.org/10.4103/2231-0762.175416.
  • 26.
    Htun TP, Xiong Z, Pang J. Clinical signs and symptoms associated with WHO severe dengue classification: a systematic review and meta-analysis. Emerg Microbes Infect. 2021;10(1):1116-28. [PubMed ID:34036893]. [PubMed Central ID:PMC8205005]. https://doi.org/10.1080/22221751.2021.1935327.
  • 27.
    Sukupolvi-Petty S, Austin SK, Engle M, Brien JD, Dowd KA, Williams KL, et al. Structure and function analysis of therapeutic monoclonal antibodies against dengue virus type 2. J Virol. 2010;84(18):9227-39. [PubMed ID:20592088]. [PubMed Central ID:PMC2937608]. https://doi.org/10.1128/JVI.01087-10.
  • 28.
    Kaufman BM, Summers PL, Dubois DR, Cohen WH, Gentry MK, Timchak RL, et al. Monoclonal antibodies for dengue virus prM glycoprotein protect mice against lethal dengue infection. Am J Trop Med Hyg. 1989;41(5):576-80. [PubMed ID:2817214]. https://doi.org/10.4269/ajtmh.1989.41.576.
  • 29.
    Lai CJ, Goncalvez AP, Men R, Wernly C, Donau O, Engle RE, et al. Epitope determinants of a chimpanzee dengue virus type 4 (DENV-4)-neutralizing antibody and protection against DENV-4 challenge in mice and rhesus monkeys by passively transferred humanized antibody. J Virol. 2007;81(23):12766-74. [PubMed ID:17881450]. [PubMed Central ID:PMC2169078]. https://doi.org/10.1128/JVI.01420-07.
  • 30.
    Endy TP, Nisalak A, Chunsuttitwat S, Vaughn DW, Green S, Ennis FA, et al. Relationship of preexisting dengue virus (DV) neutralizing antibody levels to viremia and severity of disease in a prospective cohort study of DV infection in Thailand. J Infect Dis. 2004;189(6):990-1000. [PubMed ID:14999601]. https://doi.org/10.1086/382280.
  • 31.
    Murphy BR, Whitehead SS. Immune response to dengue virus and prospects for a vaccine. Annu Rev Immunol. 2011;29:587-619. [PubMed ID:21219187]. https://doi.org/10.1146/annurev-immunol-031210-101315.
  • 32.
    Arab S, Ebrahimi Z, Izadi A, Madanchi H, Yarmohamadi M, Darban M, et al. [Relationship between the history of kidney disease, clinical findings, hospitalization duration, and mortality in COVID-19 patients]. Koomesh. 2022;24(1):102-8. Persian.
  • 33.
    Tavakoli A, Niya MHK, Ghaffari H, Keshavarz M, Keyvani H. [Role of T lymphocytes and natural killer cells in pathogenesis of chronic viral hepatitis]. Koomesh. 2017;19(4):713-20. Persian.
  • 34.
    Costa VV, Fagundes CT, Souza DG, Teixeira MM. Inflammatory and innate immune responses in dengue infection: protection versus disease induction. Am J Pathol. 2013;182(6):1950-61. [PubMed ID:23567637]. https://doi.org/10.1016/j.ajpath.2013.02.027.
  • 35.
    Halstead SB, Rojanasuphot S, Sangkawibha N. Original antigenic sin in dengue. Am J Trop Med Hyg. 1983;32(1):154-6. [PubMed ID:6824120]. https://doi.org/10.4269/ajtmh.1983.32.154.
  • 36.
    Gunther VJ, Putnak R, Eckels KH, Mammen MP, Scherer JM, Lyons A, et al. A human challenge model for dengue infection reveals a possible protective role for sustained interferon gamma levels during the acute phase of illness. Vaccine. 2011;29(22):3895-904. [PubMed ID:21443963]. https://doi.org/10.1016/j.vaccine.2011.03.038.
  • 37.
    Prabhat N, Ray S, Chakravarty K, Kathuria H, Saravana S, Singh D, et al. Atypical neurological manifestations of dengue fever: a case series and mini review. Postgrad Med J. 2020;96(1142):759-65. [PubMed ID:32900825]. https://doi.org/10.1136/postgradmedj-2020-137533.
  • 38.
    Kulkarni R, Pujari S, Gupta D. Neurological Manifestations of Dengue Fever. Ann Indian Acad Neurol. 2021;24(5):693-702. [PubMed ID:35002126]. [PubMed Central ID:PMC8680870]. https://doi.org/10.4103/aian.AIAN_157_21.
  • 39.
    Kakde U, Khatib MN. Neurological Complications in Dengue Among Males of the Adult Age Group. Cureus. 2024;16(1):e51586. https://doi.org/10.7759/cureus.51586.
  • 40.
    Hopkins HK, Traverse EM, Barr KL. Viral Parkinsonism: An underdiagnosed neurological complication of Dengue virus infection. PLoS Negl Trop Dis. 2022;16(2):e0010118. [PubMed ID:35139081]. [PubMed Central ID:PMC8827468]. https://doi.org/10.1371/journal.pntd.0010118.
  • 41.
    Chen RF, Yang KD, Wang L, Liu JW, Chiu CC, Cheng JT. Different clinical and laboratory manifestations between dengue haemorrhagic fever and dengue fever with bleeding tendency. Trans R Soc Trop Med Hyg. 2007;101(11):1106-13. [PubMed ID:17764712]. https://doi.org/10.1016/j.trstmh.2007.06.019.
  • 42.
    Nimmannitya S, Thisyakorn U, Hemsrichart V. Dengue haemorrhagic fever with unusual manifestations. Southeast Asian J Trop Med Public Health. 1987;18(3):398-406. [PubMed ID:3433170].
  • 43.
    Sandeep M, Padhi BK, Yella SST, Sruthi KG, Venkatesan RG, Krishna Sasanka KBS, et al. Myocarditis manifestations in dengue cases: A systematic review and meta-analysis. J Infect Public Health. 2023;16(11):1761-8. [PubMed ID:37738692]. https://doi.org/10.1016/j.jiph.2023.08.005.
  • 44.
    Atmaja GT, Buntubatu S, Wijaya CS, Sudarmadi ANP, Laksono IS, Indrawanti R, et al. Comparison of cardiac marker profiles in dengue myocarditis. J Med Sci (Berkala Ilmu Kedokteran). 2023;55(1). https://doi.org/10.19106/JMedSci005501202304.
  • 45.
    Malik J, Iltaf Satti D. 78 Cardiovascular manifestations of dengue. 2022. p. A58.
  • 46.
    Araiza-Garaygordobil D, Garcia-Martinez CE, Burgos LM, Saldarriaga C, Liblik K, Mendoza I, et al. Dengue and the heart. Cardiovasc J Afr. 2021;32(5):276-83. [PubMed ID:34292294]. [PubMed Central ID:PMC8756038]. https://doi.org/10.5830/CVJA-2021-033.
  • 47.
    Cabrera-Rego JO, Rojas-Quiroz AF, Vidal-Turruelles Y, Yanes-Quintana AA. Cardiovascular disorders in hospitalized patients with dengue infection. Enferm Infecc Microbiol Clin (Engl Ed). 2021;39(3):115-8. [PubMed ID:32345488]. https://doi.org/10.1016/j.eimc.2020.02.032.
  • 48.
    Khan AA, Khan FU, Akhtar SA, Ghaffar R. Dengue beyond fever-fatal dengue myocarditis and complete heart block: A case report and brief overview of cardiac manifestations of dengue fever. SAGE Open Med Case Rep. 2023;11:2050313X231193983. [PubMed ID:37605746]. [PubMed Central ID:PMC10440106]. https://doi.org/10.1177/2050313X231193983.
  • 49.
    Khadka B, Khanal K, Regmi A, Ghimire A, Kc S, Nepal R, et al. Pyopericardium progressing to cardiac tamponade in a patient with dengue fever. IDCases. 2024;36:e01996. [PubMed ID:38873641]. [PubMed Central ID:PMC11170180]. https://doi.org/10.1016/j.idcr.2024.e01996.
  • 50.
    Marin-Palma D, Sirois CM, Urcuqui-Inchima S, Hernandez JC. Inflammatory status and severity of disease in dengue patients are associated with lipoprotein alterations. PLoS One. 2019;14(3):e0214245. [PubMed ID:30901375]. [PubMed Central ID:PMC6430398]. https://doi.org/10.1371/journal.pone.0214245.
  • 51.
    Salgado DM, Eltit JM, Mansfield K, Panqueba C, Castro D, Vega MR, et al. Heart and skeletal muscle are targets of dengue virus infection. Pediatr Infect Dis J. 2010;29(3):238-42. [PubMed ID:20032806]. [PubMed Central ID:PMC2833338]. https://doi.org/10.1097/INF.0b013e3181bc3c5b.
  • 52.
    Nerella S, Sarkar UK, Namdeo H. Electrocardiographic and echocardiographic findings in children with dengue infection. J Family Med Prim Care. 2022;11(6):2334-9. [PubMed ID:36119231]. [PubMed Central ID:PMC9480629]. https://doi.org/10.4103/jfmpc.jfmpc_1280_21.
  • 53.
    Abhinayaa J, James S, Jebaraj R, Vinoth PN. Incidence of Cardiac Manifestations in Children with Dengue Fever: A Cross-sectional Study. Rambam Maimonides Med J. 2021;12(2). [PubMed ID:33938801]. [PubMed Central ID:PMC8092955]. https://doi.org/10.5041/RMMJ.10436.
  • 54.
    Tabassum CT, Arifuzzaman M, Sayem M, Mostafa T, Bodruddoza K, Kabir A. Patterns of ECG Manifestations in Dengue Infection. J Med. 2023;24(2):119-24. https://doi.org/10.3329/jom.v24i2.67274.
  • 55.
    Akter R, Tasneem F, Das S, Soma MA, Georgakopoulos-Soares I, Juthi RT, et al. Approaches of dengue control: vaccine strategies and future aspects. Front Immunol. 2024;15:1362780. [PubMed ID:38487527]. [PubMed Central ID:PMC10937410]. https://doi.org/10.3389/fimmu.2024.1362780.
  • 56.
    Pintado Silva J, Fernandez-Sesma A. Challenges on the development of a dengue vaccine: a comprehensive review of the state of the art. J Gen Virol. 2023;104(3). [PubMed ID:36857199]. [PubMed Central ID:PMC10228381]. https://doi.org/10.1099/jgv.0.001831.
  • 57.
    Al-Osaimi HM, Kanan M, Marghlani L, Al-Rowaili B, Albalawi R, Saad A, et al. A systematic review on malaria and dengue vaccines for the effective management of these mosquito borne diseases: Improving public health. Hum Vaccin Immunother. 2024;20(1):2337985. [PubMed ID:38602074]. [PubMed Central ID:PMC11017952]. https://doi.org/10.1080/21645515.2024.2337985.
  • 58.
    Wilder-Smith AB, Freedman DO, Wilder-Smith A. Edging towards a third dengue vaccine. Lancet Infect Dis. 2024;24(11):1182-4. [PubMed ID:39116905]. https://doi.org/10.1016/S1473-3099(24)00434-1.
  • 59.
    Kularatne SA, Dalugama C. Dengue infection: Global importance, immunopathology and management. Clin Med (Lond). 2022;22(1):9-13. [PubMed ID:35078789]. [PubMed Central ID:PMC8813012]. https://doi.org/10.7861/clinmed.2021-0791.
  • 60.
    Winkler AS, Klohe K, Schmidt V, Haavardsson I, Abraham A, Prodjinotho UF, et al. Neglected tropical diseases - the present and the future. Tidsskr Nor Laegeforen. 2018;138(3). [PubMed ID:29411594]. [PubMed Central ID:PMC6333920]. https://doi.org/10.4045/tidsskr.17.0678.
  • 61.
    Guzman MG, Harris E. Dengue. Lancet. 2015;385(9966):453-65. [PubMed ID:25230594]. https://doi.org/10.1016/S0140-6736(14)60572-9.
  • 62.
    World Health Organization. Dengue and severe dengue. Geneva, Switzerland: World Health Organization; 2023. [Cited:2023]. Available from: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue.
  • 63.
    Prashantha B, Varun S, Sharat D, Murali Mohan BV, Ranganatha R, Shivaprasad, et al. Prophyactic platelet transfusion in stable dengue Fever patients: is it really necessary? Indian J Hematol Blood Transfus. 2014;30(2):126-9. [PubMed ID:24839367]. [PubMed Central ID:PMC4022920]. https://doi.org/10.1007/s12288-013-0242-7.
  • 64.
    Dengue Alliance. Electronic address gdo, Dengue A. Treatments for dengue: a Global Dengue Alliance to address unmet needs. Lancet Glob Health. 2023;11(11):e1680-e1. [PubMed ID:37660714]. https://doi.org/10.1016/S2214-109X(23)00362-5.
Import into EndNoteImport into BibTex
Indexed in
logoScopus
Crossmark
Crossmark
Checking
Share on
Comments
Number of Comments:0
Cited by
Metrics
Licensing and reuse information

Ordering Reprints

Articles are published under the Creative Commons license stated on each article. No permission or royalty fee is required for uses permitted by that license. CCC handles optional bulk and customized reprint orders. Any quotation covers production and delivery services only, not copyright permission. > Request Reprints from CCC 

Search Relations

Author(s):

Related Articles

Related Article in PubMed

Related Article in Google Scholar

Create Citation Alert via Google Reader