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Microevolution and virulence of dengue viruses

Rico-Hesse R.

Adv Virus Res. 2003;59:315-41.

The evolution of dengue viruses has had a major impact on their virulence for
humans and on the epidemiology of dengue disease around the world. Although
antigenic and genetic differences in virus strains had become evident, it is mainly
due to the lack of animal models of disease that has made it difficult to detect
differences in virulence of dengue viruses. However, phylogenetic studies of
many different dengue virus samples have led to the association between specific
genotypes (within serotypes) and the presentation of more or less severe
disease. Currently, dengue viruses can be classified as being of epidemiologically
low, medium, or high impact; i.e., some viruses may remain in sylvatic cycles of
little or low transmissibility to humans, others produce dengue fever (DF) only,
and some genotypes have been associated with the potential to cause the more
severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) in
addition to DF. Although the factors that contribute to dengue virus epidemiology
are complex, studies have suggested that specific viral structures may contribute
to increased replication in human target cells and to increased transmission by
the mosquito vector; however, the immune status and possibly the genetic
background of the host are also determinants of virulence or disease
presentation. As to the question of whether dengue viruses are evolving toward
virulence as they continue to spread throughout the world, phylogenetic and
epidemiological analyses suggest that the more virulent genotypes are now
displacing those that have lower epidemiological impact; there is no evidence for
the transmission of antigenically aberrant, new strains.
The history and evolution of human dengue emergence.

Vasilakis N, Weaver SC.

Adv Virus Res. 2008;72:1-76

Dengue viruses (DENV) are the most important human arboviral pathogens.
Transmission in tropical and subtropical regions of the world includes a sylvatic,
enzootic cycle between nonhuman primates and arboreal mosquitoes of the
genus Aedes, and an urban, endemic/epidemic cycle principally between Aedes
aegypti, a mosquito that exploits peridomestic water containers as its larval
habitats, and human reservoir hosts that are preferred for blood feeding. Genetic
studies suggest that all four serotypes of endemic/epidemic DENV evolved
independently from ancestral, sylvatic viruses and subsequently became both
ecologically and evolutionarily distinct. The independent evolution of these four
serotypes was accompanied by the expansion of the sylvatic progenitors' host
range in Asia to new vectors and hosts, which probably occurred gradually over a
period of several hundred years. Although many emerging viral pathogens adapt
to human replication and transmission, the available evidence indicates that
adaptation to humans is probably not a necessary component of sylvatic DENV
emergence. These findings imply that the sylvatic DENV cycles in Asia and West
Africa will remain a potential source of re-emergence. Sustained urban vector
control programs and/or human vaccination will be required to control DEN
because the enzootic vectors and primate reservoir hosts are not amenable to
interventions.

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