Dengue is a mosquito-borne flaviviral illness that is endemic in the tropics and subtropics. An estimated 390 million infections occur annually, of which 96 million have clinical manifestations. Although mortality is relatively lower than that for other tropical infectious diseases, the scale of human suffering and economic resources that are expended to control dengue makes it a major global public health problem. The factors driving transmission and infection persist without evidence of decline.
For these reasons, the world needs a safe and effective dengue vaccine. Infection with one of the four types of dengue virus (serotypes 1, 2, 3, and 4) may result in an asymptomatic infection, a mild nonspecific viral illness, classic dengue fever, or severe dengue manifested by plasma leakage, hemorrhagic tendencies, and possibly death. Patients with a second infection with a different…
