Dengue Virus 4
Dengue virus 4 capsid(1)
Description: Dengue virus 4 (DEN-4) is one of four serotypes of dengue virus, a member of genus Flavivirus within the family Flaviridae.(2) The pathogen is transmitted to humans through its mosquito vector, Aedes aegypti. The vector is spreading, putting much of the world at risk.(3)
Power: Although primary infection can be cause flu-like illness, it is rarely fatal. The real danger is upon reinfection with another serotype of dengue, which results in antibody dependent enhancement that leads to dengue hemorrhagic fever (DHF) and, in serious cases, dengue shock syndrome (DSS). The fatality rate for DHF is around 5% and is even higher for DSS.(4)
Offenses: Primary infection with DEN-4 results in a flu-like illness. Younger victims tend to present with non-specific febrile illness with rash, while older victims tend to have the more classical symptomatology, which includes abrupt onset of high fever, arthralgia, myalgia, rash, pain behind the eyes, and a severe headache. Subsequent infection with another serotype can result in DHF and DSS, complications that can include fulminant hepatitis with extensive hemorrhage, multiple organ failure, and cardio- and encephalopathy.(5)
Defenses: Developing a vaccine has been challenging because of antibody dependent enhancement. As a result, there is no vaccination for dengue. Behavioral defenses revolve around controlling the vector. For instance, getting rid of domestic breeding grounds such as earthenware jars filled with water and spraying pesticides can reduce exposure to the vector and reduce its numbers. There is no cure for dengue. Instead, treatment is focused on supportive care such as maintaining fluid balance in patients with DHF and DSS.(6)
Game Action: Roll the dice and sit out one more day (turn) than the number shown on the dice because of dengue hemorrhagic fever.
One Liner: Get infected with dengue 4 and you’ll have a headache you can’t ignore