Institute of Public Health, University of Heidelberg, Heidelberg, Germany ; Population Health, Waikato District Health Board, Hamilton, New Zealand.
Clin Epidemiol. 2013 Aug 20;5:299-309. doi: 10.2147/CLEP.S34440. eCollection 2013.
Dengue is currently regarded globally as the most important mosquito-borne viral disease. A history of symptoms compatible with dengue can be traced back to the Chin Dynasty of 265-420 AD. The virus and its vectors have now become widely distributed throughout tropical and subtropical regions of the world, particularly over the last half-century. Significant geographic expansion has been coupled with rapid increases in incident cases, epidemics, and hyperendemicity, leading to the more severe forms of dengue. Transmission of dengue is now present in every World Health Organization (WHO) region of the world and more than 125 countries are known to be dengue endemic. The true impact of dengue globally is difficult to ascertain due to factors such as inadequate disease surveillance, misdiagnosis, and low levels of reporting. Currently available data likely grossly underestimates the social, economic, and disease burden. Estimates of the global incidence of dengue infections per year have ranged between 50 million and 200 million; however, recent estimates using cartographic approaches suggest this number is closer to almost 400 million. The expansion of dengue is expected to increase due to factors such as the modern dynamics of climate change, globalization, travel, trade, socioeconomics, settlement and also viral evolution. No vaccine or specific antiviral therapy currently exists to address the growing threat of dengue. Prompt case detection and appropriate clinical management can reduce the mortality from severe dengue. Effective vector control is the mainstay of dengue prevention and control. Surveillance and improved reporting of dengue cases is also essential to gauge the true global situation as indicated in the objectives of the WHO Global Strategy for Dengue Prevention and Control, 2012-2020. More accurate data will inform the prioritization of research, health policy, and financial resources toward reducing this poorly controlled disease. The objective of this paper is to review historical and current epidemiology of dengue worldwide and, additionally, reflect on some potential reasons for expansion of dengue into the future.
登革热目前被全球视为最重要的蚊媒病毒病。可追溯到公元 265-420 年的中国朝代的症状史表明了这一点。如今，该病毒及其载体已广泛分布于世界热带和亚热带地区，特别是在过去半个世纪以来。显著的地理扩张伴随着发病、流行和高度流行的迅速增加，导致了更严重的登革热形式。目前，登革热在世界卫生组织（WHO）的每个区域都有传播，已知有 125 多个国家存在登革热流行。由于疾病监测不足、误诊和报告水平低等因素，全球登革热的真正影响难以确定。目前可用的数据可能严重低估了社会、经济和疾病负担。每年全球登革热感染的估计发病率在 5000 万至 2 亿之间；然而，最近使用制图方法的估计表明，这一数字接近近 4 亿。由于气候变化的现代动态、全球化、旅行、贸易、社会经济、定居以及病毒进化等因素，登革热的扩张预计将会增加。目前尚无疫苗或特定的抗病毒疗法来应对登革热日益严重的威胁。及时发现病例和适当的临床管理可以降低重症登革热的死亡率。有效的病媒控制是登革热预防和控制的主要方法。监测和改善登革热病例的报告也是评估全球真实情况的必要条件，这也是 2012-2020 年世界卫生组织全球登革热预防和控制战略的目标之一。更准确的数据将为研究、卫生政策和财政资源的优先排序提供信息，以减少这种控制不佳的疾病。本文的目的是回顾全球登革热的历史和当前流行病学，并进一步思考一些未来登革热扩张的潜在原因。
