Chapter 1 The History and Evolution of Human Dengue Emergence

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Abstract

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.

Section snippets

Introduction to Flaviviruses

Dengue viruses (DENV) are members of the genus Flavivirus in the Family Flaviviridae. Flaviviruses are single‐stranded RNA viruses of positive polarity and most, but not all, require hematophagous arthropods (mosquitoes or ticks) to complete their horizontal transmission cycle. They are responsible for a broad spectrum of pathogenic manifestations in humans, domestic animals, and birds (Heinz et al., 2000). Flaviviruses are widely distributed nearly throughout the world, except Antarctica. More

Classification of dengue viruses

DENV is considered a species within the genus Flavivirus (family Flaviviridae) and includes four distinct but antigenically related serotypes (DENV‐1, ‐2, ‐3, and ‐4) in DEN antigenic complex (Calisher et al., 1989). Of the flaviviruses, DENV are among the most restricted with regard to their natural vertebrate host range, which is believed to include only primates. Currently, all four DENV serotypes can be found in nearly all urban and peri‐urban environments throughout the tropics and

History of dengue virus as a human pathogen

The geographic site of origin of DENV has been a subject of intense speculation; some argue for an African origin due to the same origin of the principal vector, Ae. aegypti (Christophers, 1960, Edwards, 1932). However the ecological and serological work of Smith and Rudnick (Rudnick and Lim, 1986, Smith, 1956), the relative insusceptibility to infection to DENV infection of the ancestral Ae. aegypti formosus from Africa (Diallo et al., 2005) and phylogenetic analyses (Wang et al., 2000) point

DENV evolutionary relationships—origins and emergence

Gubler's (Gubler, 1997) hypothesis that endemic DENV evolved from sylvatic progenitors has been the subject of intense discussion and speculation. As mentioned above, sylvatic DENV cycles occur in the forests of West Africa and Southeast Asia involving only the DENV‐2 serotype in the former region, whereas in the latter all four serotypes may be represented. Virus maintenance in both regions involves sylvatic Aedes spp. mosquito vectors, and presumably non‐human primates serving as reservoir

Epidemics and human contact

Smith (Smith, 1956) and Rudnick (Rudnick, 1986), based on their studies of DENV ecology and seroprevalence in the Malay peninsula, hypothesized that the rural population, especially those living in close proximity to forested and rubber plantation areas, were exposed periodically to sylvatic DENV. As described above in the ‘transmission cycles’ section, all of the sylvatic DENV isolates were obtained from sentinel monkeys or Ae. niveus species mosquito pools, collected within sylvan environs (

Acknowledgments

We thank Edward C. Holmes for helpful advice with the phylogenetic methods and divergence time estimates. NV was supported by the Centers for Disease Control and Prevention Fellowship Training Program in Vector‐Borne Infectious Diseases, T01/CCT622892.

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