Dengue is a rapidly spreading vector-borne disease estimated
to infect 400 million people worldwide. To date, there are no licensed treatments
or vaccines. The last few years have seen significant developments in dengue
control strategies. In this review, we will address four key areas: vaccines,
vector control, antivirals and immunotherapeutics.
RECENT FINDINGS: The first generation of dengue vaccines is able to induce good
serological responses in test individuals. However, the recent Sanofi-Pasteur
trial in Thailand found that a good serological response did not correlate with
clinical protection. This trial did not demonstrate an increase in cases of
severe disease following immunization, suggesting that concerns over
vaccine-related immune enhancement may have been overcome. The bacterium
Wolbachia appears to control dengue proliferation in Aedes mosquitoes, and field
studies are underway. A large number of antivirals are in early-stage development
and may prove useful in epidemics. Monoclonal antibodies have been postulated to
have a clinical role. Whether their clinical application is feasible has yet to
be seen.