VI.

PATHOPHYSIOLOGY
A. Written Pathophysiology
Dengue fever is a painful, debilitating mosquito-borne disease caused by any one of
four closely related dengue viruses. The course of dengue virus infection is
characterized by early events, dissemination, and the immune response and
subsequent viral clearance Dengue virus is introduced into the skin by the bite of an
infected mosquito, most commonly Aedes aegypti.
The spread of virus early after subcutaneous injection has been studied in rhesus
monkeys during the first 24 hours, virus could only be isolated from the injection site.
The major cell type infected was not defined Both Langerhans cells and dermal
fibroblasts have been proposed to be target cells for dengue virus infection in the skin.
One study using human skin dendritic cells demonstrated expression of dengue virus
antigens following in vitro exposure, suggesting that these cells are permissive for
dengue viral infection. In rhesus monkeys, virus was detected in regional lymph nodes
24 hours after infection. In one study using a mouse model deficient in both type I and
type II interferon (IFN) receptors, macrophages and dendritic cells were demonstrated
to be early cellular targets for infection. Mosquitoes become infected when they bite
infected humans, and later transmit infection to other people they bite. Two main
species of mosquito, Aedes aegypti and Aedes albopictus, have been responsible for all
cases of dengue transmitted in this country. Dengue is not contagious from person to
person.

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