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Dengue: Challenges for Policy Makers and Vaccine Developers

Because of the increasing incidence, geographic expansion and economic burden of dengue transmission, dengue poses major challenges to policy makers. A vaccine against dengue is urgently needed, but vaccine development has been hampered by the lack of an appropriate animal model, poor understanding...

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Detalles Bibliográficos
Autores principales: Wilder-Smith, Annelies, Macary, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024152/
https://www.ncbi.nlm.nih.gov/pubmed/24781826
http://dx.doi.org/10.1007/s11908-014-0404-2
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author Wilder-Smith, Annelies
Macary, Paul
author_facet Wilder-Smith, Annelies
Macary, Paul
author_sort Wilder-Smith, Annelies
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description Because of the increasing incidence, geographic expansion and economic burden of dengue transmission, dengue poses major challenges to policy makers. A vaccine against dengue is urgently needed, but vaccine development has been hampered by the lack of an appropriate animal model, poor understanding of correlates of successful human immunity, the fear of immune enhancement, and viral interference in tetravalent combinations. The most suitable target epitopes for vaccines, as well as the role of nonstructural proteins remain elusive. The chimeric yellow fever bone-based live attenuated dengue vaccine is furthest in development, but initial efficacy results have been disappointing. Lessons learnt from this failure will affect the design of future trials, and increase the urgency to identify the best epitope and immune correlates. Dengue vaccine introduction will not be the only strategy to combat dengue, but needs to be “packaged” with novel vector control approaches, with community-based interventions to reduce the number of breeding sites, and reducing the case fatality rate by improving case management.
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spelling pubmed-40241522014-05-29 Dengue: Challenges for Policy Makers and Vaccine Developers Wilder-Smith, Annelies Macary, Paul Curr Infect Dis Rep Tropical, Travel and Emerging Infections (L Chen, Section Editor) Because of the increasing incidence, geographic expansion and economic burden of dengue transmission, dengue poses major challenges to policy makers. A vaccine against dengue is urgently needed, but vaccine development has been hampered by the lack of an appropriate animal model, poor understanding of correlates of successful human immunity, the fear of immune enhancement, and viral interference in tetravalent combinations. The most suitable target epitopes for vaccines, as well as the role of nonstructural proteins remain elusive. The chimeric yellow fever bone-based live attenuated dengue vaccine is furthest in development, but initial efficacy results have been disappointing. Lessons learnt from this failure will affect the design of future trials, and increase the urgency to identify the best epitope and immune correlates. Dengue vaccine introduction will not be the only strategy to combat dengue, but needs to be “packaged” with novel vector control approaches, with community-based interventions to reduce the number of breeding sites, and reducing the case fatality rate by improving case management. Springer US 2014-04-30 2014 /pmc/articles/PMC4024152/ /pubmed/24781826 http://dx.doi.org/10.1007/s11908-014-0404-2 Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Tropical, Travel and Emerging Infections (L Chen, Section Editor)
Wilder-Smith, Annelies
Macary, Paul
Dengue: Challenges for Policy Makers and Vaccine Developers
title Dengue: Challenges for Policy Makers and Vaccine Developers
title_full Dengue: Challenges for Policy Makers and Vaccine Developers
title_fullStr Dengue: Challenges for Policy Makers and Vaccine Developers
title_full_unstemmed Dengue: Challenges for Policy Makers and Vaccine Developers
title_short Dengue: Challenges for Policy Makers and Vaccine Developers
title_sort dengue: challenges for policy makers and vaccine developers
topic Tropical, Travel and Emerging Infections (L Chen, Section Editor)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024152/
https://www.ncbi.nlm.nih.gov/pubmed/24781826
http://dx.doi.org/10.1007/s11908-014-0404-2
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