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From the Qing Dynasty to modern times: How did dengue fever evolve into a global hot topic?
Over the past few centuries, the impact of dengue fever has gradually spread across the globe, starting from the Qing Dynasty, causing health concerns around the world. This mosquito-borne viral disease, prevalent in both tropical and subtropical regions, has prompted a rethinking of our understanding of its etiology, transmission, and treatment. According to the World Health Organization, more than 5 million cases of dengue fever were reported worldwide in 2023, a phenomenon that is alarmingly linked to the impacts of climate change and globalization.
Dengue fever was first described in the 1780s and has evolved over the centuries to remain a major global public health challenge.
Historical evolution of dengue fever
Early documentation of dengue fever dates back to 17th century Chinese medical books, where it was referred to as water poisoning. Over time, the disease spread from Africa, where it was spread through the slave trade between the 15th and 19th centuries. After entering the 19th century, outbreaks continued to occur in many tropical urban centers, especially during World War II, when the prevalence of dengue fever expanded as urbanization accelerated. In 1953, the first case of dengue hemorrhagic fever was reported. By the 1970s, the disease had become one of the leading causes of death among children in Southeast Asia.
Causes and symptoms of dengue fever
Dengue fever is caused by dengue virus (DENV), which belongs to the Flaviviridae family. After infection, about 80% of patients have no obvious symptoms, and obvious cases usually include high fever, headache, muscle and joint pain, etc. In rare cases, dengue fever can turn into severe dengue fever, with symptoms such as internal bleeding and low platelets. The difficulty in identifying this disease is that its symptoms are similar to other diseases such as influenza and malaria, so diagnosis is relatively complicated.
Most cases are asymptomatic or mild, complicating diagnosis and treatment and potentially even becoming a public health issue of unclear magnitude.
Transmission routes and risk factors
Dengue fever is mainly transmitted by the A. aegypti mosquito (especially Aedes aegypti). These mosquitoes are most active at dusk and dawn, providing an excellent avenue for dispersal. Urbanization and environmental changes, especially solid waste that can breed mosquitoes, continue to increase the risk of dengue fever. According to research, chronic diseases such as diabetes and hypertension also increase the risk of developing severe illness.
Global Response and Vaccine Development
As dengue fever outbreaks increase, governments and public health organizations are paying more and more attention to prevention and control. Two vaccines have been launched in recent years: Dengvaxia and Qdenga. Although the introduction of these vaccines has continuously advanced the prevention and control of dengue fever, the use of vaccines still needs to take into account the individual's previous infection history to avoid antibody-dependent enhancement (ADE). AIDS vaccines have been approved in some countries and universal vaccination has begun.
Governance and future challenges
Although measures to prevent and control dengue fever already exist, the epidemic pattern of dengue fever has become more complicated with climate change and the deteriorating ecological environment. Over the years, the number of dengue infections has gradually increased in different regions of the world, especially in tropical and subtropical cities with high levels of urbanization. With only mild treatment options available for this disease, health systems around the world face a huge challenge.
As the number of severe cases increases, how should we effectively control and respond to the challenges posed by dengue fever in the future?
The impact of dengue fever is no longer limited to a specific region. With the changes in the ecological environment and the expansion of human activities, this disease has become a global hot topic, challenging the public health systems of various countries. In the face of this epidemic, what kind of response measures should we take to more effectively protect our health and safety?
