Unsolved epidemiological questions on dengue/dengue hemorrhagic fever- From Taiwan's experiences to global control

摘要

Background: The numbers of dengue hemorrhagic fever (DHF) have been increasing globally in recent three decades. The mechanisms that can explain these epidemiological changes have remained enigma. Through epidemiological field observations, two past major hypotheses for DHF are: (1) primary infection due to viral virulence proposed by Dr. L Rosen and (2) secondary infection of heterologous serotypes of dengue viruses (DENV) with antibody-dependent enhancement (ADE) advocated by Dr. S Halstead. However, not all secondary infection of DENV resulted in DHF cases whereas primary infection of DENV has frequently identified in Taiwan and other areas without dengue endemicity.