Scientific research on dengue has a long and rich history. The
literature has been touched by famous names in medicine- Benjamin
Rush, Walter Reed, and Albert Sabin, to name a very few- and has
been fertile ground for medical historians . The advances made in
those early investigations are all the more remarkable for the
limited tools available at the time. The demonstration of a viral
etiology for dengue fever, the recognition of mosquitoes as the
vector for transmission to humans, and the existence of multiple
viral variants (serotypes) with only partial cross-protection were
all accomplished prior to the ability to culture and characterize
the etiologic agent. Research on dengue in this period was
typically driven by circumstances. Epidemics of dengue created
public health crises, although these were relatively short-lived in
any one location, as the population of susceptible individuals
quickly shrank. Military considerations became as a major driving
force for research. With the introduction of large numbers of
non-immune individuals into endemic areas, dengue could cripple
military readiness, taking more soldiers out of action than hostile
fire. Dengue and dengue hemorrhagic fever, which assumed pandemic
proportions during the latter half of the last century, have shown
no indication of slowing their growth during this first decade of
the twenty-first century. Challenges remain in understanding the
basic mechanisms of viral replication and disease pathogenesis, in
clinical management of patients, and in control of dengue viral
transmission. Nevertheless, new tools and insights have led to
major recent scientific advances. As the first candidate vaccines
enter large-scale efficacy trials, there is reason to hope that we
may soon "turn the corner" on this disease.
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