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2. Virological Findings. 90 3. Immunity. . . . . 90 C. Secondary
Dengue: Dengue Hemorrhagic Fever and the Shock Syndrome 92 1.
General Remarks. . . . . . . . . . . . . . 92 2. Clinical Course
and Clinical Laboratory Findings 93 3. Virological and Serological
Findings. . . 95 4. Immunopathology of Secondary Dengue. 98 XI.
Immunization. . . . . . . . . . . . . . . 104 A. Anamnestic Immune
Responses in Sequential Infections With Dengue and Other Group B
Togaviruses . . . . . . . . 104 1. Results With Members of the
Dengue Subgroup 104 2. Results With Dengue and Other Flaviviruses.
107 B. Dengue Vaccines for Use in Man 108 XII. Opportunities for
the Future 113 Acknowledgments. 114 References. . . . . . . . . . .
114 I. Introduction Dengue fever is a mosquito-transmitted disease
of man which has afflicted untold millions of people over the past
two centuries. It is caused by viruses classified as a subgroup of
the group B togaviruses. Along with other members of that group as
well as group A, the dengue viruses have been investigated
intensively during recent years. Certain unique aspects of their
structure, composition, antigenicity, replication, and antigenic
relationships have established the togavirus family as quite
distinct from other families of enveloped RNA viruses (see recent
review of PFEFFERKORN and SHAPIRO, 1974). The basic studies leading
to this conclusion have coincided with epidemiological field
investigations which have resulted in a continuing increase in the
number of viruses now designated as group A or B togaviruses. This,
in turn, has led to a growing appreciation of their immense
importance as actual or potential pathogens of man and beast.
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