Dengue Fever: Viral, Environmental, and Human Factors Driving Expansion and Pandemic Risk
Mohsen Nakhaie, Amirhossein Shahpar, Mohammad Rezaei Zadeh Rukerd, Niloofar Farsiu, Javad Charostad, Davood Bashash, Nazanin Zeinali Nezhad, Mohammad Pardeshenas, Azadeh Haghi Navand, Hanieh Mirkamali, Keivan Zandi, Sazaly AbuBakar
Abstract
Dengue fever (DF), caused by the dengue virus (DENV), is the fastest-spreading mosquito-borne viral disease globally and presents significant public health challenges. This comprehensive review explores the multifaceted factors influencing DENV expansion and control. We examine viral factors, including serotypes, sub-genotypes, genetic mutations, recombination, and immune evasion mechanisms, and their role in enhancing dengue's adaptability and virulence. The influence of environmental factors, such as climate change, global warming, and unplanned urbanization on mosquito vector distribution, and the impact of natural disasters and human conflicts on population dynamics and transmission risks are discussed. Human factors, including global travel, migration, inadequate public health infrastructure, and the role of herd immunity from previous infections and cyclical outbreaks, are critically assessed. Additionally, emerging challenges like co-infections, drug resistance, and the potential for pandemic outbreaks are considered. By synthesizing current knowledge across these dimensions, this review provides insights into dengue transmission complexities and identifies key intervention areas, aiming to enhance strategies for prevention, control, and preparedness in the face of evolving global health threats.