Decoding Dengue: A Global Perspective, History, Role, and Challenges
Flora Miranda Ulgheri, Bruno Gaia Bernardes, Marcelo Lancellotti
Abstract
Dengue, caused by the dengue virus (DENV), is rapidly expanding its geographical footprint, with increasing incidence not only in over 100 endemic countries in the southern hemisphere but also with more autochthonous transmissions now reported in the northern hemisphere, including regions of Europe and the United States. The clinical presentation of DENV infection ranges from mild febrile illness to severe and potentially fatal conditions, such as dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS), and diverse neurological complications. While vaccine development efforts are underway, significant challenges remain, underscoring the urgent need for a deeper understanding of the virus. This urgency is particularly palpable in Brazil, which has faced an unprecedented surge in dengue cases during the 2024-2025 period. The country has recorded an alarmingly high number of infections and related deaths, stretching its public health infrastructure and highlighting the complex interplay of climate change, urbanization, and viral dynamics in disease propagation. This review provides a global perspective on dengue, systematically exploring its history, morphology, viral cycle, pathogenesis, and epidemiology. By integrating these critical aspects, this article aims to identify pivotal knowledge gaps and guide future research directions essential for developing improved public health interventions against this complex and evolving disease.