Resurgence of dengue.

D is an endemic mosquitotransmitted arboviral disease with an estimated 3.97 bil l ion people at risk in 128 tropical and subtropical countries around World.1 Infection by any one of the four serotypes of dengue virus (DENV-1 to DENV-4) could cause multiple spectra of disease including dengue fever, dengue shock syndrome ( D S S ) a n d d e n g u e h a e m o r r h a g i c fever (DHF). In 2008, World Health Organisation (WHO) experts agreed that dengue is one disease entity with different clinical presentations and often with unpredictable clinical evolution and outcome. The resurgence of dengue has been observed in India and dengue outbreaks have been frequently reported from different parts of the country in both urban and rural populations, with studies correlat ing increased dengue incidence with the monsoon and post monsoon season.2 There is scientific evidence that temperature and rainfall influence dengue incidence. However , complex interact ions of ecology, environment, vector and virus serotypes are crucial factors driving dengue outbreaks. Rapid transportation, industrialisation, movement of infected human populat ions and changing ecology all have facilitated its spread to newer areas. In India, 13 states were reported for DF / Dengue Haemorrhagic Fever (DHF) in endemic and epidemic proportions (Govt. of India, Ministry of Heal th , 2000-2001) . Recent ly , a wide spread outbreak of dengue was reported from previously unaffected Manipur in NE India, documenting co-circulation and high percentage of concurrent infection with two dengue virus serotypes , which is of great Resurgence of Dengue