Dengue: The break-bone fever outbreak in Kerala, India

Global disease burden of Dengue WHO has categorized Dengue as the quickest spreading arboreal disease in the world and about 50% the world's population is at jeopardy of getting affected by the deadly viral manifestations [1, 2, 3]. Dengue is a daunting global disease burden and economic burden throughout the globe [4]. Dengue is produced by one of 4 single stranded, positive sense RNA viruses, serotype DENV1-4 of family Flaviviridae and the genus flavivirus [5, 6]. The morphology of this RNA virus comprises of 3 structural proteins-capsid, envelope, glycoproteins and 7 nonstructural proteins NS1, NS2A, NS2B, NS3, NS4A, NS4B and NS5 [7]. Dengue is primarily transmitted by the mosquito Aedes aegypti but in recent year’s infection with Aedes albopictus has intensely increased [8]. Dengue has two clinical manifestations, dengue hemorrhagic fever and dengue shock syndrome. Nowadays it is known as severe dengue [9]. According to Stanaway JD et al. a total number of 60 million symptomatic dengue infections were present around the globe and resulting in about 10 000 deaths in the year 2013[10]. This figure has been reduced as compared to the Global Burden of Disease Study, which has assessed that in 2010, 14 000 people has died from dengue [11]. Whereas according to WHO, Dengue is predominant in 128 countries and 4 billion people were at danger across the globe. Dengue affects 50 million to 100 million people per year and subsequently 20 000 deaths per year [12]. It is estimated that in Southeast Asia there are about 21∙1 million cases of Dengue. [7] Dengue and dengue hemorrhagic fever is commonly found in Pacific, Caribbean islands, North America, South America and in Southeast Asia [13]. Dengue in Kerala Recently a shocking intensification of dengue cases has also been seen in India in 2017[14]. The common serotype of Dengue Asian genotype of DENV-1 was detected in South India in 2012[15]. In Orisha all four serotype of the virus has been detected and reported in 2017 by Mishra B et al [16]. In the year 2017, approximately 18,700 cases of Dengue have been confirmed from India which was quiet alarming. Kerala was at the top of the list which was having the highest number reported from India. The total number of Dengue patients in Kerala was 9104 followed by Tamil Nadu 4174, Karnataka 1945 cases, Gujarat 616, Andhra Pradesh 606, West Bengal 469, Delhi 100 till 2nd July 2017 [17]. According to the Times of India, the daily newspaper the most number of cases in the state Kerala was reported from the districts of Thiruvananthapuram, Kozhikode and Palakkad. The possible Editorial Open Access eISSN 2091-0800