A recent study investigates the link between childhood obesity and increased hospitalizations due to dengue in 91传媒. Among 4782 children aged 10 to 18, those with higher BMI percentiles had a significantly higher risk of hospitalization. Specifically, 18.2% of seropositive children with a BMI centile >97th were hospitalized, compared to 9.48% with a BMI centile <97th. These findings suggest a strong association between obesity and severe dengue outcomes, highlighting the need for increased awareness and further research.

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The new variant of dengue spreading in 91传媒 may cause a surge in the number of dengue cases, warned Prof. Chandima Jeewandara, the Head of the Department of Immunology, Allergy and Molecular Medicine at the 91传媒.

Prof. Jeewandara urged people to be aware of the breeding sites of dengue mosquitoes to prevent the spread of the disease. Meanwhile, the 91传媒 has conducted research on dengue antibodies in children, which could help plan dengue vaccination programmes.

The research found that the overall dengue seroprevalence rate in children was 24.8%, with the highest rates reported from Trincomalee (54.3%) and the lowest rates from Badulla (14.2%), which is a high-altitude estate area. The seroprevalence rates were significantly higher in urban areas (35.8%) compared to rural (23.2%) and estate areas (9.4%), but there was no association between seropositivity rates with population density in each district.

As the new variant of dengue poses a threat, the public is urged to take necessary measures to eliminate mosquito breeding sites and to seek medical attention if symptoms of dengue fever appear.

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As two pandemic years pass by and an emerging surge of dengue with the increases of public mobility, the healthcare system could see a light at the end of the tunnel in fighting with dengue with the potential dengue vaccine. Prof Neelika Malavige 鈥� Head of Scientific Affairs and the dengue programme at the Drugs for Neglected Diseases initiative (DNDi) recently told 鈥淭he Telegraph鈥� (a prominent UK newspaper) that the new vaccine approach looks 鈥減romising鈥�.

Unlike Coronavirus getting all the attention from the developed countries, Dengue virus got little less attention compared to the similar impact it made on the communities and countries with regards to hospitalization rates. Despite the lack of attention and investment on developing a vaccine during the past, a new vaccine is in the line to give potential relief to the healthcare sector in endemic countries. The Telegraph highlighted Prof Malavige鈥檚 statement 鈥淭he sort of rates of hospitalisation Britain saw with delta, with omicron 鈥� we see that on a seasonal basis with dengue. Our hospital systems are completely overwhelmed and sometimes we have to restrict access during the dengue season, which coincides with monsoon season. This is why we need investment in tools to combat the virus.鈥� To highlight the need for more investments on developing vaccines against Dengue, faster.

The Telegraph reported, Last month, Indonesia became the first country in the world to approve Qdenga vaccine, developed by the Japanese pharmaceutical company Takeda, for use in six to 45 year olds. In clinical trials, the shot (also called TAK-003) was found to be 84 per cent effective at preventing hospitalization four and a half years after a primary course of two doses, and 61 per cent effective against symptomatic disease. The vaccine is yet to receive pre-qualification status from the World Health Organization (WHO), but the data is under review by the European Medicines Agency and other dengue-endemic countries. Dr Sutee Yoksan, a Professor Emeritus at the Center for Vaccine Development at Mahidol University in Thailand, whose research is behind the vaccine mentioned the uniqueness of TAK-003 (Takeda Vaccine) vaccine, which uses DENV2 (Dengue variation 2) as its backbone with genes from the remaining 3 strains added creates a broader protection without amplifying the risk of more severe illness if someone catches the virus post-vaccination.

Sanofi- the first Dengue vaccine WHO approved in 2015 to combat dengue, increased the risk of severe dengue and hospitalisation among those who had never previously been infected by the virus, which was found by the company from its data in 2017. This led the usage of Sanofi vaccine only to the people who previously caught the disease according to the updated WHO guidance. 鈥淚t鈥檚 tricky to test whether you鈥檝e previously had dengue, so in reality, the Sanofi vaccine is rarely used now. Takeda seems to have learned lessons from Sanofi鈥檚 experience鈥� it does look promising.鈥� Prof Malavige said to The Telegraph in the interview.

Further Prof Malavie told The Telegraph, 鈥淪o given these factors, the Takeda vaccine might have a better outlook, but there is some evidence of waning of immunity with time, especially to some dengue virus serotypes. So, we can鈥檛 completely rule out people developing severe diseases following vaccination.鈥�

The Telegraph reported that the dengue vaccine developer, Takeda said it will continue to monitor data over time. The vaccine is the company鈥檚 first to be licensed outside of Japan and could generate up to $1.6 billion in annual sales. Gary Dubin, president of the company鈥檚 vaccine business unit, also said to The Telegraph 鈥淭akeda is working to have Qdenga available in Indonesia in early 2023, targeting the private market first to ensure it is available as soon as possible鈥�.

Given the facts, it鈥檚 been just a matter of time and some dollars for 91传媒 to have the new promising Dengue vaccine available for the 91传媒n community to fight against Dengue. With or without availability of the Dengue vaccine, we will have to clean up our surroundings to control the spread of blood sucking mosquitoes and diseases including dengue.

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Following is the whole article Nature News Q&A published in Nature website.

“91传媒 is in crisis 鈥� and so are its scientists
Immunologist Neelika Malavige鈥檚 study of a massive dengue-fever outbreak is being hampered by fuel shortages and power cuts.

91传媒 is in a state of crisis. With the country in vast amounts of debt and inflation sky-high, the government doesn鈥檛 have enough money to import fuel, exacerbating food shortages. Last weekend, protesters marched into the official residence of President Gotabaya Rajapaksa, demanding his immediate resignation. He has since fled the country.

More than six million 91传媒ns 鈥� three in every ten households 鈥� don鈥檛 know where to get their next meal, according to the World Food Programme. And after wave after wave of COVID-19, 91传媒 is now experiencing a massive outbreak of dengue fever.

Neelika Malavige is an immunologist at the 91传媒 in Colombo who has studied dengue for more than a decade. She spoke to Nature about the situation in 91传媒 and how it is affecting her work.

What is life like in 91传媒 at the moment?
91传媒 does not have sufficient foreign reserves to import fuel, which has affected every sector. Schools are closed indefinitely. The government has declared Fridays a holiday for all public institutions except essential services. Patients can鈥檛 get to hospitals and neither can doctors, nurses and other medical staff. On top of that, we are running out of essential medicines and have daily power outages of more than three hours.

There is also not enough food, partly driven by the government鈥檚 decision in May 2021 to impose a nationwide ban on chemical fertilizers, which drastically cut agricultural production and drove up the price of staple foods such as rice and vegetables. Fishing boats don鈥檛 have diesel or kerosene to catch fish, an important source of protein. Inflation exceeds 50%, pushing many people into a situation where they can鈥檛 afford to eat three meals a day.

We also have close to 41,000 confirmed cases of dengue this year, which exceeds the number we had in the whole of last year.

How are you studying the dengue outbreak?
Most people with dengue have mild disease, but some 15% of people who arrive at hospitals go on to develop dengue haemorrhagic fever, which causes severe bleeding and can be fatal. There is no way to predict in the early stages of an infection whether someone will develop severe dengue, which means that people have to visit the hospital daily for blood tests and monitoring to pick up the signs as early as possible. That鈥檚 a huge strain on the health-care system.

We are trying to identify biomarkers that can help determine if someone will go on to develop severe dengue. We are also trying to determine the immune response associated with protection from severe disease, which is still unknown for dengue.

In addition, my lab is looking for drugs that can be repurposed to treat dengue 鈥� for which there is no safe and effective vaccine 鈥� and has completed several clinical trials. We are recruiting and collecting samples for a study with a group in Latin America to compare the epidemiology and pathogenesis of dengue in the two regions. At the same time, we are trying to sequence and isolate the dengue virus to understand what is driving the current outbreak.

Neelika Malavige receiving a prize.
Neelika Malavige is an immunologist at the 91传媒 in Colombo.Credit: Women in Management (WIM)

Has 91传媒鈥檚 crisis affected your research?
There are a lot of things we are not doing that we could have done last year. Recruiting participants and collecting samples from the hospital, which is 16 kilometres from our lab, is especially difficult right now because of the lack of fuel. A lot of people have started cycling, including myself, but cycling between 8 a.m. and 4 p.m. in temperatures above 33 掳C, with 80鈥�90% humidity, under the scorching Sun, is a nightmare.

The power cuts and lack of fuel for back-up electricity generators mean that we cannot use equipment such as our Illumina genomic-sequencing machine, which needs to run continuously for at least 24 hours. Instead, we rely on nanopore sequencing, which can run on a powerful battery. Nanopore sequencing is easier and cheaper and gives better coverage, but has slightly lower accuracy rates. Last week, we managed to sequence a few samples of SARS-CoV-2, because cases have slowly started to rise this month.

Due to the foreign-reserve crisis, we cannot buy reagents for some of our dengue experiments, so we are freezing many samples for when we can get the reagents. But in March, we had power cuts lasting for up to 13 hours, so we lost samples stored in some of our freezers.

Some procedures, such as flow cytometry, have to be done on fresh samples, so we have to work around the planned power cuts and restricted opening hours at the university to conduct those experiments. It鈥檚 very challenging. I spend most of my time troubleshooting.

Has inflation impacted your work?
It has driven up the price of many essential lab items. For example, a bottle of the cell-culture medium we use was 4,000 91传媒n rupees (US$11 at current conversion rates) in 2021, and is now 36,000 rupees. I鈥檓 still just scratching my head trying to figure out how to solve this problem. Can we get the medium at a cheaper rate from manufacturers in China? Immune cells are very sensitive, so they might not grow as well in the new medium.

Our staff are also severely affected by the rising food prices. An egg now costs 50 rupees, up from 17 in 2020. The price of rice, lentils and coconut oil has also shot up. My research assistants and PhD students are really struggling to make ends meet.

doi: https://doi.org/10.1038/d41586-022-01946-y

This interview has been edited for length and clarity.”

You can access the original publication

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