For most people who contract it, dengue fever is a relatively mild disease—at least the first time around. For some, however, a subsequent infection by the virus unleashes a vicious and potentially deadly illness. New research from a team based at The Rockefeller University in New York has begun to reveal why certain people are more vulnerable to these dangerous secondary infections. Their latest findings, described online on January 26, 2017 in Science, could lead to better strategies to identify and better treat those most at risk. The article is titled “IgG Antibodies to Dengue Enhanced for FcγRIIIA Binding Determine Disease Severity.” “Patients with severe secondary disease have high levels of a particular type of antibody that triggers a forceful immune response. This distinctive signature did not show up in patients with more mild illness,” says senior author Dr. Jeffrey V. Ravetch, Theresa and Eugene M. Lang Professor and Head of the Leonard Wagner Laboratory of Molecular Genetics and Immunology at The Rockefeller. “Our work sheds new light on the way in which the dengue virus co-opts antibodies produced as a result of the previous infection, using them to inflict more damage the second time around,” Dr. Ravetch adds. Known as “breakbone fever” for the intense aches it causes, dengue is transmitted by mosquitos in the tropics and subtropics. In the more severe form of the disease, which typically occurs among people who have been infected before, patients can develop hemorrhagic fever, which causes them to leak fluid from their blood vessels and bleed abnormally, sometimes from the nose, gums, and under the skin. In extreme cases, people lose so much blood that they develop a critical condition known as shock.
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