As the range and severity of dengue grows, so too does the need for more effective methods of prevention, and for a better understanding of the scope and cost of the problem.
There has been an explosive increase in dengue cases in recent years, and strategies to control mosquitoes in highly affected areas are costly, difficult to maintain and have been largely ineffective. Furthermore, no drugs are available to prevent or treat dengue infection while the disease has a substantial economic impact on individuals and society, including lost wages, decreased productivity and costs associated with seeking and obtaining care.
Vector control, currently the primary method in preventing transmission, is expensive, time consuming and not always effective. Unintended consequences, such as reducing herd immunity and thus increasing the risk of massive outbreaks through reintroduction, or causing fewer cases in children but more in adults, have already been seen. However, vector control remains an important piece of controlling dengue and will need to be continued even when a vaccine against dengue is introduced.
Even more concerning is that dengue is greatly under-reported through national routine disease surveillance and reporting systems, even in countries where these systems are considered relatively strong. As it stands, it is estimated that dengue cases are nearly ten times higher than reported. Moreover, an estimated 60 percent of the economic strain caused by dengue is a result of indirect costs — primarily productivity losses affecting households, employers and government.
Better information on the incidence of dengue, on the number of people getting sick, missing work or going to the hospital, is key to understanding both the risk and burden of the disease. It is also key to estimating the cost of dengue illness for a country, and the benefits of vaccination. DVI is working to gather this evidence, through disease burden and cost of illness studies, modeling the impact of immunizations and development of introduction cases, among other projects.