Dengue fever: the souvenir that keeps on giving
ImmunoWars
Making health sciences accessible & sexy through gaming innovations and science communication.
Author: Liliana Sánchez Rocha
Read time: 6 minutes
You come back home after a delightful holiday in a tropical paradise. Soon after, a headache strikes, it must be the lack of margaritas you tell yourself. But as days go by, the fire in your head spreads to the rest of your body, making you feel as if a tractor ran over you. Then, without warning, blood begins to drip uncontrollably from your nose while it also escapes from around your teeth. The metallic taste makes you vomit and even there is more blood. You are in danger! Unaware you brought back a souvenir called dengue fever; a viral infection transmitted by a mosquito’s bite. But wait, this is not your first encounter. You fought and beat it before; shouldn’t you be protected now? Well… a family member of this virus has come back for revenge!
What is dengue fever?
Dengue fever (DF) is a viral infection caused?not by a single villain, but by four! These four viruses belong to the troublemaking Flaviviridae family. Although pretty similar they are still different, which gives them the upper hand in this immune war. Think about them as your favorite ice cream ball, all four of?the same flavor, yet with a unique touch and each one with a different delicious coating. One might be chocolate chips, the other mixed nuts, and so on, but they will always share traces of each other’s coatings. Each of these dengue viruses (DENV, 1 to 4) can independently and silently hijack your immune system at DIFFERENT times in your life, But hey! What it doesn’t kill you makes you stronger, right?? Wrong! With dengue what didn’t kill you might try harder a second time! These masters of disguise might just succeed.
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How is dengue fever transmitted?
The Flaviviridae family has found mosquitos as a very effective and comfy way to reach its victims. Do all mosquitos carry dengue? Luckily not, mainly Aedes aegypti and Aedes albopictus, these tropical and subtropical residents are enough to infect up to 400 million people each year, more than all people living in all of North America! To spread the fever, the female mosquito uses the hours of the day to drink blood from any easy target. This precious beverage is needed for egg production, the more blood the more eggs. When the mosquito quenches her thirst for blood on someone with an active dengue infection (lots of viruses in the blood), it slurps the scrumptious virus smoothie, Yummy! Then, it takes about a week for the DENV (any of the four) to settle into the salivary glands of the mosquito, the perfect headquarters from where new viruses will be launched to new victims in every mosquito’s bite, for the rest of its life. But wait! The virus also infects the eggs, so the offspring hatch armed and dangerous, ready to turn a sunny day into a dengue nightmare.?
What does it do in your body?
When the virus is injected into the skin by the mosquito, DENV1 (in this example), it holds tight to the immune cells that form part of the skin’s first line of defense. As if the chocolate coating were a secret key, it unlocks the gate into the insides of the cell. Leading to a viral invasion where the cell is turned into a virus factory. The cell under attack will send SOS alarms to its neighboring buddies, and in no time, your immune army rushes to the rescue. As a result, your body will create antibodies SPECIFICALLY against this DENV1 and its chocolate chip coating. Antibodies (AB) are one of our most potent defenses, these mini-particles act like handcuffs that latch onto the intruders and drag them off to be digested inside the macrophages’ belly. AB can also signal to complementary troops to unleash destruction on anything they are attached to, no doubt, they are our secret weapon! So, chances are you’ll win this first encounter, with or without symptoms. Then… you might wonder, what’s the big deal? Well, a second infection with DENV2 (or 3 or 4) is the big deal. It’ll be like fighting off a new supervillain who knows all your dirty little secrets.?
The antibodies produced against the DENV1 chocolate chips will kind of recognize the few choco chips on DENV2 and cling to them, but it won’t be a perfect match and the grip will be very weak. Plus, there are fewer choco chips to hold onto since DENV2’s coating is mostly nuts; it will be like putting handcuffs in just one hand! DENV2 takes advantage of this confusion and gets VIP entrance to macrophages, where it avoids digestion and subjects the cell to slavery. Meanwhile, AB signals the “complement troops” to open fire against DENV2, but this slips away easily in the middle of the attack. The immune alarms go wild, your body knows it has to destroy something, but it cannot get a hold of it! The frantic immune signals together with the virus particles will end up opening the gates of the blood vessels to let more soldiers enter the war zone. The signals are so intense that not only do immune cells escape the bloodstream, but the blood itself and its contents leak out. Without suspecting, you will be internally bleeding! Oxygen, liquid, and energy will be lost while you get weaker and weaker. You are at risk of dying if you don’t scream for help! Those antibodies that promised to protect you for life against one type of virus, can be mortal if you catch another member of “La famiglia”.
Dengue fever symptoms
You know now that the first infection is controlled and might go unnoticed, but 20% of cases can experience severe headaches, fever, rashes, nausea, pain behind the eyes, vomiting, muscle and joint pain. Most people will recover after 1-2 weeks. But 1 in 20 patients can develop severe symptoms and add acute abdominal pain and bleeding to the list, increasing chances of death. Just in 2023, dengue killed 5,500 people worldwide and research suggests that the second infection is responsible for this aggressive form.
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Dengue Fever treatment and prevention
Drink lots of water! Take some painkillers but remain far away from aspirin or ibuprofen as these can increase the risk of bleeding. In unlucky severe cases you need immediate hospitalization, Hurry! The production of an effective vaccine remains a challenge due to the DENV's multiple personalities, thus prevention is focused on controlling the mosquito. Planning holidays to these warm destinations? then use mosquito nets, repellents, and protective clothing, and eliminate any source of open water where mosquitos might lay eggs. Although Aedes aegypti live in tropical climates, global warming is broadening the horizons of these mosquitos, will they take over the world?
Gameplay Guide: Attack with Dengue in ImmunoWars
Want to annoy your opponent like a buzzing mosquito in the middle of the night? Try this card! You’ve got two sneaky options depending on your ATP budget. For just 3 ATP, you can give your rival some serious rashes and itches, making them lose 3 health points (HP) for 1 round. But if you’re feeling extra devious, spend 7 ATP and watch them roll the dice of doom! They might lose 2 HP per turn for 2 turns, or even enter in “shock syndrome” and lose a whopping 4 HP per round for 2 turns. The best part? This card has 0 contagiousness (check the biohazard circles in the bottom left corner), so you can keep attacking without risking co-infection! Is it worth the gamble?
Now, how to counterattack? Dengue has a severity of 3 stars (see the bottom right corner), making it tough to beat. You’ll need a Consumable or an Immunocard that can handle a 3-star virus. Options are slim! If you’re really desperate, you could always take a bleach shot—but beware, it’ll cost you big time! Ready to make your opponent itch and squirm? Get ImmunoWars here.
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