Individuals who develop a second dengue infection are at an increased risk of developing severe dengue due to the risk of antibody-dependent enhancement (ADE). In dengue, antibodies present in the body from the first infection will bind to the infectious dengue virus from the second infection from a different serotype. These antibodies, however, are not capable of neutralizing the virus but instead cause it to become more infectious. Only about five percent of dengue infections result in severe disease.
Adults, especially older adults, may be at risk for severe disease and death from dengue infection. Age-specific rates of severe dengue, COVID-19, and influenza are reported to be similar, however, death rates and case fatality ratios from dengue are significantly lower than both influenza and COVID-19.
When more than one dengue serotype is circulating within a community (hyperendemic dengue), children are more affected than adults and experience higher rates of dengue hemorrhagic fever.
Women who develop dengue during pregnancy may be at a higher risk for complications that include miscarriage, decreased amnionic fluid for gestational age later in pregnancy, thrombocytopenia, and postpartum hemorrhage. Babies born to dengue infected mothers may be at an increased risk for low birth weight, pre-term births, stillbirths, and intrauterine growth restriction.
IMPORTANT NOTE: NVIC encourages you to become fully informed about Dengue and the Dengue vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.
