Locally Transmitted Dengue Fever in Iran: A Growing Concern

Dengue virus (DENV) belongs to the Flaviviridae family, which includes over 70 major human pathogens, primarily affecting inter-tropical regions where 3.9 billion people reside (1).It is an arboviral disease mainly transmitted to humans by the bite of mosquitoes from the Aedes genus, particularly Aedes (Stegomyia) aegypti (Linnaeus, 1762), and less frequently by Aedes (Stegomyia) albopictus (Skuse) (2).Dengue virus has four serotypes: DENV-1, DENV-2, DENV-3, and DENV-4, all of which can infect humans (3).Primary DENV infection may be asymptomatic or result in mild fever, but if it progresses, it can cause coagulopathy, increased vascular fragility, and permeability, leading to dengue hemorrhagic fever (DHF).This condition can further develop into hypovolemic shock, known as dengue shock syndrome (DSS), both of which are lifethreatening (4).Most dengue fever (DF) cases are selflimiting with low mortality (< 1%) when treated early with appropriate medical care.However, some patients develop severe conditions like DHF or DSS, with a mortality rate of 2% -5% after treatment; without treatment, the mortality rate can rise to 20% (5, 6).Epidemiological surveys indicate that DENV infects approximately two-fifths of the world's population, with nearly 390 million infections annually, leading to 500,000 hospitalizations and 20,000 deaths.DENV is prevalent in regions such as the Eastern Mediterranean, Southeast Asia, Africa, the Western Pacific, and South America (7).Approximately 2.5 billion people are at risk of contracting dengue, with 100 million reported cases of dengue fever each year, and up to 500,000 cases developing into potentially fatal DHF or DSS.Around 80% of primary DENV infections are asymptomatic, with fewer than 20% of infected individuals showing clinical symptoms.Dengue fever is