Dengue virus Agent Information Sheet
Boston University
Research Occupational Health Program (ROHP)
617-358-7647
Agent
Dengue virus is a flavivirus and has a spherical enveloped virion 40-50 nm in diameter with single-stranded, positive sense RNA surrounded by an icosahedral nucleo capsid. It is the most prevalent mosquito-borne viral illness. It is also referred to as break bone fever. The dengue virus can infect non-human primates.
Disease/Infection
Dengue fever, Dengue hemorrhagic fever, “break bone fever”. In some adults, infection can be asymptomatic.
Pathogenicity
Can cause self-limited to fatal disease.
Special Populations at Risk
Severity increased in elderly, infants, and prior Dengue infection.
Biosafety Information
Risk Group/BSL
Risk group 2
Biosafety level: BSL2/ABSL2
Modes of Transmission
| Transmission | |
| Skin Exposure (Needlestick, bite, or scratch): | Accidental parenteral inoculation, direct or indirect contact with broken skin |
| Mucous Membrane Splash to Eye(s), Nose or Mouth: | Direct or indirect contact with mucous membranes |
| Inhalation: | Not reported |
| Ingestion: | No |
Host Range/Reservoir
Humans, mosquitoes (as a vector, Aedes spp., Stegomyia spp.) and non-human primates
Symptoms
Symptoms of Dengue fever include: sudden onset of fever for 3-5 days, intense headache, myalgia, arthralgia, retro-orbital pain, anorexia and rash. In patients with hemorrhagic dengue fever, shock, thrombocytopenia and spontaneous bleeding may occur. In rare cases, liver failure or neurological manifestations such as seizure, lethargy and coma may occur.
Incubation Period
Incubation period of 3 to 14 days; usually 4 to 7 days
Viability
Susceptible to common disinfectants; 70% ethanol, 1% sodium hypochlorite, 2% glutaraldehyde, along with formaldehyde and formalin.
Survival Outside Host
Virus stable in dried blood and exudates up to several days at room temperature
Information for Lab Workers
Laboratory PPE
Personal protective equipment includes but is not limited to safety glasses when there is a splash risk, laboratory coats or gowns and disposable gloves.
Containment
Research should be conducted using Biosafety Level 2 practices, equipment, and facility design. Gloves should be worn when handling infected laboratory animals and when there is the likelihood of direct skin contact with infectious materials. Animal studies may be performed at ABSL-2.
In Case of Exposure/Disease
- For injuries in the lab which are major medical emergencies (heart attacks, seizures, etc…):
- Medical Campus: call or have a coworker call the Control Center at 617-414–4144.
- Charles River Campus: call or have a coworker call campus security at 617-353-2121.
You will be referred to or transported to the appropriate health care location by the emergency response team.
- For lab exposures (needle sticks, bite, cut, scratch, splash, etc…) involving animals or infectious agents, or for unexplained symptoms or illness call the ROHP 24/7 hour number (1-617-358-ROHP (7647); or, 8-ROHP (7647) if calling from an on-campus location) to be connected with the BU Research Occupational Health Program (ROHP) medical officer. ROHP will refer you to the appropriate health care location.
- Under any of these scenarios, always inform the physician of your work in the laboratory and the agent(s) that you work with.
- Provide the wallet-size agent ID card to the physician.
Vaccination
None available.
Information for First Responders/Medical Personnel
Public Health Issues
Not directly transmitted from person-to-person. Standard precautions should be used.
Diagnosis/Surveillance
Monitor for symptoms. Infection with Dengue virus can be confirmed serologically and by isolating the virus via PCR in plasma or serum.
First Aid/Post Exposure Prophylaxis
Perform one of the following actions:
| Skin Exposure (Needlestick or scratch): | Immediately go to the sink and thoroughly wash the wound with soap and water for 15 minutes. Decontaminate any exposed skin surfaces with an antiseptic scrub solution. |
| Mucous Membrane Splash to Eye(s), Nose or Mouth: | Exposure should be irrigated vigorously. |
| Splash Affecting Garments: | Remove garments that may have become soiled or contaminated and place them in a double red plastic bag. |
Treatment
There is no specific medication for treatment of a dengue infection. Laboratory personnel who have been exposed to dengue virus should be asked to monitor for symptoms and use pain relievers with acetaminophen and avoid those containing aspirin or other non-steroidal analgesics. They should also rest, drink plenty of fluids, and consult a physician. If they feel worse (e.g., develop vomiting and severe abdominal pain) in the first 24 hours after the fever declines, they should go immediately to the hospital for evaluation. Immediate care of those with severe disease would include fluid resuscitation and supportive management of associated symptoms.
References
Britton S, van den Hurk AF, Simmons RJ, Pyke AT, Northill JA, McCarthy J, McCormack J. Laboratory-acquired dengue virus infection–a case report. PLoS Negl Trop Dis. 2011 Nov;5(11):e1324.
CDC. Dengue http://www.cdc.gov/dengue
Chen LH. Wilson ME. Transmission of Dengue Virus without a Mosquito Vector: Nosocomial Mucocutaneous Transmission and Other Routes of Transmission. CID., 2004;39:e56-e60.
Kuno G. Dengue Transmission without Involvement of Mosquito Vector. CID, 2005;40:774-5.
Lee C, Jang EJ, Kwon D, Choi H, Park JW, Bae GR. Laboratory-acquired dengue virus infection by needlestick injury: a case report, South Korea, 2014. Ann Occup Environ Med. 2016;28:16.
Public Health Agency of Canada; http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/msds50e-eng.php