Acute dengue virus infection

Hypothetical schema of events in acute dengue virus infection. The kinetics and general location of viral replication are diagrammed in relation to the presence of detectable viremia, general symptoms (fever, myalgias, headache, rash), and the period of risk for plasma leakage, shock, severe thrombocytopenia, and bleeding in dengue hemorrhagic fever (DHF). Nonspecific immune responses include the production of interferons (IFN) and natural killer (NK) cell activity. The kinetics of dengue virus-specific T lymphocyte activation and the production of dengue virus-specific antibodies occur later and are of lesser magnitude in primary infections (first exposure to dengue viruses) than in secondary infections (later infection with a second dengue virus serotype).