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DENGUEThe case of VEE, the evolution of which has been moulded by human environmental encroachment, parallels in some ways the emergence of dengue as a major cause of morbidity and mortality internationally.Dengue is a flavivirus spread amongst humans by Aedes aegypti mosquitoes. The WHO estimate that there are fifty million dengue infections per year across one hundred countrieswith a case fatality rate of five percent. Most of these deaths are due to dengue haemorrhagic fever (DHF), which occurs when a previously-exposed individual is subsequently re-infected with a different strain of the virus.Most infections are characterised by a short, one week, incubation period followed by high fevers, severe malaise, headache, sore throat, abdominal pain and diarrhoea with theselatter symptoms most prominent in children. The illness usually lasts (DURAR) for about one week and cases are viraemic (infectious to mosquitoes) for between two and seven days.Genetic analyses suggest that the agent, which exists as four serotypes (DENV 1-4), first appeared only about 1000 years ago and its emergence probably coincides with the human population reaching a sufficient thresholddensity to maintain transmission of the virus. 25Before emerging in the human population dengue existed in a sylvatic cycle as an infection of non-human primates transmitted by Aedes stegomia mosquitoes. Humans were only incidental hosts infected when venturing through dengue-infected areas. 26But the growth of human populations, the development of cities and human encroachmentinto virgin rainforestled to increased exposure and a greater risk of transmission of the agent to local people. At the same time urbanisation attracted novel mosquito species including the anthropophilic vector Aedes aegypti. This mosquito bites several times per day, rendering nets ineffective as a mechanism of disease prevention. It also thrives in stagnant water collecting in refuse and old tyres.Consequentlydengue moved into an “urban cycle”, adapting to exploit Aedes aegypti as a vector and humans as the main host. As a result the range of dengue is now expanding and the virus is also increasingly utilising other secondary vectors such as Aedes albopictus, which inhabit additional geographies not colonised by Aedes aegypti. 27Methods to mitigate the spread of dengue include vector control with spraysand education about careful handling of refuse to minimise breeding opportunities for mosquitoes. Tyres are a particular problem because no matter which way they are stacked they can always act as water receptacles. Stocking water-storage tanks and reservoirs with mosquito-larvae-consuming fish and small crustaceans have also been successful. At present there is no vaccine against the disease,although two candidate agents are currently undergoing trials in dengue-endemic areas, including a tetravalent agent developed by Sanofi Pasteur which has just entered clinical efficacy trials in Thailand. 28 | DENGUE El caso de Encefalitis Equina Venezolana (EEV), la evolución de la cual ha sido moldeada mediante la ocupación humana del medio ambiente, equivalentes en algunas formas de manifestacióndel dengue como las mayores causas de morbilidad y mortalidad mundial.El dengue es un flavivirus que se propaga entre los seres humanos por el mosquito Aedes Aegypti. La OMS estima que hay cerca de cincuenta millones de infecciones de dengue cada año a través de un centenar de países, con una tasa de letalidad del cinco por ciento. La mayoría de estas muertes se deben al dengue hemorrágico (DHF),que ocurre cuando una persona previamente expuesta al virus, es re-infectada posteriormente con una cepa diferente del virus.La mayoría de las infecciones son caracterizadas por un período de incubación corto, alrededor de una semana, seguido por fiebre alta, malestar general, dolor de cabeza, dolor de garganta, dolor abdominal y diarrea, estos últimos, más prominentes en los niños. La...