Dengue infection in Indonesia: Improved clinical profiling is needed to better inform patient management and disease outbreak control

Dengue is the most frequent arthropod-borne viral disease of humans globally. The vectors of transmission are mosquito species of the genus Aedes, which are common in tropical and subtropical regions, especially metropolitan areas. Dengue imposes a significant economic burden, especially in low-income nations. Infection is often asymptomatic but mild to severe forms exist and the extent of clinical manifestations varies with gender and age. Symptoms of mild infection include fever, rash, muscle and joint pain, yet for a small proportion of individuals antibody-dependent enhancement of infection triggers severe dengue, which can be fatal. In many countries, including Indonesia, the incidence of dengue fever has increased dramatically in recent years but there is still no specific therapeutic treatment or widely accepted vaccine. In an Indonesian context, in order to reduce the escalating rates of morbidity and mortality there is a pressing need to understand in more detail the clinical profile of dengue outbreaks in tertiary hospitals in Jakarta, the capital and most populous city. Such research will enhance patient care and better inform future prevention and control strategies for this emerging public health threat, including improved vector management and effective vaccination programmes, in what is predicted to be within a decade the world’s largest urban agglomeration.