Lethal dengue virus infection: a forensic overview

Abstract

Dengue virus is a single-stranded RNA virus that is a member of the family Flaviviridae, genus Flavivirus. It is usually transmitted by the female Aedes aegypti mosquito. Dengue fever is a febrile illness caused by 1 of 4 serotypes of the virus, which may progress to dengue hemorrhagic fever or dengue shock syndrome. The mortality rate of untreated dengue shock syndrome is more than 20%. The reported incidence has increased 30-fold for the past 50 years with an estimated 50 to 100 million dengue infections globally each year, which includes 22,000 deaths. Because of this rapid increase in numbers, more cases will be seen in forensic mortuaries, with diagnostic problems arising from nonspecific or unusual manifestations. In this review, the clinicopathological features of dengue viral infection are evaluated. Adequate blood and tissue sampling at the time of autopsy is mandatory for successful microbiological identification and characterization.