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Dengue is a viral infection with no therapy or effective vaccine, and a minority of patients go on to develop severe disease. To better control the infection, the dengue group at OUCRU is working to understand its biological mechanisms, targeting it with different therapies, and using innovative technology to monitor patients and predict which will develop severe disease.

My name is Dr Sophie Yacoub and I am the head of dengue research at the Oxford University Clinical Research Unit in Vietnam. My area of research is on dengue. Dengue is a viral infection that is spread by mosquitoes, Aedes mosquitoes which are day-biting mosquitoes. Dengue causes a self-limiting viral infection where people have a high fever and feel like body aches and headaches for about seven days. Most people recover but a minority can go on to get severe disease which can be life-threatening.

To improve clinical outcomes in dengue, first of all we need to identify patients earlier who are at higher risk of developing severe disease, also to be able to monitor patients more closely, and developing potential therapeutics, because there are currently no drugs to treat dengue with. An exciting area of research that is just starting in OUCRU is using innovative technology to monitor patients with dengue and predict those who would go on to severe disease. We are using innovative bio-engineering devices working with groups in Imperial College London, King’s College London and Oxford University to develop wearable devices and then use the information from those to support clinical decisions, support systems, and see if we can improve on how we can predict patients who would go on to get severe disease.

There have been a number of important discoveries in the past five to ten years. Some include understanding the immunology underlying why some patients get severe disease. And also improving vaccines: we have one vaccine that is licenced for dengue, however that is only effective in patients who have already seen one of the dengue serotypes of which there are four; there are different vaccines in the pipeline. Also, there is a quite exciting area of research that is being done by the World Mosquito Program using Wolbachia, which is a bacterium that infects insects, and when you put it into the Aedes mosquito, it can block dengue viral transmission; that’s quite an exciting area of research. And also the innovative technologies that we are developing in OUCRU, I think will be an exciting area for the next five years.

The area of research matters not only for Vietnam but also globally, dengue is continuing to expand across the globe. There about 100 million infections a year around the world and this is increasing. It’s predicted that with climate change, even more countries can become endemic. So, it is a huge problem for public health systems around the world not only in Southeast Asia but also globally. I think it is important to invest in this area of research, because currently we don’t have any particular therapies or an effective vaccine. And there is a huge gap in how we can actually make things better for patients with dengue and control the infection.

All the work that we do in the dengue group at OUCRU is translational: from understanding the biological mechanisms of severe disease, and then targeting that using different therapies, and also some of the innovative technology that I mentioned using what we know from bio-engineering and other areas of medicine and applying that to dengue, which is in effect a neglected tropical disease. All the work we do is very much translatable.

This interview was recorded in September 2019

Sophie Yacoub

Sophie Yacoub leads the Dengue Research Group at OUCRU. While most dengue clinical cases resolve spontaneously, a proportion will develop severe manifestations. Clinical research at OUCRU focusses on pathogenesis and immunology studies, cardiovascular monitoring and fluid management trials, and innovations using smart devices for risk prediction.

Translational Medicine

From bench to bedside

Ultimately, medical research must translate into improved treatments for patients. At the Nuffield Department of Medicine, our researchers collaborate to develop better health care, improved quality of life, and enhanced preventative measures for all patients. Our findings in the laboratory are translated into changes in clinical practice, from bench to bedside.