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Joan Stephenson, PhD

JAMA. 2003;290:184.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Dengue virus has long presented scientists with a puzzle: an individual who is infected with one of the four subtypes of the virus often has a more severe illness—dengue hemorrhagic fever—the second time around. Now, scientists from England and Thailand, whose findings were published June 15 in the online edition of Nature Medicine (http://www.nature.com/nm/), believe they have discovered why this occurs.

Studying dengue virus-specific responses in Thai children, the researchers found that the immune cells of volunteers with dengue fever mobilized primarily against previously encountered strains, but had weak affinity for the strain causing the current attack. Not only were the immune cells ineffectual against the new dengue virus strain, possibly causing a delay in clearing the virus, but activation and death of immune cells could exacerbate the illness.

The discovery suggests that the phenomenon also may present a barrier to vaccine development, because a . . . [Full Text of this Article]