Dengue is spreading fast: Can cutting-edge science outsmart it at last?

The European arm of the programme is funded by the European Union’s HORIZON Research and Innovation Actions, while India’s contribution is supported by the Department of Biotechnology under the Ministry of Science and Technology.

According to Prof Ujjwal Neogi, who leads the global team at Karolinska Institute, Sweden, COMBAT will help strengthen public health infrastructure and surveillance strategies to tackle the growing risk of dengue outbreaks in both endemic and non-endemic regions.

India’s role: Advanced genomics meets clinical expertise

The Indian arm is led by Prof Arindam Maitra, along with Dr Sagar Sengupta and Dr Anup Mazumder from BRIC–National Institute of Biomedical Genomics (NIBMG), Kalyani. The collaboration also includes key scientists and clinicians from the Regional Centre for Biotechnology in Faridabad, the Manipal Institute of Virology in Udupi, Max Hospital in Delhi and Artemis Hospital in Gurugram.

Prof Maitra explains that NIBMG studies how a person’s genes influence their risk of infections and how diseases develop. “Using advanced tools, the team will try to understand why dengue becomes severe in some people by closely studying genes, body responses and biological markers,” he says.

Inside the lab

High-resolution microscopy will allow scientists to observe the virus attacking cells in real time, almost like watching a live film of infection. Artificial intelligence will be integrated into biological pipelines, enabling systems to learn from dengue data and rapidly adapt insights to other emerging pathogens.

Researchers are also developing organ-on-chip models, which recreate miniature versions of human organs to safely study infection without testing on people. Together, these approaches represent a significant leap forward, offering insights that were not possible just a few years ago. Some of these technologies are also expected to be installed in Indian institutes.

Speeding up vaccines

Alongside research efforts, progress in vaccine development is gaining momentum. The Indian Council of Medical Research (ICMR), in collaboration with Panacea Biotec, is currently conducting a Phase III trial of DengiAll, a single-dose recombinant dengue vaccine. “The trial spans 20 sites across 19 states and Union Territories and has enrolled more than 10,300 participants,” says Dr Naveen Kumar, Director of ICMR-NIV (National Institute of Virology) Pune.

At the same time, Takeda’s tetravalent dengue vaccine TAK-003, known as Qdenga, has recently received clearance from the Subject Expert Committee under the Drugs Controller General of India for use in individuals aged 4 to 60 years. “This vaccine represents a significant advancement, showing 84.1 percent efficacy against hospitalized dengue cases and offering protection regardless of prior dengue exposure — an advantage over earlier vaccines that required pre-screening,” says Prof Neogi.

With approval already granted in more than 40 countries and over 10 million doses distributed since 2023, the vaccine demonstrates how strong real-world feasibility could play a crucial role in India’s dengue control strategy.

In parallel, ICMR-NIV Pune is working on antiviral candidates for dengue and chikungunya, including repurposed drugs, plant-derived compounds and siRNA-based therapies, some of which have advanced to preclinical stages. The institute has also developed multiple diagnostic tools, including point-of-care tests that are available for licensing.

Why dengue vaccines are so hard to develop

Despite these advances, developing an effective dengue vaccine remains a complex challenge. One of the biggest obstacles is antibody-dependent enhancement, a phenomenon in which antibodies from a previous dengue infection can actually worsen disease severity if a person is later infected with a different strain.

This challenge is compounded by the existence of four distinct dengue serotypes, all of which circulate widely. A successful vaccine must provide balanced and long-lasting protection against all four simultaneously.

Adding to the complexity is the immune system’s tendency to prioritise responses to the first strain it encounters. Together, these factors make vaccine design particularly difficult, as any imbalance in immune response could increase the risk of severe disease during subsequent infections. “These immunological barriers demand that vaccines induce equal levels of long-lasting immunity against all four serotypes. The COMBAT project addresses these fundamental challenges by focusing on understanding dengue’s underlying disease mechanisms and host-virus interactions, generating crucial insights that can directly inform and improve future vaccine development strategies,” says Prof Neogi.

Dengue incidence has increased dramatically worldwide over the past two decades, with reported cases rising from around 505,000 in 2000 to 14.6 million in 2024. A global temperature rise of approximately 0.9 degrees Celsius over the past 20 years has expanded the habitat of Aedes mosquitoes into higher latitudes. At the same time, environmental factors such as temperature, rainfall and humidity continue to influence transmission patterns, often with predictable time lags of two to five months. Projections suggest cases could rise by as much as 60 percent by mid-century as more regions become suitable for mosquito transmission.