However, those who develop significantly low blood pressure may have a fatality rate of up to 26%. The risk of death among children less than five years old is four times greater than among those over the age of 10. Elderly people are also at higher risk of a poor outcome. Epidemiology
Dengue is common in more than 120 countries. In 2013 it caused about 60 million symptomatic infections worldwide, with 18% admitted to hospital and about 13,600 deaths. The worldwide cost of dengue case is estimated US$9 billion. For the decade of the 2000s, 12 countries in Southeast Asia were estimated to have about 3 million infections and 6,000 deaths annually. In 2019 the Philippines declared a national dengue epidemic due to the deaths reaching 622 people that year. It is reported in at least 22 countries in Africa; but is likely present in all of them with 20% of the population at risk. This makes it one of the most common vector-borne diseases worldwide.Infections are most commonly acquired in urban environments. In recent decades, the expansion of villages, towns and cities in the areas in which it is common, and the increased mobility of people has increased the number of epidemics and circulating viruses. Dengue fever, which was once confined to Southeast Asia, has now spread to southern China in East Asia, countries in the Pacific Ocean and the Americas, and might pose a threat to Europe.Rates of dengue increased 30 fold between 1960 and 2010.
Pegaspargase, sold under the brand name Oncaspar, is a medication used in the treatment of acute lymphoblastic leukemia (ALL). Often it is used together with anthracycline, vincristine, and corticosteroids (for example prednisone and dexamethasone). Pegaspargase can be administered either via an intravenous infusion or a intramuscular injection.Known side effects include allergic reactions, coagulopathy, high blood sugar, affected liver function, pancreas inflammation, and blood clots in the brain. There is no data regarding the usage of pegaspargase during pregnancy. Therefor caution should be observed and pegaspargase should only be used during pregnancy when the benefits outweigh the possible risks. Pegaspargase is a modified version of the enzyme asparaginase which has undergone PEGylation. It works by breaking down the amino acid asparagine that are circulating in the bloodstream. The circulating asparagine is essential for the cancer cells to enable growth since they cant produce their own, in contrast to normal cells. The normal cells are therefor less affected by pegaspargase. Pegaspargase was approved for medical use in the United States in 1994. It is on the World Health Organizations List of Essential Medicines. It is made by Sigma-Tau. References
External links
"Pegaspargase". Drug Information Portal. U.S. National Library of Medicine.