As Dengue Spreads Beyond Traditional Hotspots, CDRI Scientist Calls For Multi-Pronged Strategy

As dengue cases continue to rise across India and newer regions begin reporting outbreaks once considered geographically unlikely, scientists working on next-generation dengue therapeutics have warned that the country can no longer rely on seasonal outbreak management alone and must prepare for a long-term public health battle.

Data speaks. India reported more than 2.3 lakh dengue cases and over 300 deaths in 2024, according to official estimates. Experts believe the true burden is likely to be significantly higher because of under-reporting and uneven surveillance.

Globally, the World Health Organization (WHO) estimates that nearly half the world’s population now lives at risk of dengue, with climate change, urbanisation, and expanding mosquito habitats accelerating transmission.

Against this backdrop, Dr. Rahul Shukla, who is leading efforts to develop advanced anti-dengue therapeutics at the Lucknow-based Central Drug Research Institute (CDRI)—one of the labs of the country’s top scientific research institute, the Council of Scientific and Industrial Research (CSIR)—said India urgently requires a “multi-directional approach” combining vector control, vaccines, antiviral drugs, and stronger public health preparedness.

“One approach alone is not going to work for dengue,” Dr. Shukla said in an interaction with The Health Outlook. “Vector control is important, vaccines are important to some extent, antiviral molecules are important, and governments must also remain proactive in controlling outbreaks.” Dr. Shukla, who previously worked at the International Centre for Genetic Engineering and Biotechnology (ICGEB) under noted dengue researcher Dr. Naveen Khanna, is currently leading a team focused on developing targeted antiviral molecules and bispecific monoclonal antibodies against dengue.

The therapeutic approach being explored by the team aims to neutralise multiple viral epitopes while reducing the risk of antibody-dependent enhancement (ADE), a phenomenon believed to contribute to severe dengue during secondary infections.

“We have very good anti-dengue molecules that are well-proven in laboratory settings. At present, we are optimising these molecules for better bioavailability and moving towards the preclinical requirements needed for IND filing,” Dr. Shukla said.

According to him, the team hopes to move lead candidates towards Investigational New Drug (IND) filing within the next two to three years, with possible clinical translation over the following three to five years.

Scientists say dengue remains one of the most difficult viral diseases to tackle because of the presence of four different virus serotypes and the complex immune responses associated with reinfection.

Unlike several viral diseases where prior infection provides long-term protection, dengue reinfection with another serotype can sometimes trigger more severe illness, including haemorrhagic fever and shock syndrome.

India continues to witness recurrent outbreaks during monsoon and post-monsoon seasons, with hospitals frequently reporting severe febrile illness, platelet complications, and intensive care admissions.

Public health experts say changing rainfall patterns, rapid urbanisation, and poor vector control are also expanding mosquito breeding zones into newer areas.

Dr. Shukla warned that dengue is no longer confined to traditionally tropical regions. “Climate change and warming temperatures are changing mosquito ecology. Transmission is now being reported in regions previously considered unsuitable for dengue. Even parts of Europe are increasingly reporting dengue-related concerns,” he said.

At present, dengue treatment remains largely supportive, relying on hydration, monitoring, and early identification of warning signs.

Scientists believe that the development of targeted antiviral therapies could significantly reduce hospital burden, disease severity, and mortality.

Dr. Shukla noted translational research in dengue therapeutics has historically suffered because of limited commercial investment, especially in compounds lacking strong intellectual property potential.

However, he asserted that the current generation of molecules under development offers stronger possibilities for patentability and translational scalability. Funding support for the project has partly come from Blockchain for Impact (BFI), which is supporting the dengue monoclonal antibody initiative with nearly ₹1.6 crore.

Dr. Gaurav Singh, a psychiatrist and CEO at BFI, explained that the initiative was part of a broader effort to strengthen India’s biomedical innovation ecosystem and support diseases that disproportionately affect low- and middle-income countries.

According to Dr. Singh, the dengue project is in keeping with the Government’s vision of 'Go Local'. It reflects the need for India to reduce dependence on imported biomedical technologies and invest more deeply in indigenous scientific capability, he said. “One of the major reasons that dengue continues to be a serious public health challenge is that the disease is becoming more virulent, and it disproportionately affects poorer populations. We also believe India should reduce excessive dependence on Western medical technologies and build indigenous scientific capability,” Dr. Singh said.

He asserted that BFI supports selected scientific projects after evaluating their long-term public health relevance and translational potential.