The evolution and adaptation of dengue virus: Basic concepts and public health implications in Indonesia

Virus mutation and evolution are inevitable, including dengue virus (DENV). In fact, for a long time up to the present day, we have been confronted with the continuous evolution of viruses, marked by the emergence of novel viruses in humans with the potential to cause epidemics and pandemics. This review aims to emphasize the fundamental concepts of virus evolution, specifically in DENV, as well as its public health impact in Indonesia. As an RNA virus, DENV continuously evolves in the face of selection pressure, including that of the host immune responses. Observing the evolution of viruses in real-time will make us better prepared to face epidemics caused by DENV. Several studies conducted in Indonesia have demonstrated that a shift in the dominance of circulating serotypes is associated with an increased number of cases, underscoring the importance of population immunity in outbreak dynamics. A major outbreak in Indonesia in 2004 was associated with a shift from DENV-2 to DENV-3. A similar phenomenon was also observed once there was a genotype shift. Additionally, phylogenetic studies indicated an association between particular genotypes and the severity of diseases. In conclusion, these studies clearly demonstrate that viral evolution can have a significant impact on public health. Advanced next-generation sequencing technologies can be utilised to detect subtle genetic changes that may be associated with the onset of epidemics.