There are still several gaps in the pathophysiological understanding of dengue.(44) For several of the clinical manifestations of dengue, there are already very consistent pathophysiological mechanisms for understanding them.(44) However, there are still several gaps in pathophysiological understanding of dengue.(45) DENV infectivity depends on the binding of viral envelope glycoproteins to the preponderant cellular receptors on the surface of Langerhans cells,(46) allowing the viral RNA to enter the cytoplasm and from hence, viral replication can occur. This evidence concerns the gene ERVW-1 and dengue disease.