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A few genes from the other three serotypes have been put into the virus to create the “tetravalent” vaccine.

The Philippines’ Food and Drug Administration approved Dengvaxia, tetravalent dengue vaccine, for the prevention of disease caused by all four dengue types in individuals from 9 to 45 years old living in endemic areas.

At this level, clinical investigation conducted in Thailand showed promising data for a tetravalent dengue vaccine.

Other organic compounds which contain tetravalent oxygen are exceedingly active chemically, and there seems to be much to commend this view of the chemical structure of the water molecule.

In many cases it may be connected with basic oxygen, and the salt formation is assumed to involve the passage of divalent into tetravalent oxygen.