The prophylactic arm is harder as you can give the vaccine but the person may not get bitten by dengue infected mosquito for a long time - for this FDA may suggest wider number of healthy volunteers as you have suggested. For the therapeutic arm, given the prevalence number in the millions it is possible to recruit 20k patients, the cost and duration of such trials can be about a year but quite expensive for us to fund without a partner providing upfront payment.
JIMHO. No advice.
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