Global dengue cases surge worldwide, heightening U.S. risk, according to the Centers for Disease Control and Prevention (CDC) warning.
The rising incidence of the mosquito-borne illness, often linked to the warming global climate, has been observed worldwide. The primary transmitters of the disease, Aedes aegypti and occasionally Aedes albopictus mosquitoes, thrive in warmer and wetter environmental conditions.
Typically, dengue cases in the continental US were relatively uncommon, with most infections occurring in travelers who visited countries where the disease is more prevalent. However, this year, the number of reported dengue cases among travelers to the US has surpassed expectations, with 745 cases recorded up to June 24, according to the CDC.
In 2023, a record-breaking 1,829 travel-associated cases were reported in the US, representing the highest number of travel-associated cases since dengue reporting became mandatory in 2010, according to the CDC. Over the course of the last year, 23 countries witnessed outbreaks, resulting in more than 5 million cases recorded by the World Health Organization and approximately 4,000 deaths in the Americas alone.
Historically, there have been occasional local outbreaks in states with a suitable climate for the mosquito species that transmit dengue, such as Florida, Texas, Hawaii, Arizona, and California. California reported its first locally transmitted case in Pasadena last year.
The recent CDC alert indicates that the global number of infections in 2024 has reached an all-time high. In the Americas, the number of dengue cases has already surpassed the highest recorded figure for a single year, with over 9.7 million people affected, doubling the cases recorded in 2023.
The ongoing public health emergency in Puerto Rico is a direct consequence of the staggering number of dengue cases documented there. Additional areas experiencing frequent dengue transmission include American Samoa, the US Virgin Islands, the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau.
The CDC's alert advises healthcare providers to evaluate patients exhibiting symptoms reminiscent of dengue, particularly those who have recently traveled to regions where the disease is more common.
Symptoms usually onset approximately a week following mosquito bites, although 40 to 80% of infections are asymptomatic, as per the Infectious Disease Society of America (IDSA). Symptoms of dengue can include fever, vomiting, muscle and joint pain, eye pain, headache, nausea, low white blood cell counts, and fever. Recovery typically occurs within about a week.
Warning signs that the dengue may progress to a more serious condition include persistent vomiting, fluid retention, bleeding, enlarged liver, fatigue, and pain in the abdomen. Severe disease can lead to severe bleeding, respiratory distress, and organ failure, with a fatality rate of up to 13% in untreated cases, according to the IDSA.
Infants, pregnant individuals, the elderly, and those with underlying medical conditions are at an increased risk for severe dengue. Treatment primarily involves supportive care, such as the administration of fluids and rest.
No dengue vaccine is currently recommended for travelers or adults. The production of Dengvaxia, the only existing vaccine, was discontinued due to insufficient demand. The public health departments in Puerto Rico will continue to administer the vaccine to children aged 9 to 16 years with a lab-confirmed case who reside in areas with frequent transmission until the vaccine's expiration in 2026.
In April of this year, the CDC initiated an emergency response to address the increasing dengue caseload in the US. This response involved expanding laboratory capacity and partnering with local authorities to bolster surveillance efforts for the disease.
To prevent dengue, make use of insect repellent when outdoors, especially in regions where dengue is prevalent. Wear loose, long-sleeved shirts and trousers. Run air conditioning or use window screens to keep mosquitoes outside.
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The CDC's alert highlights the surge in dengue cases globally, including the significant increase in travel-associated cases in the US, with 1,829 reported in 2023.Due to the increasing number of dengue cases, particularly in the Americas, the CDC advises healthcare providers to be vigilant and evaluate patients exhibiting symptoms reminiscent of the disease, especially those who have recently traveled to regions where dengue is more common.
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