November 29, 2015
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Dengue Fever (cont.)

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What geographic areas are at high risk for contracting dengue fever?

Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred recently in the Caribbean, including Puerto Rico, the U.S. Virgin Islands, Cuba, and Central America. Cases have also been imported via tourists returning from areas with widespread dengue, including Tahiti, Singapore, the South Pacific, including the Philippines, Southeast Asia, the West Indies, India, and the Middle East (similar in distribution to the areas of the world that harbor malaria and yellow fever). Dengue is now the leading cause of acute febrile illness in U.S. travelers returning from the Caribbean, South America, and Asia.

As of Nov. 18, 2015, there were 72 confirmed cases of dengue fever in an outbreak in Hawaii. Dengue is not native to Hawaii, and this is the first outbreak of dengue there since 2011.

New Delhi, India, reported an outbreak of dengue fever, with 1,872 testing positive for the illness as of September 2015. In American Samoa, there were 370 cases of dengue reported from May 2015 to Sept. 2, 2015; 133 people were hospitalized.

In 2015, two nonnative species of mosquito were found in California, including the Aedes aegypti mosquito, which can transmit dengue. No cases of dengue have been reported yet.

Thailand reported the worst dengue outbreak in 20 years, with 126 deaths and 135,344 people infected with the virus, in October 2013.

Picture of dengue fever distribution map
Picture of dengue fever distribution map

In 2011, Bolivia, Brazil, Columbia, Costa Rica, El Salvador, Honduras, Mexico, Peru, Puerto Rico, and Venezuela reported a large number of dengue cases. Paraguay reported a dengue fever outbreak in 2011, the worst since 2007. Hospitals were overcrowded, and patients had elective surgeries canceled due to the outbreak.

The U.S. Centers for Disease Control and Prevention (CDC) reports that from 1946-1980 no cases of dengue acquired in the continental United States were reported. Since 1980, a few locally acquired U.S. cases have been confirmed along the Texas-Mexico border, temporally associated with large outbreaks in neighboring Mexican cities.

A 2009 outbreak of dengue fever in the Florida town of Key West involved three patients who did not travel outside of the U.S. Subsequent testing of the population of Key West has shown that up to 5% of the people living in the area have antibodies to dengue. In total, 28 people were diagnosed with dengue fever in this outbreak. In 2001, 122 people in Hawaii were diagnosed with dengue.

Dengue fever is common in at least 100 countries in Asia, the Pacific, the Americas, Africa, and the Caribbean. Thailand, Vietnam, Singapore, and Malaysia have all reported an increase in cases.

According to the CDC, there are an estimated 400 million cases of dengue fever with several hundred thousand cases of dengue hemorrhagic fever requiring hospitalization each year. Nearly 40% of the world's population lives in an area endemic with dengue. The World Health Organization (WHO) estimates 22,000 deaths occur yearly, mostly among children.

Medically Reviewed by a Doctor on 11/18/2015


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