Health officials are warning of an increased risk of dengue virus infections in the U.S. and are asking health care providers to watch for possible cases.
Dengue cases globally are the highest on record this year, according to a new Centers for Disease Control and Prevention (CDC) health advisory. There have been 9.7 million dengue cases in the Americas this year, more than double all last year. In the U.S., there have been 2,241 cases, including 1,498 in Puerto Rico, which declared a public health emergency in March.
Dengue is transmitted by Aedes mosquitos and is the world’s most common arboviral disease with up to 400 million infections annually. In the U.S., it is mostly seen in territories and freely associated states. However, there also have been small outbreaks in Florida, Hawaii and Texas, and local transmission has been reported in Arizona and California in the past two years.
Dengue symptoms include fever, nausea, vomiting, rash, muscle aches, joint pain, bone pain, pain behind the eyes, headache or low white blood cell counts. Signs of severe dengue can include abdominal pain; persistent vomiting; bleeding from the nose or gums; vomiting blood or blood in the stool; and feeling extremely tired or restless.
The CDC is expanding its laboratory capacity and strengthening surveillance in light of the high case counts. It recommends health care providers take the following steps.
- Have increased suspicion of dengue among people with fever who have been in areas with frequent or continuous dengue transmission within 14 days before illness onset.
- Consider locally acquired dengue among patients with symptoms in areas with Aedes mosquitoes.
- Order appropriate diagnostic tests for acute dengue infection and do not delay treatment while waiting for test results.
- Educate yourself and your patients about symptoms and warning signs for progression to severe dengue.
- Hospitalize patients with severe dengue or any warning sign of progression to severe disease and follow protocols for IV fluid management.
- Ensure timely reporting of dengue cases to public health authorities.
- Promote mosquito bite prevention measures among people living in or visiting areas with frequent or continuous dengue transmission.
Children ages 9-16 years living in an area where dengue is endemic and who have had a previous dengue infection can be vaccinated with Dengvaxia vaccine, which is safe and effective. While it is being discontinued due to low demand, it will continue to be available until doses expire in 2026. No vaccines are recommended for travelers, adults or people without a previous dengue infection.
People can protect themselves from dengue by using mosquito repellents approved by the Environmental Protection Agency; wearing loose-fitting, long-sleeved pants and shirts; using air conditioning and window screens; dumping and draining containers holding water; and seeking medical care if they have symptoms.
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