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Global Incidence and Outbreaks
Dengue is the most common arboviral disease globally, caused by four distinct but closely related dengue viruses (DENV-1, -2, -3, and -4). In 2024, the global incidence of dengue has reached record levels, with over 10 million cases reported in the Americas from January to July 2024 [1, 4].
Transmission and Endemic Areas
Dengue is transmitted by the bites of infected Aedes species mosquitoes. The disease is endemic in six US territories and freely associated states, including Puerto Rico, American Samoa, US Virgin Islands, the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau. Locally acquired dengue cases have been detected in Florida, Texas, Hawaii, Arizona, and California in recent years.
Symptoms and Diagnosis
Common symptoms include fever, myalgias/arthralgias, retroorbital pain, nausea/vomiting, and rash. Patients with suspected DENV infection should be tested with both molecular (RT-PCR) and serologic diagnostic tests. Laboratory testing is most sensitive when performed within the first 7 days of illness.
Severe Dengue and Warning Signs
Severe dengue can develop in 1 in 20 people with symptomatic dengue and can lead to shock within hours [1, 3]. Warning signs of severe dengue include intense abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation, mucosal bleeding, lethargy or restlessness, liver enlargement, and hemoconcentration [1, 3].
People at higher risk for severe disease include pregnant individuals, infants under 1 year, adults aged 65 years or older, and those with underlying conditions such as diabetes, asthma, hypertension, chronic kidney disease, chronic liver disease, peptic ulcer disease, and obesity.
Management and Prevention
There is no specific treatment for dengue; management focuses on treating pain symptoms with acetaminophen (paracetamol) and avoiding non-steroidal anti-inflammatory drugs like ibuprofen and aspirin.
Prevention measures include avoiding mosquito bites, especially during the day, and promoting mosquito bite prevention measures during and after travel to dengue-endemic areas [1, 3]. Healthcare providers should be prepared to recognize, diagnose, manage, and report dengue cases, especially in areas with high transmission rates.
Frequently Asked Questions
What is dengue fever?
Dengue fever is an illness caused by the dengue virus, transmitted to humans through the bites of infected mosquitoes, particularly the Aedes species.
How is dengue diagnosed?
Dengue is diagnosed using molecular (RT-PCR) and serologic tests. Timely laboratory testing, within the first 7 days of illness, is crucial for accurate diagnosis.
What are the symptoms of dengue?
Common symptoms include fever, muscle and joint pain, pain behind the eyes, nausea, vomiting, and rash. Severe cases may present with abdominal pain, persistent vomiting, and clinical fluid accumulation.
Is there a treatment for dengue?
There is no specific treatment for dengue. Symptom management with acetaminophen is recommended, avoiding NSAIDs like ibuprofen and aspirin.
How can I prevent dengue?
Prevention involves avoiding mosquito bites through the use of repellents, wearing long-sleeved clothing, and staying in areas with good mosquito control. Travelers to endemic regions should take extra precautions.
Conclusion
Dengue fever remains a significant global health concern. Awareness, early detection, and proper management are crucial to mitigate the impact of this disease. With record levels of dengue cases in 2024, it is essential for both the public and healthcare providers to stay informed and vigilant.
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