Dengue has always been a low-incidence disease in the United States, which is why it is surprising that infections have tripled in 2024. The Centers for Disease Control and Prevention (CDC) reported 1,496 dengue infections in so far this year, acquired locally in three jurisdictions: Florida, the US Virgin Islands and Puerto Rico.
The situation in North America is not decontextualized because the increase in cases has occurred globally. The World Health Organization declared the emergency last December, and Puerto Rico declared the epidemic in March. However, authorities reported that many of the infections are imported, that is, they were contracted by travelers abroad. The CDC on Tuesday warned doctors to remain alert to the virus, symptoms and places patients have recently traveled to consider testing when necessary. “The global incidence of dengue in 2024 has been the highest recorded,” the institution stated in a statement, adding that in the same period the countries of the Americas have registered more than 9.7 million cases, double the 4.6 million reported last year.
In 2023, cases in the United States were around 3,000, well below the global average but the highest in a decade, with more infections caused by native mosquitoes. The three states with the highest number of cases were Florida, Texas and California.
Dengue and its complications
Dengue is a virus spread by a type of mosquito that lives in tropical or subtropical climates and is expanding its geographic range due to climate change, according to experts. CDC data indicates that one in four infected people will become ill with symptoms ranging from mild to moderate. Only one in 20 people will develop a serious illness, which can cause cramps, internal bleeding and even death.
There are four types of dengue, known simply as 1, 2, 3 and 4. When someone is first infected, their body creates antibodies against that specific virus, but if the person catches another type of dengue, they have no immunity. This is the issue that is of most concern in areas like Puerto Rico, which has registered a high incidence of dengue type 1 in the last 20 years. “We are currently seeing an increase in cases of dengue 2 and dengue 3, for which the population has very little immunity,” stated Dr. Gabriela Paz-Bailey, head of the CDC’s dengue section in Puerto Rico. Last month, the island recorded its first dengue death of the year.
Dengue vaccines
In 2021, U.S. authorities recommended a vaccine made by Sanofi Pasteur. It consists of three doses and is designed to protect against all four types of dengue, but it has one limitation: it is only intended for children and young people aged 9 to 16 with previous evidence of dengue. Given these restrictions and other problems, its use has not become widespread. In Puerto Rico, only about 140 children had been vaccinated since the vaccines became available in 2022, and the laboratory has informed the CDC that it will stop manufacturing it.
A different vaccine manufactured by Takeda pharmaceutical company, based in Tokyo, is not currently licensed in the United States, and others are in development. The truth is that there is still no widely available medication to treat dengue infections.
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