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Writer's pictureKatie Scoggins
Jul 224 min read

Are Rates of Dengue Fever Increasing in the US?

written by: Katie Scoggins RN, BSN

Dengue Fever has recently come to the forefront of attention for more people in the US as cases of dengue are surging around the world. According to Dr. Céline Gounder on CBS Health Watch, countries in North, Central & South America have already seen twice as many dengue fever cases this year, half way through 2024, as there were in total for the year in 2023. The US is also seeing a rise in cases in states and territories including the gulf coast of Florida and Texas as well as Puerto Rico (Moniuszko & Johnston, 2024).


What is dengue fever?

Dengue fever, also known as break-bone fever, is a blood borne viral infection that is spread from human to human through mosquito bites. These specific species of mosquitoes, called Aedus aegypti, lay eggs and breed in small collections of water such as discarded buckets, animal dishes, old tires, flowerpots & vases. The mosquitos themselves will become infected with the virus when they bite a human already infected with dengue, which can then be passed to another human when they are bitten by the same mosquito (CDC, 2024).


Where does it come from?

The rates for dengue infection are typically highest in areas where it is hot & humid - the environment in which these mosquitoes live. Most commonly, these areas with frequent outbreaks have historically included: Central & South America, Southeast Asia & Pacific Islands, however, over half of the world’s population lives within areas of risk to dengue (CDC, 2024). 


Experts believe the rise in cases of dengue may be coming with climate change and the increase of areas that are hot and humid. According to Dr. Gabriela Paz-Bailey, chief of the dengue branch at the CDC’s National Center for Emerging and Zoonotic Infectious: climate change, rising temperatures and also extreme weather events are helping extend the habitat range of these mosquitos (Nolan, 2024).


Signs & Symptoms

Many people who have dengue fever will have none or mild symptoms, but that doesn’t mean this virus is benign. Per the CDC, about 1 in 4 people infected with dengue will be sick with symptoms that may include:

  • High fever

  • Headache

  • Pain behind the eyes

  • Severe bone, joint & muscle pain

  • Nausea vomiting

  • Rash (primarily on hands and feet)


If symptoms of illness do occur, they usually start 4-10 days after the initial mosquito bite and can last for 2-7 days, according to the WHO. For those who do become sick, the virus will run its course through 3 stages: febrile stage, critical phase &  recovery phase (CDC, 2024).


Febrile Phase

This phase can last 2-7 days and begins with a sudden high fever up to 40 degrees Celsius (104 degrees Fahrenheit). Other symptoms might include: pain in the joints, muscles and bones (the origin of its nickname ”break-bone fever”), headaches, and rash. Once the fever drops, many people will begin improving overall and enter the recovery phase.


Critical Phase

This phase begins once fever decreases and can last up to 48 hours. Per the CDC, this window is an important period of time to monitor symptoms. While most people who experience any symptoms at all will have a mild case, 1 in 20 people who contract the virus will develop severe dengue, which can develop over the course of just a few hours. These more severe cases cause the plasma, the protein-rich fluid component of blood, to leak out of blood vessels and into other areas of the body (Nolan, 2024). It’s important to contact your doctor for closer monitoring if you develop any of the following symptoms::

  • Belly pain or tenderness

  • Vomiting (at least 3 times in 24 hours)

  • Bleeding from the nose or gums

  • Blood in the vomit or stool

  • Feeling extremely tired or restless

  • Postural hypotension (blood pressure drop when moving from sitting to standing)

  • Liver enlargement


Recovery Phase

This phase typically begins within two days after the decrease in fever. While many people will recover within a week’s time, those who experienced moderate to severe symptoms might need several weeks to fully recover their energy to pre-infection levels. For those who experienced more serious signs and symptoms, during the recovery phase is when this plasma leakage is reversed as fluids are reabsorbed back into the appropriate vessels of the body. This improvement of well-being will in turn help re-stabilize blood pressure, strength and overall resilience (CDC, 2024).


Treatment

While there is no specific treatment for this virus, it is important to monitor symptoms while allowing the virus to run its course. It is recommended to use acetaminophen for pain and fever relief as well as ensuring the proper intake of fluid and electrolytes. NSAIDs such as Advil, Motrin and Naproxen, are not recommended due to the risk of bleeding while infected with the virus. Contact your doctor if you notice any worsening or increase in symptoms throughout your sickness.


Prevention

The best way to prevent mosquito bites is simply to avoid places where there is a high concentration of mosquitoes or areas that have standing water where these insects breed. If you are in an environment where there are mosquitos, it’s best to wear clothing that covers much of your skin and use insect repellents with DEET or picaridin. If also possible, stay in places that have air conditioning or have screened windows, decreasing your exposure to the insects (Moniuszko & Johnston, 2024).


According to Thomas W. Scott, a dengue epidemiologist and professor at University of California, Davis: It is unlikely that dengue will become a serious problem in the United States due to the high number of people who live in homes with screened windows and air-conditioners, limiting exposure to mosquitoes (Nolan, 2024). And while this knowledge may ease your fear of contracting the virus, consider using these tools for your next trip abroad to hot and tropical destinations to help prevent the spread of dengue to yourself and others.




References


Cognan, J.E., (April 23, 2024). Dengue and severe dengue. World Health Organization. Retrievied from:


CDC. (May 14, 2024). Dengue. Retrieved from:


Moniuszko, S. & Johnston, T. (July 3, 2024). Maps show dengue fever risk areas as CDC warns of global case surge. Health Watch: CBS News. Retrieved from:


Nolan, S. (June 23, 2024). C.D.C. Warns Doctors About Dengue as Virus Spreads to New Regions. The New York Times. Retrieved from:


Assessed and Endorsed by the MedReport Medical Review Board

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