Similar to many illnesses, it begins with a high temperature. The affected individual experiences a severe headache that causes blurry vision, along with other common symptoms such as joint pain, nausea, sensitivity to touch, and extreme exhaustion. After the first 24 hours, the fever persists and rises above 102 F. Fortunately, it is only a mild case of the dengue virus, which is transmitted by mosquitoes. Unlike other diseases transmitted by vectors like West Nile and Zika, dengue is much more dangerous. It is known as “breakbone fever” in Africa and South America due to the excruciating pain it causes. Untreated patients who develop hemorrhagic symptoms have an average mortality rate of up to 20 percent, and a second infection increases the mortality rate to 50 percent. In comparison, even the most severe strains of COVID-19 have a mortality rate of less than 5 percent. The rapid expansion of the Aedes aegypti mosquito, which carries dengue, has allowed the virus to spread quickly in places not typically associated with tropical diseases, such as the United States. Health experts, including the World Health Organization (WHO), warn that the expanding territory of these mosquitoes due to warmer climate conditions could lead to a public health crisis.
During the World Health Assembly in Geneva, Switzerland, in May, WHO Director-General Dr. Tedros Adhanom Ghebreyesus acknowledged the ongoing threat of COVID-19 but emphasized the potential challenges posed by other diseases to global healthcare infrastructure. The WHO had previously indicated in April that nearly half of the world’s population is now at risk of contracting dengue, with more than 400 million reported cases annually in 129 countries. The number of global cases surged from around half a million in 2000 to 5.2 million in 2019. In the Americas, the number of infections more than doubled between 2021 and 2022, reaching 2.8 million. The WHO had predicted in 2013 that dengue would become a “pandemic threat,” and now, years later, several countries in the Americas are struggling to control widespread dengue outbreaks.
However, the spread of dengue within the United States is expected to be gradual. According to Dr. William Schaffner, an infectious disease expert, warmer weather and increased rainfall provide favorable conditions for mosquito breeding and expansion. The Aedes aegypti mosquito, which spreads dengue, has a unique ability to breed in very little water, such as an upturned bottle cap. While countries in Central and South America have established measures to combat dengue, healthcare systems have still been overwhelmed, resulting in a high death toll. U.S. hospitals are also at risk of being overwhelmed in the event of a serious dengue outbreak due to limited capacity and high bed occupancy rates.
Historically, the United States has experienced outbreaks of diseases like yellow fever, which is even deadlier than dengue and transmitted by the same mosquito. This suggests that dengue could continue to spread. Additionally, the rising prevalence of chronic diseases in the U.S. population and the high immunocompromised percentage further increase the potential health consequences in the event of a dengue outbreak. Mitigation strategies include training healthcare staff, educating the public, and eliminating mosquito breeding sites. The use of Ivermectin has shown promise in inhibiting the progression of dengue severity, and vaccine development is underway. Overall, proactive measures are necessary to prevent a potential public health crisis caused by dengue in the United States.