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Severe Dengue Cases Confirmed in Florida

June 10, 2021 • 10:19 am CDT
(Vax Before Travel)

The New England Journal of Medicine published an article on June 10, 2021, stating 'the global burden of dengue, a mosquito-borne viral acute febrile illness common throughout the tropics is worsening. Approximately 5% of patients have progression to severe dengue, including plasma leakage, shock, and hemorrhage, but they may also present with acute cholecystitis.'

As dengue continues to expand outside the tropics, more frequent importation and local transmission of DENV in the United States is expected. 

In evidence of this, in 2019, a total of 413 dengue cases were probably imported to Florida, including 14 cases of severe dengue (3.4%), predominantly in the Miami area. Most travel-associated cases reported recent travel to Cuba and were infected with dengue virus serotype 2 (DENV-2).

Ensuring appropriate patient care management, including close clinical monitoring and judicious use of intravenous fluids, can reduce dengue case-fatality rates. Clinicians should suspect dengue and order molecular testing for patients with acute febrile illness and relevant epidemiologic exposure because knowledge of this infection may alter clinical care.

To alert international travelers, the U.S. CDC issued a Level 1 Travel Alert in May 2021, stating 'Dengue is an ongoing risk in many parts of Central and South America, Mexico, and the Caribbean. Travelers to these areas of risk should protect themselves by preventing mosquito bites.

The CDC suggests people interested in dengue vaccination speak with a healthcare provider before traveling to at-risk areas. As of June 10, 2021, one dengue vaccine (Dengvaxia) is authorized in the USA and (1) a late-stage dengue vaccine candidate, TAK-003.

On May 5, 2021, the CDC's Advisory Committee on Immunization Practices presented updated dengue lab testing considerations required for Dengvaxia vaccination. 

As of June 2, 2021, the CDC had confirmed 12 dengue cases in the USA and 254 dengue cases reported in Puerto Rico.