From Denise Mann
HealthDay reporter
THURSDAY, June 10, 2021 (HealthDay News) – The death of a woman in her thirties from Miami from locally acquired dengue fever underscores the need to raise awareness of a potentially fatal mosquito-borne virus now found in the United States becomes.
Dengue fever, once only seen in hot and steamy tropical or subtropical areas, is on the rise in parts of the southern United States due to global warming, travel, and other factors. While most Americans still get infected while traveling to parts of the world where dengue is endemic, there have also been cases of locally acquired dengue in the United States, including an outbreak in Miami in 2019.
This can happen when a local mosquito feeds on a person infected with dengue and then passes the disease on to others.
Dengue fever is spread by a bite from an infected Aedes mosquito and can cause a high fever, rash, and muscle or joint pain. In severe cases, dengue can cause potentially fatal bleeding and shock. According to the U.S. Centers for Disease Control and Prevention, up to 400 million people will become infected with dengue each year and approximately 22,000 will die from the disease.
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In 2019, 413 people were diagnosed with dengue in Florida, most of whom had recently traveled to Cuba. This outbreak spawned 18 locally acquired cases, including one that resulted in the death of the young Miami woman. To determine the source of infection, doctors checked the woman’s travel history and performed genetic sequencing of the virus, which confirmed that it was locally acquired.
Her story is the basis of a letter in the June 10th issue of the New England Journal of Medicine. It should serve as a warning, said co-author Dr. Stephen Morris, an infectious disease specialist at Jackson Memorial Hospital in Miami.
“Florida is now sort of a quasi-endemic area for dengue fever,” he said. “We should expect this to be a risk in the future, and doctors in the southern US should know that dengue is on the table as a possible diagnosis.”
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There is no widely available vaccine to prevent dengue fever, Morris said. To fight off infection, “use a good bug spray, cover your skin, and avoid areas with lots of stagnant water,” he said. Mosquitoes like to lay eggs in buckets, bowls, flower pots, and vases near standing water.
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Screens on doors and windows can also keep mosquitos out, Morris said.
Belated diagnosis
There’s also no rapid test for dengue, so it can take several days to be diagnosed, said study co-author Tyler Sharp, an epidemiologist at the CDC’s dengue branch in San Juan, Puerto Rico.
Delay in diagnosis played a role in the Miami woman’s death. “If you think it might be dengue, treat it like you have it and if it’s negative then there are no downsides,” Sharp said.
Treatment includes hydration and close monitoring of vital signs. “Tell your doctor if you’ve been to an area where dengue is endemic or if someone you know has recently been diagnosed with dengue as this may not be a priority for many doctors,” he said.
Fighting mosquitoes at the community level has been more difficult, Sharp said.
“We need to raise awareness and develop, evaluate and eventually implement tools to combat dengue in South Florida and elsewhere,” he said.
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There are ways to reduce the mosquito population that are currently being researched. For example, in a controversial study, Florida released genetically modified male mosquitoes that pass on a gene that kills female offspring before they mature. Only female Aedes aegypti mosquitoes can bite and spread dengue.
Unless mosquito populations are reduced, “it is very important to be aware of dengue fever in Florida, Texas, and Hawaii because we know mosquito vectors are present,” said Yesim Tozan, assistant professor of global health at the NYU School of Globale public health in New York City.
Fortunately, most local outbreaks in the United States have been limited because mosquitoes can’t fly too far, she said.
“We need to be vigilant about fevers and illnesses, especially when we know mosquitoes are active,” Tozan said. The mosquito season lasts from spring to autumn.
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“Climate change makes us experience severe weather such as unexpected rain and fluctuating temperatures, and mosquitoes are very sensitive to them, suddenly we have breeding activities that we normally wouldn’t,” said Tozan, who was not involved in the new report.
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“Be an educated traveler,” she said. “If you return from areas where dengue fever and other mosquito-borne diseases are prevalent, share your travel history with your doctor.”
More information
The U.S. Centers for Disease Control and Prevention is more about dengue prevention.
SOURCES: Stephen Morris, MD, Infectious Disease Specialist, Jackson Memorial Hospital, Miami; Tyler Sharp, PhD, epidemiologist, CDC Dengue Branch, San Juan, Puerto Rico; Yesim Tozan, PhD, Assistant Professor, Global Health, NYU School of Global Public, New York City; New England Journal of Medicine, June 10, 2021
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