CDC HAN

CDC health advisory: Increased risk of dengue virus infections in the U.S.

June 26, 2024

CDC warns of the increased risk of dengue virus infections in the U.S. this year, which so far has been the highest on record; many countries are also reporting higher-than-usual dengue case numbers. In the first 6 months of 2024, countries in the Americas reported more than 9.7 million dengue cases, twice as many as in all of 2023. Puerto Rico has declared a public health emergency (1,498 cases) and a higher-than-expected number of dengue cases have been identified among U.S. travelers (745 cases) so far this year.

Recommendations for healthcare providers

In the setting of increased global and domestic incidence of dengue, CDC urges clinicians to take the following steps:

1. Maintain a high suspicion for dengue among patients with fever and recent travel (within 14 days before illness onset) to areas with frequent or continuous dengue transmission.
2. Consider locally acquired dengue among patients who have signs and symptoms highly compatible with dengue (e.g., fever, thrombocytopenia, leukopenia, aches, pains, rash) in areas with competent mosquito vectors.
3. Order appropriate FDA-approved dengue tests (RT-PCR and IgM antibody tests, or NS1 and IgM antibody tests), and don't delay treatment waiting for test results to confirm dengue.
4. Know the warning signs for progression to severe dengue, which include abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation, mucosal bleeding, lethargy or restlessness, and liver enlargement.
5. For people with suspected dengue who don't have warning signs and aren't part of a population at high risk for severe dengue, consider outpatient management with close follow-up.
6. Teach patients about the warning signs that may appear as their fever starts to decline and instruct them to seek care urgently if they experience any warning signs.
7. Recognize the critical phase of dengue, which begins when fever starts to decline and lasts for 24–48 hours. During this phase, some patients require close monitoring and may deteriorate within hours without appropriate IV fluid management.
8. Hospitalize patients with severe dengue or any warning sign of progression to severe dengue and follow CDC/WHO protocols for IV fluid management.
9. Follow local guidelines to report dengue cases to state, tribal, local, or territorial health departments.

Source:

(2024, June 25). CDC. Health Alert Network. Increased Risk of Dengue Virus Infections in the United States. https://emergency.cdc.gov/han/2024/han00511.asp