(Siam News, 2023)
The rapid rise in dengue cases worldwide has transformed it into one of the most important global health issues. Recent alerts from CDC indicate ever-heightening risks for dengue transmission within the United States. This trend is driven by the global rise in cases and the spread of mosquito vectors, Aedes aegypti and Aedes albopictus, that are favored by warmer and wetter climates induced by climate change. A readjustment in healthcare strategies, policy frameworks, and societal responses would be needed to deal with this mosquito-borne disease efficiently. According to the WHO, cases have risen from the 505,430 reported in 2000 to 5.2 million in 2019. In 2023, a record increase of over 6.5 million cases and over 7300 deaths were reported across 80 countries, indicating a highly dangerous trend underlining the fact that dengue prevention and control need to happen worldwide. It will be a complex strategy: the dynamics of how the disease is transmitted are rather complex, while at the same time integrating environmental and socio-economic variables with international cooperation and innovative solutions.
Historically, dengue was fairly rare in the mainland United States; most cases were explained by returning travelers from endemic regions. In 2023, 1,829 were counted—the largest number of travel-associated dengue cases since it started to become reportable in this condition in 2010. The latest warning from the CDC comes after a record spike in 2024, after which more than 9.7 million cases were reported in the Americas, with local transmission reported in areas with the most conducive climates, particularly in states like Florida, Texas, Hawaii, Arizona, and California.
The rise of dengue in the United States poses very special challenges to this country's public health infrastructure. With enhanced risk of outbreaks, full-scale epidemics would be impossible to avert without timely enhancement of surveillance, diagnosis, and public awareness.
The increased caseload of dengue presents several challenges to health care systems. Healthcare systems need improved surveillance and diagnostic capacity for the early detection of dengue cases. All health care providers should have a high index of suspicion for dengue, especially in patients who present with fever and have recently traveled from endemic areas. Diagnostic tools with improved performance characteristics and increased laboratory capacity are required for accurate detection.
The management and treatment of dengue still remain basically supportive, comprising fluid replacement and alleviation or symptomatic relief. However, more severe cases mandate advanced medical intervention measures. In this view, the discontinuation by Sanofi Pasteur of Dengvaxia on account of weak demand poses a plight to review efforts regarding newer vaccine development and distribution.
The escalating dengue threat calls for robust policy responses. Policies aimed at mitigating climate change are thus essential to reduce the spread of mosquito-borne diseases and have been described as having many other benefits associated with reducing greenhouse gas emissions and promoting sustainable practices. This can be complemented by infrastructure adaptation to the scenarios of climate - related impacts in an attempt to manage vector populations.
Governments need to invest in comprehensive vector control strategies, including deploying insecticides and biological control agents and public sanitation measures. Genetic modification of mosquitoes or infecting them with Wolbachia—bacteria that reduce pathogen replication in vectors—are some promising ways of reducing vector populations. At the same time, collaboration at the international level is of prime importance. Dengue is a global problem that needs concerted international action. Collaboration in research, sharing data, and developing common public health programs can improve preparation and response. Establishment of global health networks can facilitate rapid action during outbreaks. Dengue outbreaks come with a high economic burden that involves health costs to the health systems and the economy, more so in low- and middle-income countries. It thus calls for heavy investments in prevention and control that are associated with these factors: direct medical costs and indirect productivity losses.
Community participation in ridding mosquito breeding sites, enforcing measures to prevent infection, and observing public health measures could bring considerable reduction to transmission rates. It is imperative that there is an increase in access to healthcare services, especially babies, pregnant women, the elderly, and other vulnerable groups. Improvement of health infrastructure in disadvantageous areas could actually help in the outcome and reduce inequities as well.
With the alarming rise of dengue cases globally and with an emerging threat to the US, there is a dire need to have comprehensive health care strategies, robust policy frames, and active societal engagement. Minimizing the cause of transmission, building health capacity, and enhancing global cooperation can help inlets avoid this disease and save public health. The challenge of dengue, therefore, embroils and defines larger issues in climate change and global health to bring out, loud and clear, the integration and sustaining of such efforts at protecting communities worldwide.
Sources:
Christensen, J. (2024) CDC warns a surge in global dengue cases is raising risk in US. CNN
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