Dengue

Dengue Overview

Dengue is a viral vector-borne disease spread through the bite of infected mosquitoes. Common symptoms include fever, nausea, vomiting, rash, eye pain, and muscle, joint or bone aches and pains. Each year, up to 400 million people around the world are infected with dengue and transmission is most common in tropical and subtropical regions, including the U.S. territories of American Samoa, Puerto Rico and the U.S. Virgin Islands. There is an increasing incidence of cases in the continental US between travel-associated cases and locally acquired cases in Florida and California. People who have had a previous dengue infection are at greater risk of severe disease if they are infected again. Approximately 1 in 20 people who are infected will have severe disease that requires immediate medical attention.

AAP Recommendations

The AAP recommends dengue vaccination for children between ages 9-16 who have had a previous dengue infection confirmed by a laboratory test and live in dengue endemic areas (eg. Puerto Rico, American Samoa, US Virgin Islands). More information on testing, prevention and treatment for dengue infection can be found in the Dengue Chapter of the AAP Red Book.

Dengvaxia is currently the only dengue vaccine approved for use in the United States. However, the manufacturer, Sanofi-Pasteur, is discontinuing the vaccine citing a lack of demand in the global market to continue production of this vaccine. CDC, in collaboration with the Puerto Rico Department of Health, will continue alerting health professionals about the discontinuation of Dengvaxia and the use of this vaccine as recommended by the Advisory Committee on Immunization Practices (ACIP) to patients who live in dengue endemic areas. Dengvaxia is safe and effective when administered as recommended. There are two other dengue vaccines either approved or in late stages of development. However, they are not currently available in the United States. 

More About the Science

Older children and adolescents are at greater risk for severe dengue disease and hospitalization. Dengue viruses are spread to people through the bite of infected Aedes mosquitoes. The dengue vaccine is more than 80% effective at preventing illness, including severe symptoms. Warning signs of severe illness include stomach pain and tenderness, vomiting, bleeding from the nose or gums, blood in vomit or stool, and extreme tiredness or restlessness. Early testing and detection of dengue is critical for appropriate fluid management, which can prevent severe dehydration and may require oral or intravenous rehydration. Timely laboratory confirmation can drastically reduce mortality from dengue. In addition to getting vaccinated, people can continue to protect themselves and their families from dengue by preventing mosquito bites and controlling mosquitoes in and around their homes.