Opportunities for Improved Dengue Control in the US Territories

Adams et al discuss the prevalence of dengue infection in US territories and opportunities to combat it, such as vaccines and novel vector control methods. Dengue is caused by a flavivirus with 4 distinct serotypes (DENV 1-4) and is spread by Aedes mosquitoes, primarily Aedes aegypti and Aedes albopictus. The virus causes a nonspecific acute febrile illness in approximately 25% of persons infected. About 5% of symptomatic persons progress to severe dengue, manifested by plasma leakage, hemorrhage, shock, or severe organ involvement. The risk of severe dengue is greater among infants and older people, pregnant individuals, persons experiencing a second dengue infection, and people with certain underlying conditions. Antiviral treatments against DENV are not available, and without appropriate supportive management, dengue mortality can reach 13%.