In the Americas, the first probable dengue epidemics were reported to have occurred in 1635 in Guadalupe and Martinique, and Panama in 1699. The origins of the initial outbreaks were not known. However, a description of an outbreak that occurred in Philadelphia in 1780 documented by Benjamin Rush matches the symptoms of the disease. Outbreaks in the 19th Century frequently occurred in port cities in South, North, and Central America, as well as the Caribbean with most outbreaks attributed to commerce. Additional suspected dengue outbreaks occurred in Peru in 1818, and in 1827 and 1828 in the Gulf of Mexico and the Caribbean, although the latter outbreak had clinical similarity to the chikungunya virus. During the 1828 outbreak in Havana Cuba, the disease was named Dunga, and later renamed dengue.
Suspected dengue epidemics were reported in several U.S. cities after 1850, including Mobile, New Orleans, Charleston, Savannah, and Augusta, as well as in Havana Cuba. One of the largest suspected outbreaks of dengue occurred in 1873 in New Orleans and affected more than 40,000 individuals.
In the latter half of the 19th century and early 20th century, outbreaks of suspected dengue illness occurred as far north as the southern U.S, and as far south as Chile and Argentina; however, other viruses such as yellow fever and Chikungunya, with symptoms that are similar to dengue, may have also been responsible some of the outbreaks.
While outbreaks of illness that matched the clinical symptoms of dengue had been described in the medical literature for centuries, the virus was not isolated until 1943.
Four distinct dengue viruses exist, and it is believed that the ancestor of these viruses emerged over 1,000 years ago between mosquitoes and non-human primates. All four dengue viruses are thought to have independently transmitted to humans a few centuries ago.
Dengue type 1 (DENV-1) was initially confirmed in both Japan and French Polynesia in 1943, and Hawaii in 1944 and 1945. Reports of DENV-1 increased throughout Asia by the 1950s. It was first reported in the Americas in 1977 and continues to be responsible for cases and outbreaks in several countries including Puerto Rico, Mexico, and Brazil.
The first cases of dengue type 2 (DENV-2) were reported in Indonesia and Papua New Guinea in 1944, and in the Philippines in 1954. Cases of DENV-2 were reported initially in the Americas in Trinidad and Tobago in 1953, but consistent reporting of the virus did not begin until the late 1960s. In the 1970s many cases were reported in Puerto Rico, and in Brazil by the mid-1980s. In the 1990s, more severe cases of DENV-2 were noted and believed to be the result of the replacement of the circulating DENV-2 genotype with a more virulent one from Asia.
Dengue type 3 (DENV-3) was initially isolated in Thailand and the Philippines in 1953, and since 1962, the virus has been reported in Asia. Thailand reported continuous reports of DENV-3 from 1973 through 2010. Puerto Rico reported its first case of DENV-3 in 1963, and continually until 1978, then again between 1994 and 2008. Most other countries in the Americas did not report DENV-3 until the late 1980s.
Thailand and the Philippines were the first countries to report Dengue type 4 (DENV-4), and have reported cases of the virus since 1953, with most cases reported between 1999 and 2002. It was first reported in the Americas in 1981, with cases reported in Puerto Rico, the U.S. Virgin Islands, Cuba, and Brazil. DENV-4 has been reported in Venezuela and Columbia since the 1990s, and in Peru, Brazil, and Nicaragua since the late 1990s and mid-2000s.
Eradication efforts to eliminate the Aedes aegypti mosquito, one of the two mosquitoes responsible for dengue transmission, initially commenced in Havana Cuba in 1901. This was due in part to the theory that this mosquito was responsible for yellow fever outbreaks. Fumigation and removal of environmental factors that attracted mosquitoes were techniques used in early campaigns. In the 1940s, the Pan American Health Conference focused its eradication efforts in Brazil. By 1947, eradication efforts centered around the use of DDT, and intense campaigns in affected countries were widespread. By 1962, 18 South and Central American countries and several Caribbean islands had eliminated the Aedes aegypti mosquito.
After 1962, eradication efforts became less of a priority, and countries that had successfully eradicated the mosquito were no longer focused on the issue. Additionally, the increase in foreign and domestic travel, the rapid expansion of urban centers with less-than-optimal levels of sanitation, the emergence of DDT-resistant mosquitoes, along with the unwillingness of governments to fund the costly programs played a significant role in the deterioration of eradication efforts during the 1960s. By the 1970s, many countries experienced a reinfestation of the mosquito, which led to outbreaks of several dengue serotypes.
Dengue cases have continued to increase since the 1980s. During the 1980s, around one million cases occurred in the Americas; however, between 2000 and 2007, approximately 4.7 million cases were reported.
The World Health Organization (WHO) reports a 10-fold increase in dengue from 2000 to 2019, from 500,000 cases to 5.2 million cases. Health officials, however, note that reported rates of dengue decreased between 2020 and 2022 due to the COVID-19 pandemic but that rates in 2023 have increased significantly.
According to the WHO, in 2023, over 5 million cases and 5,000 dengue related deaths occurred, with over 4.1 million cases reported in the Americas.
Between 2010 and 2021, the U.S. Centers for Disease Control and Prevention (CDC) reported a total of 7,528 confirmed or probably dengue cases among U.S. travelers. The majority of the cases (20 percent) were reported in 2019. Most cases of dengue were associated with travel to the Caribbean and Asia.
Scientists believe that dengue cases have continued to rise due to the increase in travel, allowing humans to move viruses longer distances in shorter periods of time. Additionally, increases in urban development along with unsanitary and substandard living conditions are believed to attract the mosquitos that carry the dengue virus. Researchers are also examining the role of climate change on dengue and dengue epidemics.
IMPORTANT NOTE: NVIC encourages you to become fully informed about Dengue and the Dengue vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.
