Doctors in US should be on lookout for dengue fever

Christine S. Moyer in the American Medical News: As cases of dengue infection escalate around the globe, authors of a new study are urging physicians to ask patients with fevers for travel histories. The mosquito-borne infection should be considered as a possible diagnosis for people who recently visited places where the disease is endemic, including Asia, the Caribbean, Central America and South America.

Doctors also should know the trends of the disease in the United States, the authors said.

Their study, published online April 13 in the Centers for Disease Control and Prevention's Emerging Infectious Diseases, found that more than three times as many people were hospitalized in the U.S. with dengue fever in 2007 than in 2000. Hospitalizations climbed from 81 cases in 2000 to 299 in 2007.

The study's authors attribute the increase, in part, to the growing number of worldwide dengue cases and the significant number of Americans who travel to areas where the disease is abundant. The global rise has been linked to climate change. Greater rainfall and warmer temperatures make it more conducive for infected mosquitoes to circulate.

"It's important for physicians to recognize who's at risk of dengue fever," said Judy A. Streit, MD, an author of the study. "Traditionally, [it has been people who] travel to disease-endemic areas." But, she added, physicians should not rule out the disease in patients with a febrile illness who have not been outside the country recently.

"Travel is not the only risk factor. We do have the vectors present in the U.S.," said Dr. Streit, assistant professor in the Dept. of Internal Medicine in the Division of Infectious Diseases at the University of Iowa Carver College of Medicine in Iowa City…

In the 1960s, a major effort was made to eradicate the principal urban vector mosquito of dengue and yellow fever viruses, A. aegypti, from southeast United States. This field technician is looking for larvae in standing water containers. Image source: Centers for Disease Control and Prevention Publich Health Image Library.