“A disease most Americans have never heard of could soon become more prevalent if dengue, a flu-like illness that can turn deadly, continues to expand into temperate climates and increase in severity, according to a new commentary by Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and David M. Morens, M.D., Fauci’s senior scientific advisor. Their commentary appears in the January 9 and 16 double issue of the Journal of the American Medical Association.

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Dengue (pronounced “DENG-ee”) is caused by any of four related viruses transmitted to humans by the mosquitoes Aedes albopictus (nicknamed “Asian tiger mosquito”) and Aedes aegypti. First seen in the United States in 1985, Ae. albopictus has been found in 36 states, while Ae. aegypti has been found in several southern states. Experience elsewhere in the world shows that where these mosquitoes go, the disease usually follows.

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Most people infected with a dengue virus have no symptoms or a mild fever. Those who do get sick sometimes experience minor bleeding, such as from the nose or gums, and frequently develop a high fever, severe headache, pain behind the eyes and in joints and muscles, and a rash. Sometimes the disease leads to leakage of blood plasma out of the circulatory system and into tissues, causing blood pressure to drop. This condition often can be reversed by giving patients fluids and electrolytes. With proper treatment, case fatality rates for severe dengue can be less than 1 percent. If left untreated, however, the person may become unresponsive, slip into a coma and possibly die. Early diagnosis and treatment of dengue are critical to preventing shock and death. The severe forms of dengue disease have been defined by the World Health Organization as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS).”