As of 30 April 2024, over 7.6 million dengue instances were reported to WHO in 2024, together with 3.4 million proven instances, over 16 000 critical instances, and over 3000 deaths. Whilst a considerable building up in dengue instances has been reported globally within the remaining 5 years, this building up has been in particular pronounced within the Area of the Americas, the place the selection of instances has already exceeded seven million through the tip of April 2024, surpassing the once a year excessive of four.6 million instances in 2023. Lately, 90 international locations have recognized energetic dengue transmission in 2024, no longer all of that have been captured in formal reporting. As well as, many endemic international locations don’t have sturdy detection and reporting mechanisms, so the real burden of dengue globally is underestimated. With a purpose to keep an eye on transmission extra successfully, real-time tough dengue surveillance is had to cope with considerations about doable undetected instances, co-circulation and misdiagnosis as different arboviruses, and unrecorded journey actions. Those components may give a contribution to unrecognized illness unfold and identify a possible threat for native transmission in non-endemic international locations.
Dengue virus is transmitted to people during the chunk of contaminated mosquitoes. Instances are maximum repeatedly asymptomatic or lead to delicate febrile sickness. Alternatively, some instances will expand critical dengue, which might contain surprise, critical bleeding or critical organ impairment.
To make stronger world surveillance, and track temporal developments and illness occurrence, WHO has established a world dengue surveillance gadget with per 30 days reporting throughout all WHO areas with a brand new dashboard now are living (
The full capability for international locations to answer a couple of, concurrent outbreaks remains to be strained because of the worldwide loss of sources, together with shortages of excellent high quality dengue diagnostic kits for early illness detection, loss of educated medical and vector keep an eye on group of workers and group consciousness. Emergency reaction mechanisms were established, and WHO helps high-risk international locations throughout affected areas.
Given the present scale of the dengue outbreaks, the possible threat of additional world unfold and the complexity of things impacting transmission, the entire threat on the world point remains to be assessed as Prime and thus dengue stays a world danger to public well being.
International overviewCurrent situationAs of 30 April 2024, over 7.6 million dengue instances were reported to WHO in 2024, together with 3.4 million proven instances, over 16 000 critical instances, and over 3000 deaths. Whilst a considerable building up in dengue instances has been reported globally within the remaining 5 years, this building up has been in particular pronounced within the Area of the Americas, the place the selection of instances has already exceeded seven million through the tip of April 2024, surpassing the once a year excessive of four.6 million instances in 2023. Moreover, that is 3 times what was once reported all over the similar length in 2023, highlighting the acceleration of this well being drawback. Dengue virus is transmitted to people during the chunk of contaminated mosquitoes. Instances are maximum repeatedly asymptomatic or lead to delicate febrile sickness. Alternatively, some instances will expand critical dengue, which might contain surprise, critical bleeding or critical organ impairment. The danger of dengue is the same throughout areas, international locations, and inside of international locations. Components related to an expanding threat of dengue epidemics and unfold to new international locations come with: early get started and longer length of dengue transmission seasons in endemic spaces; converting distribution and extending abundance of the vectors (Aedes aegypti and Aedes albopictus); penalties of local weather alternate and periodic climate phenomena (El Nino and L. a. Nina occasions) resulting in heavy precipitation, humidity, and emerging temperatures favouring vector replica and virus transmission; adjustments within the circulating serotypes inside of a rustic affecting inhabitants immunity; fragile well being programs amid political and fiscal instability in international locations going through advanced humanitarian crises and large-scale inhabitants actions impairing the general public well being reaction;motion of people who find themselves contaminated and items that might elevate the mosquito vectors.Lately, 90 international locations have recognized energetic dengue transmission in 2024, no longer all of that have been captured in formal reporting. As well as, many endemic international locations don’t have sturdy detection and reporting mechanisms, so the real burden of dengue globally is underestimated. With a purpose to keep an eye on transmission extra successfully, real-time tough dengue surveillance is had to cope with considerations about doable undetected instances, co-circulation and misdiagnosis as different arboviruses, and unrecorded journey actions. Those components may give a contribution to unrecognized illness unfold and identify a possible threat for native transmission in non-endemic international locations.To make stronger world surveillance, and track temporal developments and illness occurrence, WHO has established a world dengue surveillance gadget with per 30 days reporting throughout all WHO areas, which is now to be had as a dashboard. This has to this point captured 103 international locations (Figures 1 and a pair of) together with 28 0 reporting international locations. No autochthonous or in the community transmitted dengue instances were reported in Europe to this point in 2024 however those knowledge might be added when autochthonous instances happen, which is able to happen when seasonal stipulations allow vector job from June to November. Given the present scale of the dengue outbreaks, the possible threat of additional world unfold and the complexity of things impacting transmission, the entire threat on the world point remains to be assessed as Prime and thus dengue stays a world danger to public well being.Determine 1. Epidemic curve of dengue instances and deaths as reported to WHO from January to April 2024** Notice: comprises 103 international locations to this point built-in within the WHO world surveillance gadget, 28 of that have submitted 0 studies to dateFigure 2: Geographical distribution of dengue instances as reported to WHO from January to April 2024*
*Notice: most effective 103
international locations built-in within the WHO world dengue surveillance gadget to this point are
proven Co-circulation of dengue, chikungunya and Zika virusesThere is really extensive overlap within the geographic distribution of dengue, chikungunya, and Zika viruses, which can be all transmitted through Aedes mosquitoes and percentage some medical options that may end up in misdiagnoses and misreporting within the absence of differential laboratory trying out. Surveillance knowledge all over wide outbreaks of ‘suspected dengue’ might erroneously come with instances of 1 or either one of the opposite sicknesses. As an example, in a single learn about in Brazil (Ribas Freitas AR, et al., 2024), within the state of Minas Gerais in 2023, ‘suspected dengue’ accounted for 84.4% of instances of the 828 654 instances of ‘suspected arboviruses’, and ‘suspected chikungunya’ most effective accounted for 15.6%. The real share of the 2 sicknesses among laboratory-confirmed instances was once 65.9% chikungunya and most effective 34.1% dengue. Surveillance programs in particular focused on endemic transmission of chikungunya or Zika are susceptible or non-existent in many nations. Misdiagnosis between sicknesses is a surveillance fear as a result of skewed surveillance can lie to coverage choices. As dengue, chikungunya, and Zika viruses percentage the similar Aedes mosquito vectors and co-circulate in the similar geographic spaces, in addition they percentage many prevention methods, corresponding to differential analysis, mosquito keep an eye on and public consciousness campaigns. Alternatively, there are vital variations between those sicknesses that have an effect on threat populations, affected person control and use of well being care sources. As an example, Zika is especially bad for pregnant girls because of its affiliation with Congenital Zika Syndrome. As a result, increasing surveillance to concurrently track for all 3 viruses can assist public well being government appropriately decide the real burden of every illness, refine threat checks, and optimize medical control and useful resource allocation for simpler public well being interventions.Thus far in 2024, greater than 250 000 instances of chikungunya were reported to WHO and virtually 7000 instances of Zika virus illness. Determine 3 presentations international locations/territories/spaces with proof of present or earlier circulate of a minimum of two of the 3 viruses.Determine 3: Nations, territories or spaces with earlier or present native mosquito-borne transmission of a couple of Aedes-borne virus (dengue, chikungunya and Zika) as of 30 April 2024
Regional review African RegionThe African area is strongly suffering from arboviruses, even if the precise burden isn’t smartly understood because of demanding situations with laboratory capability. There may be proof of present or prior dengue circulate in native populations and/or amongst travellers coming back from roughly 30 African international locations. In 2023, outbreaks had been reported in 15 international locations within the WHO African Area: Benin, Burkina Faso, Cabo Verde, Chad, Côte d’Ivoire, Ethiopia, Ghana, Guinea, Mali, Mauritius, Niger, Nigeria, São Tomé and Principe, Senegal, and Togo. In 2024, from 1 January to twenty-eight April, 13 international locations are recognized to have ongoing energetic transmission of the dengue virus — Benin, Burkina Faso, Cape Verde, Côte d’Ivoire, Ethiopia, Kenya, Mali, Mauritania, Mauritius, Niger, São Tomé and Principe, Senegal, and the Seychelles. A complete of 32 925 dengue instances (14 095 proven; 1051 critical instances) and 57 deaths were reported from those 13 international locations and an extra 16 international locations have reported 0 instances thru their respective regimen surveillance mechanisms. Stream of 3 of the 4 dengue serotypes of the dengue virus (DENV-1, DENV-2, DENV-3) has been recognized within the WHO African area. The present precedence international locations in keeping with dengue burden are Burkina Faso, Mauritius and Mali. Burkina Faso reported 72% of all instances and 89% of all deaths within the area from the start of 2023 to twenty-eight April 2024, and stays the rustic with the most important dengue burden, reporting 17 098 instances (52%) and 38 deaths (67%) in 2024. Mauritius reported 7177 dengue instances and 15 deaths all over the primary 17 weeks of 2024, with most effective DENV-2 serotype being detected so far. In Mali between 1 January and 28 April 2024, a complete of 3231 dengue instances and 3 deaths were reported, with two serotypes (DENV-1, DENV-3) recently circulating. The primary demanding situations in addressing dengue within the affected international locations come with investment constraints that impede preparedness and reaction, shortages of speedy diagnostic assessments, vector keep an eye on experts, lab technicians, and entomologists. Area of the AmericasDengue is essentially the most in style arbovirus and reasons the perfect selection of arboviral illness instances within the Area of the Americas, with cyclical epidemics each and every 3 to five years. The Ae. aegypti, the primary vector mosquito for dengue, is established in all international locations within the Americas excluding Canada, which has additionally reported no prior autochthonous dengue instances. Prior to now, the perfect burden of dengue was once reported in 2023 with 4 600 086 suspected instances, together with 2 048 048 laboratory-confirmed instances being recorded. Alternatively, in 2024 as of the tip of April, there have already been 7 517 060 suspected dengue instances (3 528 635 laboratory-confirmed), 7374 (0.10%) critical dengue, and 3504 deaths (Case Fatality Ratio (CFR) 0.05%) reported. There are 3 times extra suspected instances in 2024 so far than over the similar length in 2023. A number of international locations within the northern hemisphere also are reporting an important selection of suspected dengue instances even supposing they have got no longer but entered their length of excessive transmission, which most often happens in the second one part of the 12 months. In 2024, Brazil is the rustic with the perfect selection of instances, with 6 296 795 suspected dengue instances (3 040 736 laboratory-confirmed), adopted through Argentina (420 867 suspected instances), Paraguay (257 667 suspected instances), and Peru (199 659 suspected instances). All 4 dengue serotypes were detected around the area and in 2024; six international locations (Brazil, Costa Rica, Guatemala, Honduras, Mexico, and Panama) have already reported the simultaneous circulate of all dengue serotypes. Jap Mediterranean RegionDengue outbreaks proceed to be reported in each fragile, conflict-affected, and/or prone international locations within the area that experience weakened healthcare programs in addition to international locations with more potent healthcare programs which were suffering from strange rains because of local weather alternate. Ae. aegypti and a few Ae. Albopictus mosquitoes were recognized in many of the international locations within the area. In spaces suffering from armed clash, the loss of detailed and well timed data complicates a coordinated dengue reaction. Moreover, well timed knowledge sharing additionally stays a problem for different international locations within the area for causes corresponding to the possible have an effect on within the tourism, economic system and different sectors. Ecu RegionDengue isn’t endemic within the WHO Ecu Area and reported instances are principally travel-related. Alternatively, there were sporadic autochthonous dengue instances and few dengue outbreaks reported within the area since 2010 with proof of dengue transmission from 5 international locations: Croatia, France, Italy, Portugal (Madeira), and Spain. In 2023, autochthonous instances had been reported in 3 international locations: Italy (82), France (45) and Spain (3). No autochthonous dengue instances were reported in Europe to this point in 2024, despite the fact that the summer season has no longer but began when mosquito vector job commences. Trying out capability for dengue is restricted in lots of Member States within the WHO Ecu Area, particularly outdoor the Ecu Union, and maximum instances most likely are first-time infections and subsequently delicate and don’t provide for care, the real numbers of dengue instances is also underestimated. Sturdy public well being programs, excellent medical care together with get admission to to early analysis, case referral, and control of critical instances, rather brief vector season, and rather improper stipulations for illness transmission all give a contribution to lowered critical well being have an effect on and additional illness unfold for each imported and autochthonous instances. The area is making ready for, most likely restricted, native transmission within the upcoming summer season and early autumn months. The competent vector, Aedes albopictus, has been setting up itself additional north and west within the Ecu area over the last ten years. Moreover, Aedes aegypti has already been established in Cyprus, and Madeira, Portugal. Whilst chilly winters within the majority of the area don’t permit for year-round transmission, the climatic suitability for transmission of dengue infections within the Ecu area might building up with adjustments in local weather, together with doable upper temperatures and milder winters, building up within the geographical vary of the competent vectors, and temperature suitability for virus transmission. Adjustments in humidity and precipitation (adopted through floods and stagnant water swimming pools) might also create extra beneficial stipulations for the vector inhabitants and subsequently greater suitability for transmission of dengue virus. South- East Asia RegionIn the South-East Asia Area, all Member States have the environmental stipulations for dengue endemic transmission, and all have systematically reported dengue instances, excluding the Democratic Other folks’s Republic of Korea. There are transparent seasonal patterns in dengue occurrence, related to the local weather patterns in respective international locations. In 2024, Indonesia is experiencing a surge in dengue occurrence, with 88 593 proven instances and 621 deaths as of 30 April 2024 – roughly 3 times upper than the similar length in 2023. In 2024 Bangladesh, Nepal, and Thailand have reported a better selection of instances in comparison to the similar length of 2023. From January to April 2024, the CFR various from 0% in Nepal to at least one.09% in Bangladesh. Alternatively, deciphering those values calls for warning for the reason that case definition used varies throughout international locations with some international locations reporting most effective (lab proven) hospitalized instances (in comparison to others reporting possible instances from communities), therefore main to raised case fatality price amongst the ones hospitalized or critical dengue instances. The surge in dengue occurrence is most likely brought on through more than a few components, together with shifts within the circulating serotype and local weather alternate. No less than 5 international locations (Bangladesh, India, Myanmar, Nepal and Thailand) are recently grappling with the initiation of monsoon season, which creates appropriate stipulations for Aedes mosquito breeding and survival. Moreover, urbanization and inhabitants actions have performed a pivotal position within the expanding burden within the area. Adjustments within the fundamental circulating serotype building up no longer most effective the occurrence but additionally the inhabitants threat of next publicity to a heterologous DENV serotype, which in flip will increase the danger of upper charges of critical dengue and deaths. Western Pacific RegionThe Western Pacific Area continues to stand a excessive burden of mosquito-borne arboviral sicknesses, in particular dengue, which is endemic in twenty-three international locations within the area. In 2024, seven international locations together with Australia, Cambodia, China, Lao Other folks’s Democratic Republic, Malaysia, Singapore, and Viet Nam have reported dengue instances; Malaysia and Viet Nam are essentially the most affected as of twenty-two April, reporting 50 650 instances and 39 deaths (CFR 0.07%) and 16 111 instances and one dying (CFR 0.01%) respectively. Components corresponding to local weather alternate, underdevelopment of infrastructure, cross-border inhabitants actions, and the resurgence of worldwide journey following the COVID-19 pandemic, building up the danger of additional world unfold. The selection of instances is predicted to proceed expanding as soon as the wet season starts in June. There have no longer been any wide outbreaks reported from Pacific Island international locations/territories (PICs) in numerous years on the other hand in 2024, outbreaks were reported in Fiji (3841 instances), Samoa (261 instances), Tokelau (130 instances as of 23 January 2024) and French Polynesia (43 instances). With ongoing journey between the PICs and the presence of competent Aedes mosquitoes, there’s a threat of outbreaks going on as a result of creation from spaces with energetic transmission. Member States within the area with endemic transmission proceed to file longer seasonal dengue epidemics with expanding magnitude and geographic unfold. Alternatively, illness burden estimation is much less dependable because of the underreporting of instances, in particular within the PICs, in keeping with their present syndromic reporting of dengue as dengue-like sickness (DLI). Additional, the reported selection of deaths because of critical dengue is heterogenous throughout international locations. As such, country-level and sub-national CFRs might seem inconsistent. A subset of the area calls for further fortify for dengue to deal with operational gaps in medical control, surveillance, laboratory fortify, threat conversation and group engagement, and operational control. There could also be a wish to give a boost to adherence to the prevailing WHO “Framework for Nationwide Surveillance and Regulate Plans for Aedes vectors” for non-endemic international locations within the Pacific Area, in particular setting up a complete Early Caution Machine that integrates local weather, illness, viral/serological, and entomological surveillance.
Dengue is basically an city illness of the tropics and the viruses that reason it are maintained in a cycle that comes to people and Aedes aegypti mosquitoes. The similar mosquitoes transmit chikungunya and Zika viruses. The proximity of mosquito vector breeding websites to human habitation is an important threat issue for dengue virus an infection. Aedes species mosquitoes can turn into contaminated with the virus after biting folks contaminated with DENV after which transmit the virus to others within the neighborhood. This cycle, subsequently, makes the infective mosquito able to spreading the dengue virus inside of families and within the neighbourhoods of instances, resulting in clusters. Efficient vector keep an eye on interventions are key to the prevention and keep an eye on of dengue. Vector keep an eye on actions must goal all spaces the place there’s a threat of human-vector touch, corresponding to flats, places of work, colleges, and hospitals. WHO promotes Built-in Vector Control (IVM) to keep an eye on Aedes species. IVM must come with eliminating doable breeding websites, lowering vector populations, and minimizing particular person publicity. This must contain vector keep an eye on methods for larvae and adults (i.e., environmental control and supply aid), particularly tracking water garage practices, draining and cleansing family water garage boxes weekly, larvicide in non-potable water the usage of WHO-prequalified larvicides at proper dosages, distribution of insecticide-treated nets (ITNs) for fever/dengue inpatients to comprise unfold of the virus from well being amenities. Indoor area spraying for abruptly containing dengue-infected mosquitoes is also difficult to ship in densely populated spaces. Private protecting measures all over out of doors actions come with topical repellents to uncovered pores and skin or the remedy of clothes and the usage of long-sleeved shirts and pants. Moreover, indoor coverage can come with the usage of family insecticide aerosol merchandise, or mosquito coils all over the day; window and door monitors can scale back the possibilities of mosquitoes coming into the home and insecticide-treated nets be offering excellent coverage to folks towards mosquito bites whilst dozing all over the day. Private protecting measures are really helpful from break of day to nightfall because of the diurnal Aedes aegypti. Those measures and mosquito keep an eye on must additionally quilt places of work and colleges for the reason that vectors are day-biting mosquitoes. Entomological surveillance must be undertaken to evaluate the breeding doable of Aedes mosquitoes in boxes to focus on vector keep an eye on actions and track insecticide resistance to assist choose among the finest insecticide-based interventions. There is not any particular remedy for dengue an infection. Alternatively, early detection and get admission to to suitable healthcare for case control reduces mortality, as can speedy detection of dengue instances with caution indicators and well timed referrals of critical instances to tertiary healthcare amenities. Case surveillance must proceed to be enhanced in all affected international locations and globally. The place possible, sources must be allotted for the strengthening of case referral mechanisms and for the affirmation and serotyping of the dengue viruses. Vaccination towards dengue must be seen as a part of an built-in method to keep an eye on the illness, together with vector keep an eye on, correct case control, group training, and group engagement. WHO recommends the usage of TAK-003 (most effective to be had vaccine) in kids elderly 6–16 years in settings with excessive dengue transmission depth. Nations are inspired to be told and undertake a success examples of efficient case control, prevention, and keep an eye on of dengue and different arboviruses thru heightened analysis tasks, in particular given the hot WHO tips about medical trials. Enforcing medical surveillance and case and dying file paperwork for dengue may well be in particular helpful in figuring out the illness higher and likewise shape a foundation for creating medical trials for brand new remedies or high quality growth tasks.WHO must intently overview native interventions and beneath the most productive proof to simply accept and counsel them for public well being programmes, facilitating early adaptation to cut back the rising well being have an effect on of dengue. Ministries of Well being and companions must intently overview native interventions to simply accept and counsel them for public well being programmes for early adaptation to cut back the rising well being have an effect on of dengue. WHO does no longer counsel that any normal journey or industry restrictions be implemented to international locations in keeping with the to be had data.
