Global Dengue Surge; 10 Million Cases So Far In 2024; Puerto Rico Infections Jan-May More Than All Of 2023

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The girl, Genesis Polanco Marte, is among a record 10 million people who have fallen ill with dengue so far this year — an unprecedented surge that scientists say is fueled in part by climate change. Soaring global temperatures have accelerated the life cycles and expanded the ranges of the mosquitoes that carry dengue, helping spread the virus to roughly one in every 800 people on the planet in the past six months alone. An influx of patients has overwhelmed hospitals from Brazil to Bangladesh, recalling the worst days of the coronavirus pandemic. Puerto Rico declared a public health emergency this spring, with more dengue cases reported in the first five months of 2024 than all of last year. Public health officials are bracing for the virus to crop up in more temperate regions, including the southernmost portions of the United States. “The storm’s comin’, folks,” Grayson Brown, executive director of the nonprofit Puerto Rico Vector Control Unit, advised a group of California officials in a recent webinar. “It’s here in Puerto Rico, but you guys are going to feel it pretty soon.”

Last week, the Centers for Disease Control and Prevention warned of an increased risk of dengue infections in the United States, urging clinicians to stay on alert for the disease when treating feverish patients who have traveled to places with dengue transmission. But even as human-made warming spurs cases to historic highs, dengue remains one of the world’s most neglected tropical diseases, according to the World Health Organization. Three out of four cases are mild or asymptomatic, making the illness difficult to track. And because the virus comes in four varieties, or serotypes, natural immunity after one illness does not protect against future infections with other types. What makes dengue unusual is that the risk of severe complications may actually increase with sequential infections of a different type.

There is no cure for the virus, which in severe cases can lead to plasma leaking from veins, internal bleeding, organ failure and, in rare instances, death. Unlike other illnesses, vaccination is complicated. Few options are available, and few people know about them. The only vaccine available in the United States is for children 9 to 16 years old who have already been infected with dengue — those most vulnerable to hospitalization. But it won’t be available after 2026.

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Only 145 children in Puerto Rico have started the vaccine series since it became available in 2022, according to CDC — a tiny fraction of the roughly 140,000 eligible. And now access to the vaccine is closing. A few months before Puerto Rico declared its public health emergency in March, Sanofi informed U.S. officials that it has stopped producing Dengvaxia because of low demand. The last doses will expire in August 2026. Adam Gluck, who leads Sanofi’s U.S. corporate affairs, said the company tried making the vaccine easy to access but the complexity of screening for a prior infection before administering the required three doses kept demand low. The decision to discontinue the vaccine “is not driven by quality, safety or efficacy concerns,” he said in a statement.

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https://www.washingtonpost.com/health/2024/06/30/dengue-puerto-rico-mosquito-climate-change/