What is the Current Situation?

Dengue virus is present in all tropical and many subtropical areas worldwide. The mosquitoes that carry dengue are most active in the morning and evening and during hot, wet times of the year. However, they can spread infection all year long and at any time of day.

For up-to-date, country-specific information on dengue, see the Dengue Map on the CDC website.

Africa and the Indian Ocean Islands

In September 2011, the Uganda Ministry of Health (MOH) reported a dengue outbreak in Mogadishu. In September 2011, the Kenyan MOH reported multiple outbreaks of dengue in several northern Kenyan towns. Dengue infection was confirmed in Mandera and Wajir.

South Pacific and Southeast Asia

In October of 2011, the Republic of the Marshall Islands declared a state of emergency due to a large dengue outbreak.  A total of 1,638 cases have been reported.  Majuro Atoll had the highest number of dengue cases. Visit the Marshall Islands government page for information on the Marshall Island dengue outbreak.

A dengue outbreak was also reported in Yap state of the Federated States of Micronesia (FSM), as well as one in Palau.  As of February 27, 2012, 1,173 cases of dengue have been reported from Yap. 

In addition, the Philippines, Vietnam, and Thailand are among the countries that reported dengue activity in 2011. Australia also continues to report sporadic dengue activity in areas of northern Queensland.  For more information about dengue reports in Thailand and Vietnam, visit the Thailand Ministry of Public Health and the WHO Western Regional Office  (PDF) website.

The Americas and the Caribbean

In 2011, 1,034,064 cases were reported to the Pan American Health Organization (PAHO), including 18,321 severe dengue cases and 716 deaths. In 2011, the number of dengue cases and deaths have surpassed previous years, with outbreaks in Paraguay, Panama, Aruba, Bahamas, and Saint Lucia.

Middle East

Dengue activity is reported sporadically throughout the Middle East, including areas popular with travelers, such as Jeddah in Saudi Arabia.

What is Dengue?

Dengue fever is the most common cause of fever in travelers returning from the Caribbean, Central America, and South Central Asia. This disease is spread through the bites of infected mosquitoes and cannot be spread person to person.

Severe dengue can be fatal, but with good treatment, less than 1% of patients die from dengue.

Symptoms of dengue include:

• fever
• headache
• pain behind the eyes
• joint and muscle pain
• rash
• nausea/vomiting
• mild bleeding, such as nose or gum bleeding or easy bruising

People who have had dengue before may get severe dengue if they are infected again. Anyone with dengue who experiences the following warning signs should go to a doctor or emergency room immediately:

• Severe abdominal pain or persistent vomiting
• Red spots or patches on the skin
• Bleeding from nose or gums
• Vomiting blood
• Black, tarry stools (feces, excrement)
• Drowsiness or irritability
• Pale, cold, or clammy skin
• Difficulty breathing

How Can Travelers Protect Themselves?

Travelers can reduce their risk of dengue infection by protecting themselves from mosquito bites:

• Stay in hotels that are well screened or air conditioned.
• Use insect repellent on uncovered skin.
  • Look for a repellent that contains one of the following active ingredients: DEET, picaridin (KBR 3023), Oil of Lemon Eucalyptus/PMD, or IR3535.
  • Always follow the instructions on the label when you use the repellent.
  • If sunscreen is needed, apply before applying insect repellent.
  • For more information on the use of insect repellents, see the information on the Mosquito and Tick Protection webpage.
• Wear loose, long-sleeved shirts and long pants when outdoors.
  • For more protection, clothing may be sprayed with a repellent containing permethrin. (Don't use permethrin on skin.)

If you return from a trip abroad and get sick with a fever, seek medical care right away. Tell the doctor about your recent travel.

Clinician Information:

Early and proper diagnosis of dengue is important, as many other diseases may mimic dengue. Health care providers should consider dengue, malaria, chikungunya, and leptospirosis, depending on the itinerary and exposure, in the differential diagnosis of patients who have fever and a history of travel to tropical areas during the 2 weeks before symptom onset.

See the Clinical & Laboratory Guidance on the CDC dengue website for information about reporting dengue cases and guidance regarding dengue diagnostic testing. A serum sample should be obtained as early after the onset of fever as possible for dengue diagnostic testing. Molecular testing for DENV and immunodiagnostic testing for IgM anti-DENV should be ordered and can be obtained from commercial reference laboratories and a number of state or territorial health department laboratories. Consultation regarding management of suspect dengue cases or diagnostic testing can be obtained from:

CDC Dengue Branch
Division of Vector-Borne Diseases
National Center for Emerging and Zoonotic Infectious Diseases
1324 Calle Cañada
San Juan, Puerto Rico 00920-3860
Telephone: 787-706-2399; fax, 787-706-2496

Additional Information:

For more information about dengue and protection measures, see the following links:

• Dengue Fever in CDC Health Information for International Travel 2012
• Mosquito and Tick Protection
• Questions and Answers: Insect Repellent Use and Safety
• CDC Dengue website

For more information about dengue in travelers, see

• Travel-Associated Dengue Surveillance—United States, 2006–2008 [MMWR 2010, 59 (23)]
• Travel-Associated Dengue—United States, 2005 [MMWR 2006, 55 (25)].
• Travel-Associated Dengue Infections—United States, 2001-2004 [MMWR 2005, 54 (22)]