1. Introduction
Dengue fever, a mosquito-borne viral disease, has emerged as one of the most significant and rapidly spreading infectious diseases in the world today. Transmitted primarily by the Aedes aegypti mosquito, the dengue virus (DENV) affects millions annually, with severe consequences for public health, healthcare systems, and economies, especially in tropical and subtropical regions. In recent years, climate change, unplanned urbanization, and increased global travel have contributed to the expansion of dengue's geographic reach, bringing it into regions that were once considered low-risk.
The World Health Organization (WHO) estimates that around 390 million dengue infections occur each year, with about 96 million presenting clinically. The disease ranges in severity from a mild flu-like illness to severe dengue (also known as dengue hemorrhagic fever or dengue shock syndrome), which can be fatal without timely treatment. With the lack of a widely available and universally effective vaccine and no specific antiviral treatment, dengue control relies heavily on prevention, early diagnosis, and supportive care.
The growing frequency and intensity of outbreaks—such as the record-breaking dengue epidemic in Latin America and Asia in 2024–25—underline the urgent need for a coordinated global response. This article provides a comprehensive exploration of dengue fever, from its historical roots and transmission patterns to clinical management, prevention, and emerging challenges in the 21st century.
2. History of Dengue
Dengue fever is not a new disease. Historical evidence suggests that dengue-like illnesses were recognized in ancient Chinese medical texts as early as 992 AD. The illness was known as "water poison" and was linked to flying insects.However, the first recorded dengue epidemics occurred in the 18th century across Asia, Africa, and North America. These outbreaks were likely facilitated by the increased movement of people and goods during colonial trade, which also helped spread the Aedes aegypti mosquito from Africa to other parts of the world.
The name “dengue” is believed to have originated from the Swahili phrase ka-dinga pepo, meaning “a sudden cramp-like seizure caused by an evil spirit.” The term “dinga” may also be derived from the Spanish word “dengue,” which was used to describe a stiff and cautious walk, characteristic of patients suffering from joint pain due to the disease.
Dengue remained relatively rare until the mid-20th century. During and after World War II, the global spread of the virus accelerated due to the movement of troops, disruption of public health services, and increased mosquito breeding in war-torn environments. The first confirmed cases of severe dengue (dengue hemorrhagic fever) were documented in the 1950s in Southeast Asia, particularly in the Philippines and Thailand. These outbreaks were especially deadly among children and marked the beginning of dengue’s transformation into a major public health concern.
Since then, dengue has evolved into a truly global disease. By the late 20th century, the virus had established endemic transmission in more than 100 countries. In the 21st century, with rapid urbanization, climate variability, and globalization, the scale and frequency of dengue outbreaks have continued to grow. Recent years have seen significant epidemics in Latin America, the Caribbean, South Asia, and even parts of Europe and the Southern United States—areas once considered safe from the disease.
Today, dengue fever is recognized not only as a medical condition but also as a socio-economic burden and a reflection of wider issues such as climate change, inadequate sanitation, and health inequities. Understanding its historical trajectory provides valuable insights into how human activity and environmental changes have shaped the spread and impact of this disease.
3. Epidemiology & Global Burden
Dengue fever has seen a dramatic rise in both incidence and geographic spread over the past few decades. The disease is now endemic in more than 100 countries across Southeast Asia, the Western Pacific, the Americas, Africa, and parts of the Eastern Mediterranean. According to the World Health Organization (WHO), dengue is the most rapidly spreading mosquito-borne viral disease in the world, with a 30-fold increase in global incidence over the past 50 years.
In 2023 alone, over 6.5 million cases and 7,300 deaths were reported worldwide. However, these numbers were significantly higher in 2024, when the dengue seasons in Brazil, Argentina, Paraguay, and Peru were the worst on record. In Argentina, for example, there were over 333,000 officially reported cases and 238 deaths, putting a lot of pressure on hospitals and the healthcare system to deal with the largest dengue outbreak ever recorded. More than 14 million cases and 10,576 deaths were documented across 112 countries, with the Latin American and Caribbean region bearing the brunt of the outbreak. systems.
Dengue’s global burden is not limited to health outcomes alone. The economic cost of managing outbreaks—including hospitalization, lost productivity, vector control programs, and public health campaigns—can be substantial. Studies estimate that the annual global cost of dengue exceeds $8.9 billion USD, a burden disproportionately affecting low- and middle-income countries.
Several factors have contributed to dengue's global expansion:
Climate change has widened the habitable zones for Aedes mosquitoes, especially in warmer and wetter regions.
Unplanned urbanization has created densely populated areas with poor waste management and standing water—ideal breeding grounds for mosquitoes.
International travel and trade facilitate the rapid movement of infected individuals and mosquito vectors across borders.
Inadequate vector control infrastructure in many endemic regions hampers efforts to contain outbreaks.
Despite being preventable and manageable with early intervention, dengue remains a neglected tropical disease in terms of international funding and political attention. Its ability to overwhelm healthcare systems during seasonal outbreaks makes it not just a medical issue, but a development and humanitarian challenge.
