QDENGA Dengue Vaccine

India to Offer Dengue Vaccinations in 2026

Donald Hackett — Mon, 28 Apr 2025 18:55:50 +0000

Reviewer:

With the world continuing to grapple for solutions to limited Dengue fever outbreaks, India may soon offer its population a proven vaccine.

In 2024, India reported over 230,000 dengue cases and 236 related fatalities.

According to reporting by The Times of India on April 28, 2025, the 'Make in India' initiative intends to offer Takeda's QDENGA® dengue vaccine in 2026.

This vaccine launch includes a collaboration with Hyderabad-based firm Biological E. Limited, which is expected to produce about 50 million QDENGA doses annually.

QDENGA (Dengue Tetravalent Vaccine [Live, Attenuated]) is an approved two-dose vaccine preventing dengue fever and/or Severe Dengue caused by any of Dengue's four serotypes.

On December 8, 2022, QDENGA became the first dengue vaccine approved in Europe for use regardless of previous exposure and without the need for pre-vaccination testing. Since then, the World Health Organization added QDENGA to its List of Prequalified Vaccines,

Currently, over 35 countries offer commercial access to the vaccine.

In the United States, Takeda announced on July 11, 2023, that the Company voluntarily withdrew the Biologics License Application for QDENGA following discussions with the U.S. Food and Drug Administration (FDA) on aspects of data collection that could not be addressed within the review cycle.

Furthermore, during the April 2025 U.S. Centers for Disease Control and Prevention (CDC) vaccine committee meeting, QDENGA was not on the agenda.

A previously FDA-approved Dengue vaccine (Dengvaxia) was withdrawn from the market in early 2024.

As of April 2025, the CDC has identified more cases of Dengue than expected among U.S. travelers returning from outbreak countries in the Americas. The CDC recently advised clinicians to consider Dengue in patients with fever who live in or have recently traveled to areas with a risk of Dengue.

The CDC reported on April 23, 2025, that 1,568 travel-related Dengue cases and one local case were reported in 31 jurisdictions this year. The U.S. territories of Puerto Rico and the U.S. Virgin Islands have become endemic for Dengue infections.

The CDC Travel Health Advisory, published on April 15, 2025, states that Dengue is a year-round risk in many parts of the world, and travelers to risk areas should take precautions to prevent mosquito bites.

Sub Title:

QDENGA dengue vaccine is available in various countries in 2025

Reference:

Dengue Cases and Deaths in the Country since 2019

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news18.com 2021

Dengue Infections Cause Cardiovascular Complications

Karen McClorey Hackett — Tue, 22 Apr 2025 08:59:41 +0000

Reviewer:

Robert Carlson, MD

When vacationers return with symptoms similar to a cold, most associate their illness with influenza. However, when visiting most countries in the Americas in 2025, one can also be exposed to the mosquito-transmitted dengue virus.

In the United States, dengue infections are often misdiagnosed. They can cause a range of symptoms, from a mild febrile illness to severe conditions such as dengue hemorrhagic fever and shock, which can result in cardiovascular collapse.

Recently, there have been more reports of atypical presentations following infection by any of the four dengue virus (DENV) serotypes, including cardiac manifestations such as electrocardiographic abnormalities, myocarditis, and pericarditis, which require further investigation.

This review, published on April 18, 2025, discusses our current understanding of the cardiovascular manifestations of dengue and their management, explores the proposed pathogenesis, and concludes with potential future research directions.

The global incidence of dengue has been increasing, partly due to higher travel volumes to areas where dengue is endemic and climate change, which has expanded the range of Aedes mosquito vectors, found at elevations below 2,500 feet.

Last year, more than 13 million dengue cases were reported, the highest year on record.

As of April 16, 2025, the U.S. CDC has reported 1,481 travel-related dengue cases in 30 jurisdictions this year. One locally acquired case in southeast Florida has been confirmed.

In 2024, 53 jurisdictions, led by Arizona, California, Florida, New Jersey, New York, and Puerto Rico, reported 9,391 dengue cases.

To reduce these dengue infections, the ideal DENV vaccine would elicit a balanced and highly protective immune response against all four serotypes of DENV.

Current tetravalent live-attenuated DENV vaccines have faced challenges due to the uneven replication of vaccine virus strains, which stimulate a strong immune response to one serotype and weak responses to the other three serotypes.

While forty countries have enabled access to a second-generation dengue vaccine by 2025, the United States government has not.

Which means it's best to avoid mosquito bites to prevent infection while vacationing in the Americas, including Miami Beach.

Sub Title:

Second generation dengue vaccines are available outside of the U.S.

References:

Cardiovascular Complications of Dengue Virus

Major acute cardiovascular events after dengue infection–A population-based observational study

Cardiovascular manifestations of the emerging dengue pandemic

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An Expert Opinion On Second-Generation Dengue Vaccine

Donald Hackett — Thu, 10 Apr 2025 16:17:55 +0000

Reviewer:

Robert Carlson, MD

In 2024, approximately 13 million dengue cases were reported, marking the highest year on record. Now classified as a grade 3 emergency, this mosquito-transmitted disease could cause additional outbreaks, endangering 4 billion people worldwide.

Therefore, access to innovative vaccines has become an essential public health priority in 2025.

Today, Taylor and Francis Online published a research article titled TAK-003: Development of a Tetravalent Dengue Vaccine. These independent researchers wrote on April 10, 2025, 'One tetravalent dengue vaccine based on a yellow fever backbone has been approved, but due to increased risk of severe disease in dengue-naïve recipients, its use is limited to individuals with prior dengue exposure.'

And that first-generation vaccine has been withdrawn from most markets, including the United States.

However, this article summarizes the clinical development of QDENGA® (TAK-003), a tetravalent dengue vaccine based on a live-attenuated DENV-2 backbone. They discuss vaccine development and preclinical and clinical work leading to a commercially available formulation.

This article's conclusion is inserted below:

Dengue presents a substantial burden on healthcare systems in endemic countries. With increasing urbanization and other factors such as increased global travel and changing weather patterns, DENV will likely spread into currently temperate regions over the coming decades, with potentially millions of dengue-naïve people becoming newly exposed to the virus.

Given the limited effectiveness of current control strategies, an effective dengue vaccine that can be universally administered regardless of previous exposure is a much-needed tool in the global armamentarium against dengue.

A multimodal approach to preventing dengue disease should incorporate routine vector control and public education to reduce mosquito exposure.

Emerging technologies, such as CRISPR, to reduce fertility and flight in Ae. aegypti, infection of mosquitoes with Wolbachia to reduce DENV infection of the mosquitoes, and reverse sterilization of mosquitoes might also be incorporated into multimodal approaches to disease reduction.

Ideally, a vaccine such as TAK-003 should be implemented into national childhood vaccination schedules in endemic regions to provide high immunity levels in young children at risk for DENV infection.

TAK-003 may also be useful in outbreak settings and as a travel vaccine.

Health economic assessments conducted by public health authorities can inform decisions about vaccine incorporation into a dengue prevention strategy.

Collecting real-world evidence will benefit the evaluation of vaccine performance across endemic populations following vaccine introduction. Ideally, within the next 5 years, routine vaccination against dengue in endemic areas and the successful introduction of other mosquito-control technologies can substantially reduce the global burden of dengue disease.

As of 2025, most dengue cases in the United States remain travel-related.

On April 9, 2025, the U.S. CDC reported 1,435 travel-related Dengue cases and one local case had been reported in 30 jurisdictions this year.

However, in 2024, Florida, Puerto Rico, and the U.S. Virgin Islands confirmed numerous locally acquired dengue cases.

While transmission of dengue virus serotypes (DENV-1, -2, -3, and 4) remains high in the Region of the Americas, DENV-3 has become the most common (84%) serotype identified in 2025.

To help identify dengue cases in the U.S., the CDC recently issued this Health Alert Network Health Update to provide additional information to healthcare providers, including updates to testing recommendations.

The CDC wrote on March 18, 2025, 'Healthcare providers, public health departments, and the public are urged to continue to take steps to prevent, detect, diagnose, and respond to dengue.'

By following this CDC advice, dengue outbreaks may be reduced in 2025.

Sub Title:

Qdenga dengue vaccine authorized in 40 countries in 2025

References:

TAK-003: development of a tetravalent dengue vaccine

Ongoing Risk of Dengue Virus Infections and Updated Testing Recommendations in the United States

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US CDC Dengue case map April 2, 2025

Brazil's Dengue Outbreak Moves South

Karen McClorey Hackett — Wed, 02 Apr 2025 10:40:27 +0000

Reviewer:

Robert Carlson, MD

For decades, the Federative Republic of Brazil has been one of the most affected countries by dengue outbreaks in the world, with an average of over three million confirmed cases most years.

Over the past 25 years, nearly 18 million Brazilians have been infected with this mosquito-transmitted virus.

However, Brazil was the unfortunate leader in the Region of the Americas last year, reporting over 9.6 million dengue cases and 5,441 related deaths in 2024. Many of those cases were confirmed in São Paulo.

According to a commentary published by The Lancet on March 22, 2025, this 'situation poses a concern about whether the epidemic will be recurrent or decline as more people get infected and develop lifelong immunity.'

There are four dengue viruses, which means people can be infected multiple times.

A study published in 2024 concluded that the co-circulation of multiple dengue virus genotypes is associated with increased cases, highlighting the importance of continuous surveillance.

There is a concern about whether the current range of dengue across the territory will be rescinded, maintained, or expanded. The latter appears to be the present situation, with particular concern for the South region.

These researchers created risk maps for potential outbreaks using Brazil's historic dengue incidence rate to answer this.

'First, we summarized the dengue incidence for each municipality over the past ten years. We aggregated the confirmed dengue cases from 2015 to 2024 and calculated the cases-to-population ratio, representing the historical incidence.

To create a more accurate version of this ratio, we applied a Bayesian model that considers the case counts from neighboring areas to estimate the actual number of cases within each municipality.

For the short-term period, we assumed that the ratio reflects lifelong immunity and that it is unlikely for a dengue season to include serotypes that were not represented in our dataset. Then, the complement of the ratio was calculated to determine the outbreak risk.

'This means that areas (in the south and mountains) with low dengue incidence over the past ten years are likely to be more susceptible to dengue outbreaks,' wrote these researchers.

Mosquitoes that spread Dengue viruses usually live below 6,500 feet elevation; therefore, a person's chances of getting dengue in high altitudes are very low.

To notify international travelers, the U.S. Centers for Disease Control and Prevention (CDC) published a Health Update on March 18, 2025, highlighting the ongoing risk of dengue infections and updates to testing recommendations.

On March 20, 2025, the CDC reissued a Global Travel Health Notice regarding dengue outbreaks in the Americas, which highlighted Brazil.

While about 40 countries offer dengue prevention vaccines in 2025, the U.S. does not.

Sub Title:

Dengue is a vaccine preventable disease in April 2025

Reference:

On the verge: outbreak risk after two years of record-breaking dengue epidemics in Brazil

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The Lancet March 22, 2025

U.S. CDC Under-Discloses Dengue Outbreaks

Donald Hackett — Fri, 21 Mar 2025 14:51:36 +0000

Reviewer:

Robert Carlson, MD

With the World Health Organization (WHO) and over 100 countries reporting Dengue cases in 2025 and classifying Dengue outbreaks as a grade 3 global emergency, the new U.S. CDC Travel Health Advisory appears to be under-highlighting this global health issue.

On March 20, 2025, the CDC only identified 16 countries with higher-than-expected Dengue cases among U.S. travelers returning from those countries.

Previously, the CDC stated that the Dengue virus was endemic in the U.S. territories of Puerto Rico, American Samoa, and the U.S. Virgin Islands. In the continental U.S., Dengue is frequently detected in Florida's Miami-Dade County.

As of March 21, 2025, the WHO/PAHO data dashboard indicates over 1.2 million Dengue cases and 348 related fatalities have already been reported this year in the Region of the Americas, which includes the United States.

In 2024, more than 13 million Dengue cases were reported in the Americas, making it the highest year on record.

The CDC stated today that international 'travelers should practice prevention measures for all areas with a risk of dengue, an acute febrile illness.'

An estimated 40%–80% of DENV infections are asymptomatic.

However, symptoms in perinatally infected neonates typically present during the first week of life and include fever, hemorrhagic manifestations, hypotension, and thrombocytopenia.

A previous study found that 'compared to uninfected mothers, babies born to mothers with dengue are likely to have worse outcomes. Preterm birth and low birth weight are frequently observed in dengue-affected pregnancies, which can have serious effects on the health and development of the child.'

The CDC recommends that visitors to Dengue-risk areas prevent mosquito bites by using an EPA-registered insect repellent, wearing long-sleeved shirts and pants outdoors, and sleeping in rooms with window screens.

While many countries have authorized a second-generation Dengue vaccine (QDENGA) to reduce the number of mosquito-transmitted Dengue infections, this vaccine is unavailable in the U.S.

However, several Dengue vaccine candidates are conducting late-stage clinical trials, which could be authorized in the U.S. in the future.

Sub Title:

Dengue vaccine unavailable in the United States in 2025

References:

US CDC Global Dengue March 20, 2025

Review of Maternal and Perinatal Outcomes of Dengue in Pregnancy

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WHO Dengue Case Map March 2025

Unintentional Dengue Vaccination Produce Few Side Effects for Neonates

Karen McClorey Hackett — Wed, 19 Mar 2025 19:01:23 +0000

Reviewer:

Robert Carlson, MD

Millions of couples vacation in the Caribbean, where Dengue virus is endemic. While visiting these countries, some women have gotten vaccinated with the second-generation Dengue vaccine, which is not an authorized use.

TAK-003 (QDENGA) vaccination is authorized in about 40 countries in 2025 but is contraindicated during pregnancy and lactation.

Original Research published by Taylor and Francis Online on March 18, 2025, found no evidence of increased adverse pregnancy outcomes following unintentional TAK-003 vaccination occurring inside the exposure window compared with placebo.

This post-hoc analysis of phase 2 and 3 clinical studies evaluated pregnancy outcomes and neonatal adverse events (AEs) following unintentional vaccination when women could be pregnant within 44 days before the last menstrual period until the outcome of pregnancy.

Of the 557 reported pregnancies in these studies, 38 occurred inside the exposure window. Of these, 28 (TAK-003, n = 23; placebo, n = 5) resulted in live births, four resulted in elective terminations (TAK-003, n = 2; placebo, n = 2), five in spontaneous abortions (TAK-003, n = 3; placebo, n = 2) and one unknown outcome (placebo).

Of the spontaneous abortions, there was no significant difference between TAK-003 and placebo recipients or between those occurring within or outside the exposure window.

However, six mothers who received TAK-003 in the exposure window and two neonates experienced serious AEs, but none were considered TAK-003 related.

These researchers identified a significant concern... administering live-attenuated vaccines during pregnancy is the potential for vertical transmission and a replicating vaccine virus posing a risk to the fetus.

The limitations of this post-hoc analysis include the small sample size of unintentional pregnancies occurring within the exposure window. Therefore, the quality and level of information about the pregnancies differed and depended on the extent of availability and level of antenatal care sought.

Currently, 46 countries and territories in the Americas report dengue outbreaks. About 1.2 million Dengue infections have already been reported in 2025.

As of March 19, 2025, the QDENGA vaccine remains unavailable in the United States.

Takeda Pharmaceuticals International AG, the producer of QDENGA, funded this study.

Sub Title:

Dengue vaccine is contraindicated during pregnancy and lactation

Reference:

Pregnancy outcomes following unintentional exposure to TAK-003

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Do Dengue and Tennis Mix in Miami

Karen McClorey Hackett — Wed, 19 Mar 2025 08:40:01 +0000

Reviewer:

Robert Carlson, MD

With about 390,000 worldwide tennis fans attending the Miami Open 2025 tennis tournament, most Florida visitors are unaware of ongoing mosquito-transmitted health risks in late March.

The Miami Open 2025 is an international tennis event that welcomes fans from the Caribbean, Central and South America.

Throughout the Region of the Americas, including southeast Florida, Dengue outbreaks set records last year. In total, 49 countries and territories reported over 13 million cases in 2024.

In the continental United States, the U.S. Centers for Disease Control and Prevention (CDC) reported that locally acquired Dengue cases were confirmed in Florida (91), California (18), and Texas (1) last year.

Additionally, a record number of dengue cases (3,483) were identified among U.S. travelers in 2024, an 84% increase from 2023. The highest number of travel-associated cases was reported in Florida (1,016).

As of March 19, 2025, about 1.2 million Dengue cases and 348 related fatalities have been reported in the Americas this year.

To better inform everyone of this health risk, the CDC issued a Health Update regarding Dengue fever outbreaks on March 18, 2025. According to the CDC, these disease outbreaks are expected to continue throughout 2025, with increased dengue activity in endemic areas, such as Brazil, Cuba, and Puerto Rico.

According to the Florida Department of Health, Miami-Dade County led all counties in Local (91) and Travel (1,016) cases last year. So far in 2025, 44 cases of Dengue have been confirmed in Florida among people who have traveled internationally, including 23 people arriving from Cuba.

Additionally, Miami-Dade County reports its initial locally-acquired Dengue case of 2025.

To alert visitors to the greater Miami area, Florida's health department issued a mosquito-borne illness alert scheduled to remain in effect until December 31, 2025. Furthermore, Duval, Hillsborough, Manatee, and Pasco counties are also under mosquito-borne illness alerts.

Since Dengue vaccines remain unavailable in the U.S. in 2025, the CDC advises preventing mosquito bites during travel, particularly when visiting areas with frequent Dengue virus transmission.

Recently, DENV-4 has become the dominant subtype.

In addition, the CDC says travelers should prevent mosquito bites for a few weeks after returning home to avoid possibly spreading the virus to others if they are in an area where mosquitoes are active.

An additional disease prevention recommendation is posted on the Miami Open 2025 website.

'We urge everyone attending events at Hard Rock Stadium to adhere to the COVID-19 recommendations of the CDC, which include getting vaccinated and wearing masks in indoor spaces, regardless of vaccination status.'

The CDC and Florida both recommend wearing long-sleeved shirts when possible to reduce mosquito bite risks, which may also prevent sunburns while watching tennis matches!

Note: This news article was updated on March 20, 2025, to include local Dengue case in Miami-Dade County.

Sub Title:

Miami Dade County Florida under mosquito-borne illness alert until December 2025

Reference:

Miami-Dade County Alerts

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Italy's Mosquito Tracking System Sets New Standard

Karen McClorey Hackett — Tue, 18 Mar 2025 10:04:03 +0000

Reviewer:

Robert Carlson, MD

The spread of invasive mosquito species, such as the tiger mosquito, poses global health risks due to their potential to carry diseases such as chikungunya, dengue, malaria, and Zika.

An innovative use case in Italy connected the operational mosquito monitoring agency with OEMC tools and data to address the expanding health risk posed by climate change.

The Mosquito Alert System leverages continuous capillary point observations from the regional administration and different state-of-the-art machine-learning techniques to provide data-driven insights for mosquito population control.

This system provides two open-source model applications whose outputs support and integrate Emilia-Romagna region (RER) efforts to manage and control Ae. albopictus populations. Data on mosquito occurrence has been collected daily since 2017 (755 overlaps in 10 main cities).

The project includes spatial analysis and modeling training in open-source environments to support decision-making and enhance the region’s control strategies.

When using this system, public health agencies, regional environmental departments, and communities will benefit from improved identification of where mosquito eggs are at risk.

In the United States, this system could help identify dengue-carrying mosquitos in Miami, Florida, and San Juan, Puerto Rico, where dengue vaccines are unavailable in 2025.

Sub Title:

Infected mosquitoes can carry chikungunya, dengue, malaria, and Zika viruses in 2025

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New Zealand Visitors Increasing in 2025

Karen McClorey Hackett — Sat, 04 Jan 2025 15:06:30 +0000

Reviewer:

Robert Carlson, MD

New Zealand's tourism industry is well-positioned to set international visitor records in 2025. Over the last few weeks, various government agencies have updated Vista requirements and safety advisories and clarified vaccination recommendations for visitors to the 'Most Beautiful Country.'

New Zealand is an island nation in the Pacific Ocean southwest of Australia. It has two main islands, the North and South Islands, and over 700 smaller islands that offer world-class tourism opportunities.

New Zealand's tourism upswing began in 2024. For example, 240,200 overseas visitors arrived last October, far surpassing the previous year's totals.

About 46% of these visitors were from Australia, 9% were from the United States, and 5% were from the United Kingdom.

To encourage future visitors, the U.S. Department of State announced, on January 3, 2025, an updated travel advisory for visiting New Zealand.

The State Department's lowest-level advisory advises exercising normal precautions in New Zealand and enrolling in the Smart Traveler Enrollment Program to receive alerts and make locating you in an emergency easier.

While in New Zealand, the U.S. Consulate General in Auckland offers various support services.

Seperately, the UK Health Security Agency confirmed on January 2, 2025, If you are planning to visit a remote area in New Zealand, check with the local tourist authorities for advice.

The New Zealand government recently announced reforms to the Accredited Employer Work Visa program. The changes will be implemented throughout 2025, beginning in January.

From a health perspective, the U.S. CDC says there are no Health Travel Advisories currently in effect when visiting New Zealand. Check the vaccines and medicines list and see a healthcare provider at least a month before your trip to get the necessary medications.

Most mosquito-borne disease cases in New Zealand are acquired overseas. Dengue fever was the most commonly reported disease as the global outbreak reached the entire Pacific Region in 2024.

Dengue vaccines have become available, and new vaccine candidates are nearing approval in 2025.

Sub Title:

New Zealand most beautiful country offers healthy and safe vacation options in 2025

References:

Travel Advisory January 3, 2025New Zealand - Level 1: Exercise Normal Precautions

UK Health Security Agency

NZ International travel: October 2024

NZ Visa program 2025

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by Claudio Bianchi

Tourism Often Leads to Dengue Infection

Karen McClorey Hackett — Tue, 03 Dec 2024 16:09:02 +0000

Reviewer:

Robert Carlson, MD

Throughout the global Dengue outbreak of 2024, vacationers have asked how to avoid this mosquito-transmitted disease. Most travel vaccination experts say don't visit an endemic destination.

According to the most extensive analysis of international travel-related Dengue to date published by the Journal of Travel Medicine (Volume 31, Issue 7, October 2024), the most frequent regions of Dengue acquisition were South East Asia (50.4%), South Central Asia (14.9%), the Caribbean (10.9%) and South America (9.2%).

In the Region of the Americas, 43 countries and territories have reported over 12,576,159 Dengue cases and 7,656 related deaths in 2024. Brazil has confirmed the most cases of Dengue, followed by Mexico and other countries.

This analysis found that tourism was the most frequent reason for visiting these countries (67.3%).

Furthermore, this analysis revealed some good news.

While Dengue is a benign, self-limiting disease in most travelers, it can be unpleasant, with flu-like symptoms. Severe Dengue in travelers is rare, occurring in just 0.5% of the data sample. A previous, smaller study in Israel reported that 1.6% of international travelers have severe Dengue.

As of December 2024, 52 jurisdictions in the United States had reported 7,858 Dengue cases, most of which were travel-related. This is an increase of about 19% compared with 2023.

The unfortunate leaders are California, Florida, New Jersey, New York, Puerto Rico, and Texas.

In June 2024, the U.S. CDC updated a Health Alert Network Health Advisory, notifying healthcare providers, public health authorities, and the public of an increased risk of Dengue while traveling abroad. The CDC says clinicians should consider Dengue in patients with fever who live in or recently traveled to areas with risk of Dengue.

However, detecting Dengue requires specific tests unavailable to most healthcare providers.

"Educating international travelers about the potential disease risks from insect bites while traveling and ways to avoid insect bites while traveling should be part of a travel consultation with a travel health specialist," commented Beverly Schaefer, RPh.

"Avoiding bug bites is most travelers' top goal for staying healthy while abroad," added Schaefer with Katterman's Sand Point Pharmacy, Seattle, WA 98105.

From a Dengue-prevention perspective, one vaccine is in high demand but is in limited supply in 2024. Furthermore, access is restricted in the U.S. as the Qdenga vaccine is not FDA-approved.

But, according to recent news, new Dengue vaccine candidates may become authorized in 2025, increasing access and protection options for international travelers.

Sub Title:

Severe Dengue detected in a few international travelers

References:

Epidemiology of travel-associated dengue from 2007 to 2022: A GeoSentinel analysis

Comparison of clinical and laboratory parameters of primary vs secondary dengue fever in travellers

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Additional Evidence From Brazil Suggests Blood Transfusion-Transmitted Dengue Virus

Karen McClorey Hackett — Sat, 30 Nov 2024 11:31:19 +0000

Reviewer:

Robert Carlson, MD

Over the past decade, clinical evidence has suggested a potential route of blood transfusion-transmitted dengue virus (TT-DENV).

On November 29, 2024, the Lancet Infectious Disease published a Correspondence reporting six dengue cases from two pediatric cardiovascular intensive care units (CICUs) in São Paulo, Brazil.

These children were transfused multiple times following cardiac surgeries for complex congenital heart diseases during the peak of Brazil's current dengue outbreak. Most patients developed fever and thrombocytopenia, and dengue infection was confirmed by NS1 antigen test and serology (IgM positive).

There were four deaths, two of which were complicated by severe hepatitis and two by bacterial sepsis.

These researchers wrote that the blood donors were not screened for dengue but concluded TT-DENV was the most likely source of infection.

Furthermore, 'these cases raise considerable concerns about transfusion safety during dengue outbreaks.'

TT-DENV has been documented in previous epidemics, where dengue RNA-positive blood donations led to confirmed transmissions.

Studies have shown that asymptomatic blood donors with DENV viremia represent a potential source of TT-DENV transmission. Asymptomatic infections account for a substantial proportion of cases during large outbreaks, making them difficult to detect through routine screening.

According to these researchers, nucleic acid testing (NAT) has proven to be a more reliable method for detecting early-stage infections when viral load is present. Yet, widespread implementation of NAT remains limited in dengue-endemic regions, such as the Americas.

With DENV viremia rates reported in up to 5.5% of blood donors during outbreaks, 'it is imperative that we reevaluate current blood safety protocols.

Given Brazil's status as a hotspot for mosquito-transmitted diseases such as chikungunya, dengue, and zika, 'we urge health authorities to prioritize introducing more rigorous blood screening measures during outbreaks, such as targeted NAT, to safeguard transfusion recipients.'

'Failure to address this risk could result in a hidden epidemic of TT-DENV during dengue outbreaks in patients receiving blood products, particularly those who are more susceptible to severe disease.'

This new study and the previous studies may impact blood donation activity on Florida's southeast coast, Texas, and throughout Puerto Rico, where dengue has become endemic.

On November 25, 2024, the Texas Department of State Health Services reported the first locally acquired case of dengue virus in Cameron County. Also, there have been 106 travel-associated dengue cases, including one death reported in Texas this year.

Just across the Rio Grande River in south Texas, Mexico has reported about 500,000 dengue cases in 2024.

According to the Red Cross website, as of November 30, 2024, blood donations are tested for multiple disease markers, but not dengue, chikungunya, or zika.

Note: This article was fact-checked, edited for tone, and updated on Dec. 2, 2024.

Sub Title:

Dengue

References:

Dengue: a hidden threat in blood transfusions amidst Brazil's largest outbreak

Dengue virus transmission risk in blood donation: Evidence from Thailand

Transfusion-Transmitted Dengue and Associated Clinical Symptoms During the 2012 Epidemic in Brazil

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Texas Joins California, Florida, Others Reporting Local Dengue Cases

Karen McClorey Hackett — Tue, 26 Nov 2024 22:19:43 +0000

Reviewer:

Robert Carlson, MD

According to local health officials, the global dengue virus outbreak in 2024 has reached another U.S. state.

On November 25, 2024, the Texas Department of State Health Services (DSHS) reported the first locally acquired case of dengue virus in a Cameron County resident located in south Texas. As of today, there have been 106 travel-associated dengue cases, including one death reported in Texas.

Since 2013, 625 travel-related dengue cases have been reported, and 40 cases have been acquired in Cameron, Hidalgo, Starr, Val Verde, Webb, and Willacy counties.

This unfortunate activity may continue through 2024 as disease-carrying mosquitoes remain active in much of Texas into December.

"It is important for health care providers to consider a diagnosis of dengue virus and test for it if their patient has symptoms consistent with the disease," said DSHS Commissioner Jennifer Shuford, MD, MPH, in a press release.

While this DSHS news is unsettling, Texas ranks well behind other U.S. states and territories.

In California, the San Bernardino County Public Health Department recently reported a locally-acquired dengue case in San Bernardino. The Los Angeles County Department of Public Health has reported 12 locally acquired dengue cases in the San Gabriel Valley. And in San Diego, Escondido, and Visa reported local dengue cases in 2024.

As of November 23, 2024, the Florida Health Department reported over 803 travel-associated and 66 locally acquired dengue cases this year.

Throughout New York, including New York City, 301 dengue cases have been confirmed in 2024.

Furthermore, Puerto Rico's Department of Health confirmed dengue is endemic in the greater San Juan area, with 4,467 cases reported this year.

Dengue is a viral disease caused by any of the four related viruses: dengue virus 1, 2, 3, and 4, says the U.S. CDC. A person can be infected with dengue multiple times in their life.

Symptoms of dengue usually begin within 2 weeks of being bitten by an infected mosquito and typically last 2–7 days. Most people recover after about a week, but no specific medicine treats dengue.

From a prevention perspective, dengue vaccines are currently unavailable in the U.S.

Sub Title:

Dengue Vaccines are unavailable in the U.S.

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Texas public health officials announce first locally acquired case of dengue virus in 2024

US CDC Dengue 2024

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Wednesday, November 27, 2024 - 06:00

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US CDC Dengue Map November 2024

America's Dengue Cases Increase 280%

Karen McClorey Hackett — Fri, 15 Nov 2024 18:18:48 +0000

Reviewer:

Robert Carlson, MD

As the global dengue fever outbreak of 2024 reaches new records, the United States, its Territories, and freely associated states are unfortunately exceeding past milestones.

As of November 15, 2024, the U.S. Centers for Disease Control and Prevention (CDC) reported that in the continental U.S., 2,495 dengue cases have been confirmed this year. This compares with 1,540 in 2023.

Additionally, the CDC confined the U.S. territories that reported 4,166 dengue cases in 2024, far exceeding the 782 cases reported last year. To alert international travelers of these dengue outbreaks, the CDC reissued its Level 1 advisory.

Throughout the entire Region of the Americas, 43 countries and territories have reported over 12,371,235 dengue cases and 7,456 related fatalities this year. This data compares with 2023, when 4,617,108 dengue cases were reported.

One factor influencing these mosquito-transmitted outbreaks is the lack of vaccines.

While the first-generation vaccine (Dengvaxia) was withdrawn in most countries in 2024, including the U.S., a more effective second-generation vaccine (Qdenga®) is facing overwhelming demand.

Qdenga's manufacturer, Takeda, announced in February 2024 that it intends to deliver 100 million doses annually by 2030.

Since the U.S. FDA and Takeda have not announced progress in approving Qdenga, hopefully, other dengue vaccine candidates will become available in the U.S. next year.

Sub Title:

Dengue vaccines are unavailable in the United States in 2024

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US CDC Dengue Travel Advisory 2024

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US. CDC Dengue Case Map November 2024

Southern California's Dengue Outbreak Reaches San Bernardino County

Karen McClorey Hackett — Sun, 10 Nov 2024 16:24:40 +0000

Reviewer:

Robert Carlson, MD

According to the California Department of Public Health (CDPH), most dengue cases reported in California involve people infected while traveling abroad. As of early November 2024, CDPH reported a total of 344 dengue cases this year.

However, the mosquitoes that spread dengue (Aedes aegypti and Aedes albopictus) are found in California, especially in So-Cal, where 15 local dengue cases have been reported this year.

As of November 10, 2024, the San Bernardino County Public Health Department reported a locally acquired dengue case in the city of San Bernardino.

To the west, the Los Angeles County Department of Public Health recently reported 12 locally acquired dengue cases in the San Gabriel Valley.

To the south, Escondido and Visa reported local dengue cases in San Diego in mid-2024.

Last year, CDPH only reported seven locally acquired cases (Long Beach and Pasadena) in So-Cal.

Muntu Davis, MD, MPH, Los Angeles County Health Officer, recently stated in a press release, “Providers should consider dengue in any patient with fever and signs and symptoms of dengue including headache, eye pain, muscle, bone or joint pain, nausea and vomiting and order testing for dengue regardless of travel history.”

While any local dengue case may indicate a pending outbreak, two areas in the southeastern United States have already confronted travel-related and local case outbreaks.

In Florida, 720 travel-associated and 59 locally acquired dengue cases were confirmed this year.

And dengue has become endemic in Puerto Rico.

Throughout the U.S., the Centers for Disease Control and Prevention (CDC) have reported that 52 jurisdictions have confirmed 7,101 dengue cases as of October 31, 2024.

Furthermore, the Region of the Americas reports its most intense dengue outbreak season ever, with over 12.2 million cases in 2024. Unfortunately, there have been 7,420 dengue-related deaths in the Americas this year.

Since infected mosquitoes can transmit chikungunya, dengue, and zika viruses, the CDC recently issued travel advisories for various countries, such as Brazil and India. The CDC recommends that international travelers protect themselves from mosquito bites and speak with a travel vaccine expert about options at least one month before departure.

In the U.S., the newly approved chikungunya vaccine (IXCHIQ®) is offered at various travel clinics and pharmacies. However, dengue and zika vaccine availability are pending.

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Local dengue infections in Los Angeles, San Bernardino, San Diego counties in 2024

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First locally acquired human case of dengue virus reported in San Bernardino County

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Sunday, November 10, 2024 - 09:00

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Google Maps November 2024

Is Dengue Endemic in Los Angeles

Donald Hackett — Sun, 03 Nov 2024 16:52:54 +0000

Reviewer:

Robert Carlson, MD

While the Dengue virus has progressively become endemic in southeast Florida and Puerto Rico over the past few years, recent reports from California indicate that this mosquito-transmitted virus may have found a home in Los Angeles.

As of November 3, 2024, the Los Angeles County Department of Public Health (LACDPH) reported 11 locally acquired dengue cases in the San Gabriel Valley, located east of LA's downtown.

The LACDPH has confirmed Dengue cases in the cities of Baldwin Park (7), El Monte (2), Hollywood Hills (1), and Panorama City (1) in 2024.

Last year, LACDPH reported seven locally acquired Dengue cases (Long Beach and Pasadena).

On October 15, 2024, Muntu Davis, MD, MPH, Los Angeles County Health Officer, commented in a press release, "We are still investigating, but these new cases raise concern about the potential for continued local spread of dengue through the bite of infected mosquitoes in Baldwin Park."

"As part of this investigation, Public Health and San Gabriel Valley Mosquito and Vector Control District teams will conduct outreach and offer testing for Dengue and enhanced mosquito control services for those living and working in the area. It's also important for everyone to focus on protecting themselves from mosquito bites and eliminating places where mosquitoes can breed and grow."

"Together, we can protect our communities from dengue and other mosquito-borne diseases."

In June 2024, the U.S. CDC updated a Health Alert Network Health Advisory, notifying healthcare providers, public health authorities, and the public of an increased risk of Dengue virus infections in the U.S. The CDC stated clinicians should consider Dengue in patients with fever who live in or have recently traveled to areas with a risk of Dengue.

With the withdrawal of the only U.S. FDA-approved Dengue vaccine in early 2024, Dengue vaccines and candidates are unavailable in the U.S. but are offered in over 20 countries.

Sub Title:

San Gabriel Valley reported 11 locally acquired dengue cases in 2024

Reference:

Current Dengue Case Situation in LA County

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