The average incubation period for dengue infection is 5 days, followed by an infectious period of viremia lasting for an average of 4.5 days.4,5 There is no licensed dengue vaccine and the only means of prevention is through avoidance of bites from the mosquito vector. The principal dengue vectors, Aedes aegypti and Aedes albopictus mosquitoes, are common throughout the tropics and subtropics. Roughly, one third of the world’s population lives
in dengue-endemic areas in over 100 countries, with an estimated 50 to 100 million dengue cases occurring worldwide annually.6 Over the past two decades, dengue epidemics with cases of DHF have been occurring with increasing frequency around the globe.7,8 Although the vast majority of dengue click here infections occur among residents of dengue-endemic areas, dengue is being increasingly diagnosed among travelers to these destinations.9 Recent findings from the GeoSentinel Surveillance Network9,10 indicate that dengue is the
most commonly reported cause of acute febrile illness in travelers returning from the Caribbean, South America, south central Asia, and southeast Asia. Moreover, dengue was found to be the second most common cause of febrile this website illness (after malaria) in travelers returning from sub-Saharan Africa and Central America.9 In the United States, this upward trend will likely continue with the increasing rates of international travel in recent years,11 and the increasing number of new US immigrants from endemic countries12 who are likely to visit friends and relatives in their countries of origin.13,14 Concern over the risk of reintroduction of dengue virus into the United States has been recently expressed.15Ae. aegypti mosquitoes
exist in a few states in the southeastern United States.16 However, Ae. albopictus mosquitoes exist in 26 states throughout the southeastern United States and Hawaii.17 The presence of competent vectors in the continental United States and Hawaii, along with the O-methylated flavonoid increasing global incidence of dengue and travel to dengue-endemic areas, underscores the need for vigilance regarding possible importation of dengue virus via travel-associated cases. The Division of Vector-Borne Infectious Diseases at the US Centers for Disease Control and Prevention (CDC) conducts dengue surveillance in collaboration with the Puerto Rico Department of Health. This laboratory-based Passive Dengue Surveillance System (PDSS) collects serum samples and epidemiologic information from suspected dengue cases reported by healthcare providers from Puerto Rico, the US Virgin Islands, and the 50 US states and the District of Columbia. This analysis uses PDSS surveillance data to describe the epidemiology of travel-associated dengue among travelers from the United States during the period of 1996 to 2005.