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U.S. officials warn doctors about dengue as worldwide cases surge
U.S. health officials on Tuesday warned doctors to be alert for dengue cases as the tropical disease breaks international records.
The virus, which is spread by mosquitoes, has been surging worldwide, helped by climate change. In barely six months, countries in the Americas have already broken calendar-year records for dengue cases.
The World Health Organization declared an emergency in December, and Puerto Rico declared a public health emergency in March.
Dengue remains less common in the continental United States, but in the 50 states so far this year there have been three times more cases than at the same point last year. Most were infections that travelers got abroad, and officials note there is no evidence of a current outbreak. But they also warn that local mosquitos pose a threat.
In its health alert Tuesday, the Centers for Disease Control and Prevention advised doctors to know the symptoms, ask questions about where patients recently traveled and consider ordering dengue tests when appropriate.
“Global incidence of dengue in 2024 has been the highest on record for this calendar year,” the CDC said in its advisory, adding that so far this year, countries in the Americas have reported more than 9.7 million cases, twice as many as the 4.6 million cases reported for the whole of 2023.
Often referred to as dengue fever or “break-bone fever,” due to pain being a major symptom, dengue (pronounced DEHN’-gay) is caused by a virus spread by a type of warm weather mosquito that is expanding its geographic reach because of climate change, experts say.
About 1 in 4 people infected with dengue will get sick, the CDC says, with symptoms ranging from mild to extreme. About 1 in 20 people who get sick will develop severe dengue, which can result in shock, internal bleeding and even death.
Repeated infections can be especially dangerous.
There are four types of dengue virus, simply known as 1, 2, 3 and 4. When someone is first infected, their body builds antibodies against that type for life. If they get infected with another type of dengue, the antibodies from the first infection may fail to neutralize the second type —and actually can help the virus enter immune cells and replicate.
That’s a concern in Puerto Rico, which for the last two decades has been widely exposed to type 1. Last month, the island reported its first dengue death of the year.
“We’re currently seeing is increases in the cases due to dengue 2 and dengue 3, for which the population has very little immunity,” said Dr. Gabriela Paz-Bailey, the Puerto-Rico-based chief of the CDC’s dengue branch.
There is no widely available medicine for treating dengue infections.
Vaccines have been tricky. U.S. officials in 2021 recommended one vaccine, made by Sanofi Pasteur. The three-dose vaccine is built to protect against all four dengue types and is recommended only for children ages 9 to 16 who have laboratory evidence of an earlier dengue infection and who live in an area —like Puerto Rico— where dengue is common.
Given those restrictions and other issues, it hasn’t been widely used. As of late last month, only about 140 children had been vaccinated in Puerto Rico since shots became available there in 2022, and Sanofi Pasteur has told the CDC it is going to stop making the vaccine.
A different vaccine made by the Tokyo-based pharmaceutical company Takeda is not currently licensed in the U.S. Others are in development.
Across the world, more than 6.6 million infections were reported by about 80 countries last year. In the first four months of this year, 7.9 million cases and 4,000 deaths have been reported, according to the World Health Organization. It’s been particularly intense in the Americas, including in Brazil and Peru.
In the United States, the numbers have been far more modest —about 3,000 cases last year in U.S. states and territories. But it was the worst in a decade, and included more infections that occurred locally, courtesy of native mosquitoes. Most were in Puerto Rico, but about 180 were in three U.S. states — Florida, Texas and California.
So far this year, there have been nearly 1,500 locally acquired U.S. cases, nearly all of them in Puerto Rico.
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Biden says Hezbollah leader Hassan Nasrallah’s killing a “measure of justice” for his many victims
Washington, D.C., – President Biden said on Saturday the killing of Hassan Nasrallah, the overall leader of the Iran-backed group Hezbollah, in a Friday airstrike in Beirut, Lebanon was a “measure of justice,” for his many victims.
In a statement released by the White House, Mr. Biden said “Nasrallah and the terrorist group he led, Hezbollah, were responsible for killing hundreds of Americans over a four-decade reign of terror,” including thousands of Israelis and Lebanese civilians. Nasrallah’s killing, which the statement said took place in the broader context of the conflict that began with Hamas’s massacre on Oct. 7, 2023, happened after the Hezbollah leader “made the fateful decision to join hands with Hamas and open what he called a “northern front” against Israel.”
Hezbollah has been firing rockets and drones across Lebanon’s southern border into Israel for almost a year amid the country’s war with Hamas.
Nasrallah was killed in a series of massive explosions targeting leaders of the militant group, which started with numerous pagers exploding across Lebanon on Sept. 18 killing at least 12 people — including members of the militant group Hezbollah and two children — and wounding several thousand, according to Lebanon’s public health minister.
Strikes escalated in recent days, with one senior U.S. administration official calling the situation between Israel and Hezbollah in Lebanon “delicate and dangerous.” More than 500 people were killed in Lebanon on Monday, according to Lebanon’s health ministry, as missiles slammed into residential buildings. Israel said it was targeting Hezbollah weapons hidden in the building.
Tensions in the Middle East have engulfed Mr. Biden’s last – and his final – year of presidency. His administration has said the U.S. “fully supports Israel’s right to defend itself against Hezbollah, Hamas, the Houthis, and any other Iranian-supported terrorist groups,” and he has directed the Secretary of Defense “to further enhance” the defense posture of U.S. military forces in the Middle East.
Mr. Biden said in the statement ultimately his administration aims to de-escalate the ongoing conflicts through diplomatic means.
During his final speech to the United Nations General Assembly as president on Thursday Mr. Biden said, “full scale war is not in anyone’s interest.”
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