Dengue

Dengue Overview

Dengue is a viral vector-borne disease spread through the bite of infected mosquitoes. Common symptoms include fever, nausea, vomiting, rash, eye pain, and muscle, joint or bone aches and pains. Each year, up to 400 million people around the world are infected with dengue and transmission is most common in tropical and subtropical regions, including the U.S. territories of American Samoa, Puerto Rico and the U.S. Virgin Islands. There is an increasing incidence of cases in the continental US between travel-associated cases and locally acquired cases in Florida and California. People who have had a previous dengue infection are at greater risk of severe disease if they are infected again. Approximately 1 in 20 people who are infected will have severe disease that requires immediate medical attention.

AAP Recommendations

While a vaccine (Dengvaxia) was previously available for children who live in dengue endemic areas, this vaccine was discontinued and all available doses expired in fall 2026. Therefore, there is no dengue vaccine available in the United States at the present time. Information on testing, prevention and treatment for dengue infection can be found in the Dengue Chapter of the AAP Red Book.

More About the Science

Older children and adolescents are at greater risk for severe dengue disease and hospitalization. Dengue viruses are spread to people through the bite of infected Aedes mosquitoes. Warning signs of severe illness include stomach pain and tenderness, vomiting, bleeding from the nose or gums, blood in vomit or stool, and extreme tiredness or restlessness. Early testing and detection of dengue is critical for appropriate fluid management, which can prevent severe dehydration and may require oral or intravenous rehydration. Timely laboratory confirmation can drastically reduce mortality from dengue. People can  protect themselves and their families from dengue by preventing mosquito bites and controlling mosquitoes in and around their homes.