Dengue among Hospitalized Patients, United States | CDC EID

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Volume 17, Number 5–May 2011
Dispatch
Upward Trend in Dengue Incidence among Hospitalized Patients, United States
Judy A. Streit, Ming Yang, Joseph E. Cavanaugh, and Philip M. Polgreen
Author affiliation: University of Iowa, Iowa City, Iowa, USA


Suggested citation for this article

Abstract
International travel and a global expansion of dengue fever have the potential to increase the incidence of dengue in the United States. We conducted a retrospective cohort analysis of trends in dengue among hospitalized patients by using the National Inpatient Sample (2000–2007); the number of cases more than tripled (p< 0.0001).
The worldwide number of cases of dengue infection has increased nearly 35-fold in the past half-century, with a concomitant rapid geographic expansion (1). A large percentage of the world's population is at risk for dengue fever: an estimated 2.5 billion persons live in virus-endemic areas. Each year, 50–100 million cases occur, hospitalizations for the infection have reached 500,000, and the global death toll is >20,000 persons (2). Large outbreaks have also occurred in close proximity to the US mainland (3,4). Despite the close proximity of these outbreaks to the United States, autochthonous cases in the continental United States have been relatively unusual, until the recent large autochthonous outbreak in Florida (5,6).

Risk for dengue infection to US residents has primarily been posed by travel. Among a multinational sample of ill travelers with a systemic febrile illness for whom a diagnosis could be determined, the GeoSentinel Surveillance Network reported that dengue fever was the second most common cause of such cases, behind malaria (7). A study from the same network reported that among travelers from all but 2 regions confirmed or probable dengue was more common than malaria (8). However, a recent published report indicated that, although reported cases of travel-associated dengue had increased during 1996–2005, "no significant trend" was shown (9). Another recent report showed a travel-associated increase, but this finding may have been due to, in part, the expansion of surveillance to include 2 independent monitoring systems (10). Because dengue has not been a reportable disease in the United States until recently, incidence and disease trends are difficult to determine. The goal of this study was to determine incidence of dengue fever among hospitalized patients and to analyze the recent trend in hospitalizations among patients with this disease.

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Dengue among Hospitalized Patients, United States | CDC EID


Suggested Citation for this Article
Streit JA, Yang M, Cavanaugh JE, Polgreen PM. Upward trend in dengue incidence among hospitalized patients, United States. Emerg Infect Dis [serial on the Internet]. 2011 May [date cited].
http://www.cdc.gov/EID/content/17/5/914.htm


DOI: 10.3201/eid1705.101023


Comments to the Authors
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Philip M. Polgreen, Department of Internal Medicine, Division of Infectious Diseases, University of Iowa Carver College of Medicine, 200 Hawkins Dr, SW 34 GH, Iowa City, IA 522242, USA; email: philip-polgreen@uiowa.edu