Top docs Dr. Orin Levine and Dr. Ciro de Quadros share some unfortunate news: dengue fever, a mosquito-borne viral disease, is making a reemergence in the United States.
If someone told you that they’d survived “break bone fever” would you know the disease they’re talking about? If they told you that the first outbreak of this disease in the United States was recorded in Philadelphia in 1870, would that help? If they revealed that mosquitoes that spread the disease are found in many parts of the United States today, would that shed any light?
If you didn’t know that this disease was dengue fever, you’re not alone. Many Americans have long since forgotten about this disease and the risks it poses. But we may soon need to reeducate ourselves, because today, dengue –- the most prevalent mosquito-borne viral disease known to humankind -– is reemerging in the United States. Last week, the best scientific minds convened in Philadelphia to discuss scientific advances in tropical medicine and global health -– and the urgent need to combat dengue fever was front and center.
Dengue is characterized by soaring and debilitating fever and deep and searing body pain, and the most severe forms can inflict unspeakable misery and sometimes death. While severe dengue is not endemic within our borders, more than 125 million international tourists visit countries where dengue is present annually. As a result of the interconnected nature of our world and the ease of international travel, dengue outbreaks have recently been reported in states stretching from Hawaii to Florida –- illustrating that we can no longer regard dengue as a disease that happens on foreign soil.
The immediate risk of a dengue epidemic spreading quickly to other parts of the world, including the United States, should be a signal that infectious diseases must be addressed with concerted efforts from all countries.
There is currently no specific treatment for dengue. Patients with access to medical care typically only receive fluids to help stave off dehydration and medication to help ease the pain. There is good news, however, on the prevention front. Several dengue vaccines are in various stages of development, with clinical trials now underway on five candidate vaccines. Trials in the most advanced stages are showing encouraging preliminary data and hopes are that a safe, effective vaccine could be available as early as 2015. These vaccines will be a crucial piece of preventing the millions of dengue infections that occur each year.
Dialogue among experts in Philadelphia last week focused on urging the world’s more than 100 endemic countries to begin planning for dengue vaccines now -– namely by developing plans for procurement and introduction, mobilizing and budgeting financial resources, and making necessary health system improvements to ensure that vaccines can be delivered swiftly and efficiently once available.
When diseases can crisscross the world on airplanes, boats or trucks, everyone has a stake in global health. With dengue vaccines we have a unique opportunity to get ahead of the disease rather than being forced to react and play catch-up. We know the toll of dengue is growing, and we know a vaccine is coming. Whether we are ready for the vaccines and ahead of the outbreaks requires all those countries affected by dengue to begin their planning now for vaccines in 2015. While there are costs of working to plan for a vaccine that might not come, the costs of inaction will be even greater.
Dr. Orin Levine is executive director of the International Vaccine Access Center (IVAC) at Johns Hopkins University and president of the American Society of Tropical Medicine and Hygiene (ASTMH) Committee on Global Health.
Dr. Ciro de Quadros is the executive vice president of the Sabin Vaccine Institute. Dr. de Quadros serves as Associate Adjunct Professor at the Johns Hopkins School of Hygiene and Public Health in Baltimore, MD; and an Adjunct Professor in the Department of Tropical Medicine at The George Washington University School of Medicine and Health Sciences in Washington, DC.
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