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Am. J. Trop. Med. Hyg., 81(3), 2009, pp. 467-474
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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*Dengue

Description of a Large Island-Wide Outbreak of Dengue in Puerto Rico, 2007

Kay M. Tomashek*, Aidsa Rivera, Jorge L. Muñoz-Jordan, Elizabeth Hunsperger, Luis Santiago, Oscar Padro, Enid Garcia, AND Wellington Sun
Dengue Branch, Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Puerto Rico Department of Health, San Juan, Puerto Rico

Dengue is a mosquito-borne viral disease that affects 40% of the world’s population. Nearly four million U.S. citizens live in dengue-endemic areas; the most affected population resides in Puerto Rico. Data from a dengue surveillance system were used to describe all suspected cases reported in Puerto Rico in 2007. Rates of infection per 10,000 residents were calculated by age, sex, and residence. Rates and clinical outcomes were compared with those from outbreaks in 1994–1995 and 1998. In 2007, 10,508 suspected cases were reported; 52.5% persons were hospitalized, 31.8% reported hemorrhage, 2.2% had dengue hemorrhage fever, and 44 died. A total of 3,293 (33.0%) of processed specimens were laboratory positive for dengue virus (DENV); DENV-3 (1,342, 61.7%) and DENV-2 (677, 31.1%) were detected most often. The overall incidence of laboratory-positive dengue was 8.6 infections per 10,000 population. Rates were highest among persons 10–14 years of age (19.0), followed by persons 15–19 years of age (17.9) and infants (10.9). Higher rates of hospitalization and hemorrhage were reported in 2007 than in 1994–1995 or 1998. United States citizens residing in Puerto Rico are at risk of acquiring dengue. Data suggest that the severity is worsening, and persons 10–19 years of age and infants continue to be most affected.

Received January 31, 2009. Accepted for publication May 7, 2009.

* Address correspondence to Kay M. Tomashek, Dengue Branch, Division of Vector-Borne Infectious Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, 1324 Calle Cañada, San Juan, PR 00920. E-mail: ktomashek{at}cdc.gov

Authors’ addresses: Kay M. Tomashek, Aidsa Rivera, Jorge L. Muñoz-Jordan, Elizabeth Hunsperger, Luis Santiago, Oscar Padro, and Wellington Sun, Dengue Branch, Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, San Juan, PR 00920. Enid Garcia, Puerto Rico Department of Health, San Juan, PR 00911.

Reprint requests: Kay M. Tomashek, Dengue Branch, Division of Vector-Borne Infectious Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, 1324 Calle Cañada, San Juan, PR 00920.






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Copyright © 2009 by the American Society of Tropical Medicine and Hygiene.