Travel-Associated Dengue Cases - United States, 2010-2021

Abstract

Dengue, the leading cause of arboviral disease worldwide, can be fatal without appropriate treatment. Among 7,528 confirmed or probable travel-associated U.S. dengue cases reported during 2010-2021, one in five (1,474, 20%) was reported in 2019. This is 168% higher than the annual average number of cases reported during 2010-2018 and 2020-2021 (approximately 550 per year) and 61% higher than the 913 cases reported in 2016, the second highest year on record. The number of cases as a fraction of air traffic volume to international destinations outside North America or Europe was also highest in 2019, with 41.9 cases per million trips, compared with 21.0 per million in other years during 2010-2021. This report compares the number and characteristics of travel-associated dengue cases reported to national surveillance in the United States in 2019 with cases reported during 2010-2018 and 2020-2021. Areas with conditions suitable for dengue transmission as well as the population at risk for dengue are expected to increase, placing U.S. travelers at higher risk for infection. Health care providers should be aware that dengue is a common cause of fever in the returning traveler and be familiar with its signs and symptoms, testing, and management. Dengue vaccines are not currently recommended for U.S. travelers; therefore, persons should review areas of dengue risk and follow guidance for preventing mosquito bites.

FIGURE 1

Reported confirmed and probable travel-associated dengue cases, by year (N = 7,528) — National Arbovirus Surveillance System, United States, 2010–2021

FIGURE 2

Reported confirmed and probable travel-associated dengue cases (N = 5,757) per million international air trips, by region of acquisition — multiple data sources, United States, 2010–2021 Abbreviations: APIS = Customs and Border Protections Advance Passenger Information System; ArboNET = National Arbovirus Surveillance System. * The following cases were excluded: 1) those associated with travel to U.S. states or territories (481), because data from APIS excludes domestic travel; 2) those associated with travel to multiple regions (96) or where the country was unknown (306); 3) those associated with travel to North America (882), because travel between the continental United States and other North American countries commonly occurs by land borders, and the mode of travel for travel-associated cases is not reported to ArboNET; and 4) those associated with travel to Europe (six). ^† International air traffic volume information (denominator) is from the APIS/I-92 Monitor (https://www.trade.gov/us-international-air-travel-statistics-i-92-data) and from the Survey of International Air Travelers (https://www.trade.gov/survey-international-air-travelers-siat), both managed by the U.S. Department of Commerce, National Travel and Tourism Office.