Emergence of dengue hemorrhagic fever in the Americas

Dengue, or "breakbone fever," has been recognized for over 200 years. The virus is spread by Aedes mosquitoes, which have taken full advantage of opportunities created by changes in human habitat and by air travel. A growing number of countries have recently experienced severe dengue epidemics, and this disease is becoming a serious public health problem and a leading cause of hospitalization. The growth of dengue has been most dramatic in the Americas, where the incidence of dengue has increased sharply since the 1960s. Ln this article, the investigators describe the history of dengue infection in this region and make a case for a major international effort that will be needed to combat this disease.