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Dengue virus, a flavivirus, is the most common arbovirus infection in the world, with recent estimates of 390 million cases of dengue infection in the world per year, with the majority of them being asymptomatic.1 Classic dengue fever is usually a self-limited illness, but it can give rise to a life-threatening hemorrhagic fever. Both central and peripheral nervous system involvement occurs with dengue virus infection. The dengue virus vector is either the day-feeding mosquito Stegomyia (formerly Aedes2) aegypti or, less commonly, Stegomyia albopictus, both of which are endemic in the continental United States, particularly in the Southeast but present also in other regions.3 Epidemics of assumed dengue virus infection have been reported in the United States since 1780, when an epidemic occurred in Philadelphia, with the last epidemic reported in 1945, in Louisiana (summarized by Anez and Rios3). Currently, many cases of dengue virus infection are diagnosed in travelers who acquired the disease outside the continental United States. However, autochthonous (locally acquired), as opposed to imported, cases of dengue were recognized in recent years in both Florida and Texas. Thus in the United States dengue is an emerging, or re-emerging, infectious disease that has the potential for major neurologic complications.
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- © 2014 American Academy of Neurology
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