Are there any local cases of dengue fever in Ohio?

Dengue Fever in Ohio: Current Status

There are currently no documented locally acquired cases of dengue fever in Ohio. 1 Dengue fever in the United States is primarily seen as an imported disease in travelers returning from endemic regions.

Epidemiology and Distribution of Dengue

Dengue fever is found throughout tropical and subtropical regions, particularly in:

• Asia and South America (primary endemic areas)
• Caribbean islands
• Africa
• Pacific islands 1

The disease is transmitted by day-biting Aedes mosquitoes, primarily Aedes aegypti, which are not established as competent vectors in Ohio's climate. 1

Risk Assessment for Ohio

Several factors make local transmission in Ohio unlikely:

1. Geographic limitations: Dengue is endemic to tropical and subtropical regions, not temperate zones like Ohio 1

2. Vector absence: The primary vector Aedes aegypti has limited distribution in the northern United States

3. Surveillance data: No documented locally-acquired cases have been reported in Ohio through public health surveillance systems 1

4. Climate factors: Ohio's seasonal climate does not support year-round mosquito populations needed for sustained transmission

Imported Cases in the United States

While local transmission in Ohio has not been documented, imported cases do occur in the United States:

• Florida reported 18 imported dengue cases during a 1997-1998 surveillance period 2
• In 1981,44 imported cases were reported across 14 states, mostly originating from Caribbean travel 3
• Travelers returning from endemic areas represent the primary risk group 4

Clinical Implications

Healthcare providers in Ohio should:

1. Consider dengue in returning travelers: Include dengue in the differential diagnosis for patients with fever who have recently traveled to endemic areas 1

2. Recognize key symptoms: Be alert for the classic presentation of:

   • Fever
   • Headache (particularly retro-orbital pain)
   • Myalgia and arthralgia
   • Rash
   • Potential hemorrhagic manifestations in severe cases 1

3. Order appropriate testing: For suspected cases, obtain:

   • PCR testing for acute infection
   • IgM capture ELISA if symptoms have been present for >5-7 days
   • Paired serum samples for IgG confirmation 1

Public Health Response

If a suspected case is identified in Ohio:

• Immediate reporting to local health departments is essential
• Case confirmation through laboratory testing
• Assessment of travel history to determine if it's an imported case
• Environmental assessment only if local acquisition is suspected 1

Conclusion

While dengue fever represents a significant global health concern with increasing incidence in endemic regions, there is no evidence of local transmission in Ohio. The risk to Ohio residents is primarily limited to those who travel to endemic areas. Healthcare providers should maintain vigilance for imported cases to ensure proper treatment and prevent any potential for local transmission.