Abstract
Since 2001, three autochthonous dengue fever outbreaks have occurred in the United States: in Hawaii (2001); Brownsville, Texas (2005); and southern Florida (2009-2011). We sought to characterize and describe the response to these outbreaks from the perspectives of public health and vector control officials. By conducting a medical literature review through PubMed and news media searches through Google, we identified persons involved in managing each outbreak; 26 persons then participated in qualitative, semistructured interviews. After analyzing the 3 outbreaks, we found the following prominent themes in the response efforts: timely detection of illness; communication of up-to-date, correct information; and development of a rapid response that engages the community. We therefore recommend that public health authorities involve the clinical and laboratory community promptly, provide accurate information, and engage the local community in vector control and case identification and reporting.
Highlights
Practical experience with dengue in the United States is decades old, and mitigation measures used decades ago may not be fully applicable today
We describe the responses to 3 recent US dengue outbreaks from the perspectives of public health and vector control officials at local, state, and federal levels
We conducted a retrospective analysis to assess mitigation strategies used during each outbreak and identify policy implications for public health departments, vector control agencies, and clinicians in areas vulnerable to dengue and other mosquitoborne diseases
Summary
Practical experience with dengue in the United States is decades old, and mitigation measures used decades ago may not be fully applicable today. As the threat of dengue grows, the risks for an outbreak and the responses needed must be understood. We describe the responses to 3 recent US dengue outbreaks (in Hawaii, 2001; Brownsville, Texas, 2005; and southern Florida, 2009–2011) from the perspectives of public health and vector control officials at local, state, and federal levels. We conducted a retrospective analysis to assess mitigation strategies used during each outbreak and identify policy implications for public health departments, vector control agencies, and clinicians in areas vulnerable to dengue and other mosquitoborne diseases. The goal of this study was to help improve community responses to future dengue outbreaks. The analysis concludes with recommendations for practitioners and policy makers
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