Local Transmission of Dengue in South Florida: A Case Report.

Abstract

Dengue is a significant global health concern, primarily prevalent in tropical and subtropical regions, affecting approximately 400 million people annually worldwide. This case report highlights the emergence of dengue in South Florida and raises concerns about the possibility of a local transmission. Unlike most cases, the patients discussed had not recently traveled, prompting the need for further investigation into the local transmission of dengue. In October 2023, two adult brothers presented to the Emergency Department (ED) with symptoms including fever, chills, nausea, vomiting, rash, severe headache, and syncope. Laboratory tests revealed thrombocytopenia, atypical lymphocytes, and elevated liver enzymes. With this clinical picture, dengue was suspected, and management was initiated accordingly. Both patients denied recent travel and had no known dengue infections in the past but had been exposed to mosquitoes a week prior. Both patients were managed with supportive treatment and platelet transfusions, which led to clinical improvement. However, the laboratory tests for dengue diagnosis had to be sent to a third-party laboratory, resulting in delayed confirmation of the disease. We received confirmation of a positive dengue serology approximately a week after the first patient was discharged. Two suspected cases of dengue virus were confirmed. The availability of local laboratory tests is crucial for the early diagnosis and management of dengue. The study calls for increased awareness of the disease's severity and its risk factors, emphasizing early recognition, judicious use of intravenous fluids, and the need for accessible local diagnostic resources to facilitate timely patient care.