The federal Centers for Disease Control and Prevention offers a look at the first three of these cases in its current Morbidity and Mortality Weekly Report.
Case No. 1 was in an otherwise healthy 34-year-old Rochester, N.Y., woman who, after returning from Key West and coming down with fever, headache, malaise and chills, headed off to see her doctor. That doctor, unsurprisingly, did not immediately diagnose dengue. The woman was treated for a urinary tract infection and sent on her way.
A couple of doctor visits -- and tests and confirmatory tests -- later, the diagnosis of dengue fever was reached. The woman recovered just fine.
So did the others. But, the report notes, from 1946 through 1980 the United States had no reported cases of this mosquito-borne disease, which kills 25,000 people around the world each year.
The account states:
"Concern about the potential for emergence of dengue in the continental United States has increased in recent years. Reported dengue cases in South America, Central America, Mexico, and the Caribbean increased fourfold, from 1,033,417 during 1980-1989 to 4,759,007 during 2000-2007. Rapid urbanization with a proliferation of man-made containers able to serve as mosquito-breeding sites, increased international travel, and lack of effective vector-control measures likely have been major factors in the spread of dengue."
The mosquitoes most likely to spread the disease here are Aedes aegypti and, to a lesser extent, Aedes albopictus.
The report doesn't suggest we should blame dengue fever the next time we come down with chills and a fever, but it does suggest we shouldn't rule it out:
"The timely reporting of dengue in the index patient from New York illustrates that, despite an absence of compatible travel history, clinicians throughout the United States should consider appropriate laboratory testing based upon clinical presentation. Had the index patient not been evaluated promptly and reported, the cases in Key West residents likely would not have been diagnosed. Dengue should be included in the differential diagnosis of acute febrile illnesses for patients who live in or have recently traveled to subtropical areas in the United States or to the tropics. This is particularly important when signs and symptoms such as thrombocytopenia, leukopenia, hemoconcentration, rash, or eye pain are present."
-- Tami Dennis
Photo: An Aedes aegypti mosquito as seen on human skin. Credit: U.S. Department of Agriculture