The Cost of Dengue, the Neglected Epidemic

Dengue season is just about to begin. Currently, dengue is the most important vector-borne disease worldwide in terms of morbidity, mortality and economic importance.

The disease is caused by a mosquito-borne virus and has three different manifestations: dengue fever, hemorrhagic fever and hemorrhagic shock. It is common in tropical and subtropical regions such as in Central and South America, in places with stagnant water. To date there is no vaccine to prevent it and the general recommendations of health authorities is to beware mosquitos in tropical regions.

WHO has pointed to a potential link between poverty and higher rates of infection and death among those exposed to the disease. “Dengue is most closely associated with poor and crowded urban and peri-urban areas, it also affects more affluent neighborhoods of tropical and sub-tropical countries and there is evidence of increasing rural transmission,” says the organization.

In Mexico, during the past decade dengue fever and hemorrhagic fever became increasingly common among the juvenile and infant population, according to a study by Hospital Infantil de Mexico. This is particularly alarming due to the appearance of early complications. Among the risk factors that might be behind this increase, climate change, the circulation of serotypes, the genetics of viral populations and the genetic characteristics of the population, have been proposed.

Mexico has seen several outbreaks of dengue. The last large one happened in 2019 with 41,505 new cases confirmed, most of them in Jalisco, Veracruz and Chiapas. The most affected groups of the population were children between 10-14 years and teenagers between 15-19 years. Women where particularly more affected.

The impact of dengue in Mexico’s economy has been considerable, explains NCBI, as it involved not just the direct medical and non-medical costs but also those linked to surveillance, vector control and prevention. Total direct medical costs and the cost to patients and caregivers amounted to US$46.05 million in a normal year for the disease, such as 2016. Expenditure on prevention programs, surveillance and control program costs were estimated to be US$11,766.52 per every 10,000 inhabitants taking the total economic impact of dengue to US$156.84 million.

Last year, dengue cases dropped dramatically in part due to COVID-19 lockdowns. During 2020, Mexico saw 120,639 dengue cases, less than half of 2019’s 268,458, according to the Ministry of Health. The government of Jalisco, one of the states most affected by dengue in 2019, commented cases in Jalisco dropped by 54 percent. Enrique Alfaro, Governor of Jalisco, reported that non-severe dengue cases fell by 42 percent, cases with signs of alarm by 73 percent and cases of severe dengue by 84.7 percent. The state reported only 20 confirmed deaths of dengue in 2020, while there were 108 deaths the year before. Alfaro said that the fall in dengue cases were a result of joint actions by citizens, the state and municipalities, including home visits and fumigations. He encouraged the state’s Ministry of Health to continue these efforts and build more policies to protect citizens.