Dengue and dengue hemorrhagic fever in Latin America and the Caribbean

Four serotypes of dengue viruses produce dengue fever, dengue hemorrhagic f ever, and dengue shock syndrome. They are the most important arbovirus infe ctions of humans, in terms of both morbidity and mortality, constituting on e of the most rapidly expanding and re-emerging infectious disease problems in Latin America. In less than 20 years, the region has transformed itself from hypoendemic to hyperendemic, while serotype circulation in most count ries has gone from none or single to multiple. Changes in endemicity have c oincided with the emergence and increasing incidence of the severer forms o f dengue infection. This article reviews the clinical presentations of thes e diseases. Health care providers who see patients in or returning from are as of Latin America, the Caribbean, and other tropical areas must consider dengue in the differential diagnosis of patients presenting with compatible symptoms, and must be knowledgeable in the current management of this impo rtant disease.