Diagnosis and management of dengue.

Dengue has been reported in almost 70 countries, with about five million cases reported between 2000 and 2007 (figs 1 and 2).1 In 2002, at the peak of the current pandemic, over 1.2 million cases were reported worldwide. Until the end of the 1980s South East Asia and the Western Pacific region were the regions most affected by dengue. In recent years, however, the incidence of dengue has increased in the Central and South America region, which now accounts for 70% of all cases reported worldwide. Mortality from dengue has varied greatly across countries, but the World Health Organization estimates that about 22 000 deaths are associated with dengue every year.1 2 Despite efforts to control the main vector (the mosquito Aedes aegypti), the incidence of the disease has not shown any tendency to decrease. Dengue is predominantly a childhood disease in South East Asia but an adult disease in most North and South American countries.3 4 However, since 2007, Brazil (the country responsible for more than 70% of cases of dengue in the Americas) has experienced an unexpected increase in the incidence of the disease in people aged under 15 years.4 5 This article reviews the diagnosis and treatment of dengue and discusses the importance of the organisation of healthcare systems in reducing deaths from dengue in areas where the disease is endemic.