Dengue fever, often referred to as “breakbone fever,” is seeing a concerning rise in cases, primarily in Latin America, Africa, and Southeast Asia. However, incidents are also cropping up in Europe and the United States, with an estimated 4 billion people worldwide at risk. According to Ana Luísa Braga, a 38-year-old social worker and mother from Belo Horizonte, Brazil, her experience with dengue in March was harrowing. “The fatigue was so bad I couldn’t stand, and that’s terrible when you need to take care of a child, right? My head hurt, my eyes hurt – I couldn’t keep them open for long,” she recalls.

Braga’s case is among millions impacted by what is becoming the largest outbreak on record. In 2023, there were 6.5 million reported cases globally, and 2024 is on track to potentially double that to 12.4 million. The rise in dengue cases is attributed to several factors: urbanization, climate changes, and higher rates of chronic conditions, which are heightening vulnerability among populations.

“The pain was so intense,” Braga reflected, noting her need for hospital treatment after her condition worsened. “Even after being hospitalized for five days, I only gradually started getting better. The fatigue, in particular, didn’t leave me for about 15 days.”

Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, has expressed alarm at this trend. He recently launched a global strategy to combat rising dengue cases, with an emphasis on mosquito control and surveillance, requiring $55 million over the next year.

Most dengue cases are currently concentrated in Latin America, but as climate change fosters conditions for mosquito survival, infections are spreading globally, including in mainland Europe. According to Professor Sophie Yacoub, head of the dengue research group at Oxford University’s clinical research unit in Vietnam, the culprits are two main mosquito species: Aedes aegypti and Aedes albopictus, the latter of which thrives in urban environments and can breed in minimal standing water.

Dr. Najmul Haider, an epidemiologist at Keele University, recently published research indicating a surge in cases that may be underestimated, as many infections go unnoticed due to their mild or asymptomatic nature. He warns that subsequent infections can be particularly dangerous due to the existence of four distinct dengue serotypes.

In Brazil, health officials report that all four serotypes are circulating simultaneously, further complicating the situation. Despite historically lower death rates than diseases like malaria, the fatality rate for dengue is now increasing, leading experts to suggest that comorbidities like obesity and diabetes play significant roles in the severity of the disease.

With no specific treatment for dengue, medical care typically focuses on supportive measures. While two vaccines exist, their limitations make widespread immunization challenging. However, local efforts in places like Brazil are underway to leverage these vaccines effectively. As Daniel Soranz, Rio’s municipal health secretary, remarked, “If we successfully produce the vaccine on a large scale, we could eradicate dengue in Brazil within five or six years.”

In the meantime, many in high-risk areas are turning to traditional remedies. Solange Fletcher-Herbert shared her experience of caring for her son, who contracted dengue while vacationing in Tobago. “We started to give him Pepto-Bismol to settle his stomach, paracetamol, and just coconut water to keep his electrolytes up,” she explained. Following medical treatment, they also tried brewing papaya leaf tea, a remedy suggested by family and friends, which they believe aided in his recovery.

While there is some evidence suggesting that compounds in papaya could impact blood clotting, further research is necessary. Dr. Michael Head from the University of Southampton stressed the need for effective treatment options, stating, “Given dengue is a high burden and occasionally serious infection, treatment options would be useful.”