Despite this tremendous expansion of both diseases, relatively few cases of Chikungunya fever have been reported in Africa (3, 6, 7 ), and few dengue-2 virus (DENV-2) epidemics have been reported (8, 9 ).
More adults may have been affected because fewer dengue epidemics, and therefore fewer exposures to dengue viruses during childhood, had occurred; subsequently, the immune status in adults had changed.
Intervention clusters also reported fewer dengue cases in the past year (24.7%, 1.8% to 51.2%; number needed to treat 71, 48 to 143).
During the past few decades, dengue has emerged in tropical and subtropical countries worldwide (1, 7 ).
Reported in fewer numbers, dengue fever was also included to compare its differences with other disease groups.
In 1988, for the first time, a few cases of dengue hemorrhagic fever (DHF) were seen (4 ).
As with malaria, although most travelers had a pre-travel health care visit, few knew that dengue is a risk in Haiti and compliance with protective measures was low.
Few patients experience Dengue Shock Syndrome, which includes a sudden onset after a fever of 2-7 days long, frank bleeding, cool skin, faint blood pressure, and circulatory failure.
Widespread use of a vaccine that protects against three serotypes might result in fewer cases of dengue hemorrhagic fever and reduce the overall disease burden; modeling could be used to investigate this scenario.
In 2012, there were 80 times fewer cases of dengue fever in Lahore than in 2011.
