{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:33:20Z","timestamp":1779287600354,"version":"3.51.4"},"reference-count":46,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,2]]},"abstract":"<jats:p>Dengue, chikungunya, and Zika viruses, primarily transmitted by <jats:italic>Aedes<\/jats:italic> species mosquitoes, have caused large outbreaks in the Americas, leading to travel-associated cases and local mosquito-borne transmission in the United States. We describe the epidemiology of dengue, chikungunya, and noncongenital Zika virus disease cases reported from U.S. states and territories in 2017, including 971 dengue cases, 195 chikungunya cases, and 1,118 Zika virus disease cases. Cases of all three diseases reported from the territories were reported as resulting from local mosquito-borne transmission. Cases reported from the states were primarily among travelers, with only seven locally acquired mosquito-transmitted Zika virus disease cases reported from Texas (<jats:italic>n<\/jats:italic> = 5) and Florida (<jats:italic>n<\/jats:italic> = 2). In the territories, most dengue cases (<jats:italic>n<\/jats:italic> = 508, 98%) were reported from American Samoa, whereas the majority of chikungunya (<jats:italic>n<\/jats:italic> = 39, 100%) and Zika virus disease (<jats:italic>n<\/jats:italic> = 620, 93%) cases were reported from Puerto Rico. Temporally, the highest number of Zika virus disease cases occurred at the beginning of the year, followed by a sharp decline, mirroring decreasing case numbers across the Americas following large outbreaks in 2015 and 2016. Dengue and chikungunya cases followed a more seasonal pattern, with higher case numbers from July through September. Travelers to the United States and residents of areas with active virus transmission should be informed of both the ongoing risk from dengue, chikungunya, and Zika virus disease and personal protective measures to lower their risk of mosquito bites and to help prevent the spread of these diseases.<\/jats:p>","DOI":"10.4269\/ajtmh.19-0309","type":"journal-article","created":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T07:00:21Z","timestamp":1566284421000},"page":"884-890","source":"Crossref","is-referenced-by-count":38,"title":["Epidemiology of Dengue, Chikungunya, and Zika Virus Disease in U.S. States and Territories, 2017"],"prefix":"10.4269","volume":"101","author":[{"given":"Laura E.","family":"Adams","sequence":"first","affiliation":[{"name":"Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacey W.","family":"Martin","sequence":"additional","affiliation":[{"name":"Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole P.","family":"Lindsey","sequence":"additional","affiliation":[{"name":"Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer A.","family":"Lehman","sequence":"additional","affiliation":[{"name":"Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aidsa","family":"Rivera","sequence":"additional","affiliation":[{"name":"Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Kolsin","sequence":"additional","affiliation":[{"name":"Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly","family":"Landry","sequence":"additional","affiliation":[{"name":"Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Erin","family":"Staples","sequence":"additional","affiliation":[{"name":"Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler M.","family":"Sharp","sequence":"additional","affiliation":[{"name":"Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Paz-Bailey","sequence":"additional","affiliation":[{"name":"Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Fischer","sequence":"additional","affiliation":[{"name":"Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"N Engl J Med","first-page":"1552","article-title":"Zika virus","volume":"374","author":"Petersen","year":"2016"},{"key":"b2","series-title":"Clin Infect Dis","first-page":"942","article-title":"Chikungunya fever: an epidemiological review of a re-emerging infectious disease","volume":"49","author":"Staples","year":"2009"},{"key":"b3","series-title":"Emerg Infect Dis","first-page":"1477","article-title":"Dengue fever seroprevalence and risk factors, Texas\u2013Mexico border, 2004","volume":"13","author":"Brunkard","year":"2007"},{"key":"b4","series-title":"J Infect Dis","first-page":"S441","article-title":"Epidemiology of chikungunya in the Americas","volume":"214","author":"Yactayo","year":"2016"},{"key":"b5","series-title":"Dengue Guidelines for Diagnosis, Treatment, Prevention and Control","author":"World Health Organization and the Special Programme for Research and Training in Tropical Diseases (TDR)","year":"2009"},{"key":"b6","series-title":"Emerg Infect Dis","first-page":"673","article-title":"Persistent arthralgia associated with chikungunya virus outbreak, US Virgin Islands, December 2014\u2013February 2016","volume":"23","author":"Feldstein","year":"2017"},{"key":"b7","series-title":"Am J Trop Med Hyg","first-page":"128","article-title":"The epidemiology of dengue in the Americas over the last three decades: a worrisome reality","volume":"82","author":"San Martin","year":"2010"},{"key":"b8","series-title":"Dengue Fever in the Americas: Number of Reported Cases By Country or Territory","author":"Pan American Health Organization","year":"2017"},{"key":"b9","series-title":"J Travel Med","first-page":"taw062","article-title":"Evidence-based risk assessment and communication: a new global dengue-risk map for travellers and clinicians","volume":"23","author":"Jentes","year":"2016"},{"key":"b10","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"577","article-title":"Locally acquired dengue-key west, Florida, 2009\u20132010","volume":"59","author":"Centers for Disease Control and Prevention","year":"2010"},{"key":"b11","series-title":"Emerg Infect Dis","first-page":"742","article-title":"Dengue fever, Hawaii, 2001\u20132002","volume":"11","author":"Effler","year":"2005"},{"key":"b12","series-title":"MMWR CDC Surveill Summ","first-page":"7","article-title":"Dengue surveillance\u2013United States, 1986\u20131992","volume":"43","author":"Rigau-Perez","year":"1994"},{"key":"b13","series-title":"Am J Trop Med Hyg","first-page":"364","article-title":"Epidemic dengue and dengue hemorrhagic fever at the Texas\u2013Mexico border: results of a household-based seroepidemiologic survey, December 2005","volume":"78","author":"Ramos","year":"2008"},{"key":"b14","series-title":"Clin Infect Dis","first-page":"e121","article-title":"Chikungunya fever in the United States: a fifteen year review of cases","volume":"52","author":"Gibney","year":"2011"},{"key":"b15","series-title":"Chikungunya Virus in the United States","author":"Centers for Disease Control and Prevention","year":"2018"},{"key":"b16","series-title":"Am J Trop Med Hyg","first-page":"192","article-title":"Chikungunya virus disease among travelers-United States, 2014\u20132016","volume":"98","author":"Lindsey","year":"2018"},{"key":"b17","series-title":"Chikungunya","author":"Pan American Health Organization","year":"2018"},{"key":"b18","series-title":"Am J Trop Med Hyg","first-page":"212","article-title":"Zika virus disease in travelers returning to the United States, 2010\u20132014","volume":"95","author":"Hennessey","year":"2016"},{"key":"b19","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"983","article-title":"Zika virus disease cases\u201350 states and the District of Columbia, January 1\u2013July 31, 2016","volume":"65","author":"Walker","year":"2016"},{"key":"b20","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"774","article-title":"Update: ongoing Zika virus transmission\u2013Puerto Rico, November 1, 2015-July 7, 2016","volume":"65","author":"Adams","year":"2016"},{"key":"b21","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"265","article-title":"Update: noncongenital Zika virus disease cases\u201350 U.S. States and the District of Columbia, 2016","volume":"67","author":"Hall","year":"2018"},{"key":"b22","series-title":"Ann Intern Med","first-page":"99","article-title":"Travel-associated Zika virus disease acquired in the Americas through February 2016: a GeoSentinel analysis","volume":"166","author":"Hamer","year":"2017"},{"key":"b23","series-title":"J Travel Med","first-page":"1","article-title":"Zika in travellers 1947\u20132017: a systematic review","volume":"25","author":"Wilder-Smith","year":"2018"},{"key":"b24","series-title":"Surveillance Case Definitions for Current and Historical Conditions","author":"Centers for Disease Control and Prevention","year":"2018"},{"key":"b25","series-title":"Dengue Virus Infections 2015 Case Definition","author":"Centers for Disease Control and Prevention","year":"2015"},{"key":"b26","series-title":"Neuroinvasive and Non-neuroinvasive 2015 Case Definition","author":"Centers for Disease Control and Prevention, Arboviral Diseases","year":"2015"},{"key":"b27","series-title":"Zika Virus Disease and Zika Virus Infection 2016 Case Definition","author":"Centers for Disease Control and Prevention"},{"key":"b28","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"1319","article-title":"Outbreak of dengue virus type 2\u2014American Samoa, November 2016\u2013October 2018","volume":"67","author":"Cotter","year":"2018"},{"key":"b29","series-title":"Emerg Infect Dis","first-page":"1081","article-title":"Seasonality, annual trends, and characteristics of dengue among ill returned travelers, 1997\u20132006","volume":"14","author":"Schwartz","year":"2008"},{"key":"b30","series-title":"PLoS Negl Trop Dis","first-page":"e0007084","article-title":"Risk factors for hospitalization of patients with chikungunya virus infection at sentinel hospitals in Puerto Rico","volume":"13","author":"Hsu","year":"2019"},{"key":"b31","series-title":"J Trop Pediatr","first-page":"43","article-title":"Epidemiology, clinical and laboratory features and course of chikungunya among a cohort of children during the first Caribbean epidemic","volume":"63","author":"Kumar","year":"2017"},{"key":"b32","series-title":"Emerg Infect Dis","first-page":"891","article-title":"Severe sepsis and septic shock associated with chikungunya virus infection, Guadeloupe, 2014","volume":"22","author":"Rolle","year":"2016"},{"key":"b33","series-title":"PLoS Negl Trop Dis","first-page":"e0004625","article-title":"First chikungunya outbreak in Suriname; clinical and epidemiological features","volume":"10","author":"van Genderen","year":"2016"},{"key":"b34","series-title":"J Infect Dis","first-page":"S475","article-title":"Surveillance for chikungunya and dengue during the first year of chikungunya virus circulation in Puerto Rico","volume":"214","author":"Sharp","year":"2016"},{"key":"b35","series-title":"J Infect Dis","first-page":"1678","article-title":"Differences in prevalence of symptomatic Zika virus infection, by age and sex-Puerto Rico, 2016","volume":"217","author":"Lozier","year":"2018"},{"key":"b36","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"1219","article-title":"Incidence of Zika virus disease by age and sex\u2014Puerto Rico, November 1, 2015\u2013October 20, 2016","volume":"65","author":"Lozier","year":"2016"},{"key":"b37","series-title":"PLoS Med","first-page":"e1002726","article-title":"Prior dengue virus infection and risk of Zika: a pediatric cohort in Nicaragua","volume":"16","author":"Gordon","year":"2019"},{"key":"b38","series-title":"Emerg Infect Dis","first-page":"1232","article-title":"Genetic and serologic properties of Zika virus associated with an epidemic, Yap state, Micronesia, 2007","volume":"14","author":"Lanciotti","year":"2008"},{"key":"b39","series-title":"J Gen Virol","first-page":"37","article-title":"Antigenic relationships between flaviviruses as determined by cross-neutralization tests with polyclonal antisera","volume":"70","author":"Calisher","year":"1989"},{"key":"b40","series-title":"J Clin Microbiol","first-page":"e01115","article-title":"Ability to serologically confirm recent Zika virus infection in areas with varying past incidence of dengue virus infection in the United States and U.S. territories in 2016","volume":"56","author":"Lindsey","year":"2018"},{"key":"b41","series-title":"Emerg Infect Dis","first-page":"299","article-title":"Zika virus IgM detection and neutralizing antibody profiles 12\u201319 months after illness onset","volume":"25","author":"Griffin","year":"2019"},{"key":"b42","series-title":"PLoS Negl Trop Dis","first-page":"e0004551","article-title":"Is dengue vector control deficient in effectiveness or evidence?: Systematic review and meta-analysis","volume":"10","author":"Bowman","year":"2016"},{"key":"b43","series-title":"PLoS Negl Trop Dis","first-page":"e0003655","article-title":"A critical assessment of vector control for dengue prevention","volume":"9","author":"Achee","year":"2015"},{"key":"b44","series-title":"Clim Change","first-page":"487","article-title":"The potential impacts of 21st century climatic and population changes on human exposure to the virus vector mosquito Aedes aegypti","volume":"146","author":"Monaghan","year":"2018"},{"key":"b45","series-title":"PLoS One","first-page":"e89783","article-title":"Vectorial capacity of Aedes aegypti: effects of temperature and implications for global dengue epidemic potential","volume":"9","author":"Liu-Helmersson","year":"2014"},{"key":"b46","series-title":"Emerg Infect Dis","first-page":"86","article-title":"Texas lifestyle limits transmission of dengue virus","volume":"9","author":"Reiter","year":"2003"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/101\/4\/article-p884.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/101\/4\/article-p884.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/101\/4\/article-p884.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T21:35:49Z","timestamp":1722461749000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/101\/4\/article-p884.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,2]]},"references-count":46,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.19-0309","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,2]]}}}