Dengue Infections Cause Cardiovascular Complications

When vacationers return with symptoms similar to a cold, most associate their illness with influenza. However, when visiting most countries in the Americas in 2025, one can also be exposed to the mosquito-transmitted dengue virus.

In the United States, dengue infections are often misdiagnosed. They can cause a range of symptoms, from a mild febrile illness to severe conditions such as dengue hemorrhagic fever and shock, which can result in cardiovascular collapse.

Recently, there have been more reports of atypical presentations following infection by any of the four dengue virus (DENV) serotypes, including cardiac manifestations such as electrocardiographic abnormalities, myocarditis, and pericarditis, which require further investigation.

This review, published on April 18, 2025, discusses our current understanding of the cardiovascular manifestations of dengue and their management, explores the proposed pathogenesis, and concludes with potential future research directions.

The global incidence of dengue has been increasing, partly due to higher travel volumes to areas where dengue is endemic and climate change, which has expanded the range of Aedes mosquito vectors, found at elevations below 2,500 feet.

Last year, more than 13 million dengue cases were reported, the highest year on record.

As of April 16, 2025, the U.S. CDC has reported 1,481 travel-related dengue cases in 30 jurisdictions this year. One locally acquired case in southeast Florida has been confirmed.

In 2024, 53 jurisdictions, led by Arizona, California, Florida, New Jersey, New York, and Puerto Rico, reported 9,391 dengue cases.

To reduce these dengue infections, the ideal DENV vaccine would elicit a balanced and highly protective immune response against all four serotypes of DENV.

Current tetravalent live-attenuated DENV vaccines have faced challenges due to the uneven replication of vaccine virus strains, which stimulate a strong immune response to one serotype and weak responses to the other three serotypes.

While forty countries have enabled access to a second-generation dengue vaccine by 2025, the United States government has not.

Which means it's best to avoid mosquito bites to prevent infection while vacationing in the Americas, including Miami Beach.