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In the Americas, dengue fever intensified as a public health problem during the 1980s -- between 1980 and 1990 more than one million dengue cases were reported. Also, during those years, an increase in cases of the potentially fatal forms of dengue, dengue hemorrhagic fever and dengue shock syndrome, was observed in various countries of the Americas.

Prospects for reversing the recent trend of increased epidemic activity and geographic expansion of dengue are not promising. New dengue virus strains and serotypes will likely continue to be introduced into many areas where the population densities of Aedes aegypti are at high levels. With no new mosquito control technology available, in recent years public health authorities have emphasized disease prevention and mosquito control through community efforts to reduce larval breeding sources. Although this approach will probably be effective in the long run, it is unlikely to impact disease transmission in the near future. We must, therefore, develop improved, proactive, laboratory-based surveillance systems that can provide early warning of an impending dengue epidemic. At the very least, surveillance results can alert the public to take action and physicians to diagnose and properly treat dengue/DHF cases.