The recent heavy rains and floods have hindered public health control efforts because some areas had been rendered inaccessible for an effective health-needs survey. Moreover, mosquito vectors are widely distributed in these countries and because community public health officials' and physicians' awareness of dengue is low and specialized laboratory diagnostic methods are not available locally, low-level dengue transmission may go undetected.

Even though the dengue IgM test is the most appropriate assay for determining current infection, it is not routinely performed and may not be readily available if requested. An educational campaign for health officials and health-care providers and an active laboratory-based surveillance program that facilitated prompt, accurate diagnosis of dengue to assess the risk for local dengue fever transmission should be implemented.