‘Breakbone’ fever is making a comeback in the United States

WASHINGTON — Anna Manzanarez was a picture of good health. But about a week after catching what she thought was a bad case of the flu, the 28-year-old waitress from Seaside, Calif., collapsed getting out of the shower.

The next day, despite intensive care at a hospital, she died.

Her death shocked her family, but the discovery of what killed her hit public health officials like a bolt from the blue: She had fallen victim to a virulent form of a mosquito-borne disease that long ago had been eradicated in the U.S. and once was close to being eliminated throughout South America as well.

The disease, dengue fever, is on the march again and beginning to make its presence felt in the U.S., with cases popping up in Texas, Hawaii and Puerto Rico. Last week, top health officials warned that a “widespread appearance” in the continental U.S. is “a real possibility.”

Thus far, cases of dengue fever in North America, where disease scientists thought they had conquered it 30 years ago, have tended to be scattered and affect relatively few people.

But increased travel to and from South America, where a resurgence has made dengue widespread, is thought to be boosting the disease’s spread northward. And some experts suspect climate change is aggravating the problem.

“It’s starting to creep up from South America to the Caribbean,” said Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases. “If it can occur right at the tip of Texas, a disease which maybe people never heard of could actually appear here.”

There is no vaccine against dengue, nor is there a drug that can cure it, although a race to develop both seems to be gathering momentum. Most people who get the less virulent forms of the virus recover on their own, although many experience the strong pains that have given dengue its nickname, breakbone fever.

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