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Epidemiological Alert: Dengue in the context of COVID-19, 28 July 2020

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In several countries and territories of the Caribbean and Central America, the season with the highest circulation of dengue has begun; this is occurring in a context of intense transmission of SARS-CoV-2 in the Americas. The Pan American Health Organization / World Health Organization (PAHO / WHO) calls on Member States to strengthen surveillance, diagnosis, and treatment, and at the same time to carry out actions for the eventual expansion of primary and specialized care services, mainly in places where a seasonal increase in the number of cases of dengue and other arbovirosis is expected, along with the increase in cases of COVID-19.


In the context of the current COVID-19 pandemic, the potential seasonal increase in dengue cases in endemic countries represents a challenge for both the population at large and health service providers who would be responding to concomitant emergencies (Figure 1). This situation is especially worrisome in areas where highly vulnerable communities to dengue and other arboviruses and COVID-19 reside.

Factors that may influence the response capacity of endemic countries and territories due to the COVID-19 pandemic include, but are not limited to:

• Possible underreporting of dengue cases due to the exhaustion of healthcare services or because patients opt not to go to healthcare services.

• Delayed medical consultation of dengue cases with warning signs as a result of COVID-19 pandemic containment measures or as the result of fear of COVID-19 exposure in health care services by the population.

• Focus of the health care services on COVID-19 response.

• Interruption of fumigation activities (restrictions on the mobility of healthcare workers or other teams in charge of fumigation).

• Limited numbers of healthcare professionals with experience in handling dengue cases and / or COVID-19.

• Exhaustion of specialized care beds.

• Laboratory overload for confirmation of severe cases and lack of supplies for virologic surveillance.