Virginia and Florida health officials have confirmed their states’ first locally acquired cases of dengue fever, a mosquito-borne illness traditionally tied to international travel, following separate infection chains in residents with no recent travel history.
Northern Virginia Discovery Marks State’s First Local Transmission
Virginia health officials confirmed the state’s first-ever documented case of locally acquired dengue fever in a Northern Virginia resident who had not left the state, according to the Virginia Department of Health (VDH).
Working alongside the Fairfax County and Loudoun County health departments, VDH investigated the infection after the patient fell ill without any known travel outside Virginia. State Health Commissioner Cameron Webb detailed the transmission chain in a letter to clinicians, noting that the patient had been in close proximity to another Virginia resident diagnosed with an internationally acquired case of dengue a few weeks earlier.
"Transmission of the virus likely occurred when a local mosquito bit the internationally acquired case while infectious and subsequently infected the second case," Webb wrote. The two residents reside in different counties across Northern Virginia.
Recognizing Symptoms of ‘Breakbone Fever’
Dengue is spread through the bites of infected Aedes species mosquitoes. Infections can range from asymptomatic or mild illness to severe disease, according to VDH. Symptoms typically begin with a fever and can include a severe headache, pain behind the eyes, nausea, and a rash, lasting anywhere from two to seven days. The virus is also known as "breakbone fever" due to the intense joint and muscle pain it frequently causes.
While the illness is most common in tropical regions such as the Caribbean and parts of South America and Africa, most U.S. cases have historically been linked to international travel.
State Risk Assessment and Ongoing Surveillance
VDH reported no evidence of continued transmission and no additional locally acquired cases in Virginia, characterizing the overall state risk as low. Health officials are collaborating with local partners to monitor for further cases and conduct surveillance of mosquito populations capable of carrying the virus.
Clinical Directives and Community Prevention Protocols
In guidance issued to clinicians, VDH recommended that medical providers obtain thorough travel histories for patients presenting with acute febrile illnesses, consider dengue for patients living in or recently visiting at-risk areas, and alert local health departments immediately if dengue is suspected in patients without travel history or standard risk factors like a recent blood or organ transplant.
To reduce exposure risks, health officials advised residents to eliminate mosquito breeding sites around homes and businesses. Because Aedes mosquitoes can breed in water-filled containers as small as a bottle cap, VDH encouraged property owners to "tip and toss" standing water. Officials noted that these preventive steps also mitigate risks associated with West Nile virus, which is already endemic to Virginia.
State health authorities continue to monitor the situation through ongoing mosquito surveillance and clinician alerts.
