A Death from Dengue May Signal That the Disease in U.S. Is Here to Stay

Gay Rabb Small, an almost-80-year-old Tampa resident who walked daily along the shore, died of dengue in September after developing a tremor. She had not recently traveled, making a local mosquito bite the likely source. Her death is the only reported fatality in Florida’s current outbreak, but the scale of local transmission has alarmed health experts: dengue in the continental United States has usually been linked to travel. Florida has recorded 880 cases this year, including 503 acquired locally, far exceeding its previous high of 189 locally acquired cases in 2023. Transmission has shifted from Miami-Dade to Hillsborough County, where most locally acquired infections are now concentrated.

Officials do not yet know why cases have risen or moved north, but warm, wet weather, flooding, climate change and travel between Florida and dengue-affected regions may all contribute. Experts expect local infections to become a recurring feature, though they say the outbreak remains small compared with those in parts of Latin America and should ease as temperatures fall. Dengue can cause severe fever and pain and, rarely, shock, bleeding or organ failure; a second infection with a different virus type can be especially dangerous. No dengue vaccine is approved in the United States, and treatment mainly manages symptoms. Florida counties have declared emergencies and received federal aid for mosquito surveillance and control, even as proposed property-tax cuts threaten local services. Prevention depends heavily on reducing mosquito exposure and standing water.