Dengue Fever: At least 5 million cases and 5,500 deaths in horror year

• New Save the Children analysis finds over 5,500 people died from dengue fever across 20 countries hardest hit by the disease in 2023, a year which saw at least five million cases — more than any year over the past five years [1].
• Bangladesh, Peru and Burkina Faso were among the countries with the highest known death tolls, while Brazil had the highest number of known cases.
• An estimated 1.3 billion children globally - over one in two - live in countries where dengue outbreaks are frequent and continuous, and the situation is expected to get worse due to the climate crisis
• Save the Children is urging world leaders on COP28 Health Day (3 December) to take action to fight climate change, which is contributing to spikes in illnesses such as dengue.

DUBAI, 3 December - More dengue fever cases have been recorded so far in 2023 than in the last five years annually, as increasingly extreme weather events fuel the spread of the mosquito-borne illness, said Save the Children.

The aid agency found that there were approximately 5 million cases of dengue fever across 20 of the worst-impacted countries between January and November 2023 [2]. This marked a 30% increase in cases compared to the entirety of 2022 and 18% more than the figures in 2019, when the world saw its most recent major outbreak.

At least 5,500 people were killed by dengue across the 20 countries, up 32% from 2022 and up 11% compared to 2019. The actual number of deaths and cases is likely to be far higher as many cases are not reported.

While a breakdown of child deaths was not available for many countries, children are particularly vulnerable to the disease because their immune systems are weaker than adults and they tend to play outside where there is less protection against the mosquitos. Children under five are at particular risk of developing dehydration and shock from dengue if they contract the illness, and children are most impacted if the illness incapacitates or kills their parents and other caregivers.

Bangladesh, which had the highest known global death toll, faced its worst dengue fever outbreak on record in 2023, with over 300,000 people infected since January, a massive jump from the 62,000 people known to have the illness in 2022. The outbreak resulted in 1,598 deaths—including over 160 children, mostly aged under 10 [4]—with the death toll in 2023 more than five times that of 2022.

In Peru, at least 50 children died and another 80,300 children were infected with the deadly virus this year in the worst epidemic of the disease that the country has seen in over a decade. The country has recorded more than 270,000 cases of dengue in 2023, almost four times the 74,000 cases in 2017, the last El Niño year in the country. The outbreak, which led Peru to declare a state of emergency in 18 of its 24 provinces in February, has been driven by the El Niño phenomenon, which has brought torrential rains, floods and an increase in temperature to the northern regions of Piura and Lambayeque.

In West Africa, Burkina Faso reported 511 dengue deaths this year, marking a sharp rise from the 18 deaths reported in 2017 and 15 in 2016—the last years for which data is available. Probable cases are at almost 50,000, according to the Ministry of Health.

This year’s El Niño event coupled with the climate crisis is understood to have exacerbated the dengue fever outbreak. Although El Niño events are natural and cyclical, its impacts are aggravated by the climate crisis, with storms and floods increasing mosquito populations as they provide them with shallow, stagnant pools where they can reproduce. Dengue can also, however, increase in drought situations as the mosquitoes that transmit the disease are able to survive when water is scarce.

An estimated 1.3 billion children - more than one in two - live in countries or regions within countries that the US Centre for Disease Control says face a frequent or continuous risk of the disease.[3] Dengue fever is a viral infection contracted via mosquito bites and can cause flu-like symptoms, including high fevers, pain behind the eyes, rash, severe headaches and body aches. In the most serious cases it can progress to dengue haemorrhagic fever or dengue shock syndrome, which can be fatal.

Save the Children's Senior Health and Nutrition Advisor for Asia, Dr Yasir Arafat, said:

"Across Asia, extreme weather events have contributed to making 2023 a devastating year for dengue deaths, throwing the lives of children into disarray. Children are impacted not only as the victims of dengue but by disruption to their education, increased economic and emotional pressure on their families, and when their caregivers contract and die from disease.”

“We need local plans to fight dengue - at village and city level - and with the involvement of communities.  Controlling mosquitos, diagnosing the disease and treatment needs to be a government-wide effort and not just the work of health departments. Funding needs to better anticipate extreme weather and climate shocks to manage the risk and not just the crisis.” 

Save the Children is urging world leaders at COP28, particularly those from high-income countries and historical emitters, to take action to fight climate change, which is contributing to spikes in illnesses such as dengue. The agency is calling on leaders to increase climate finance, directing support to children and families for adaptation to the climate crisis and addressing losses and damages. Governments must recognise children as key agents of change and work urgently to limit temperature rise to 1.5°C above pre-industrial levels. 

Almost 70% of the global population at risk from dengue resides in the Asia-Pacific region according to the World Health Organisation.  The changing climate and more frequent and extreme weather events are however, fuelling the spread of the disease into new locations and extending dengue seasons in countries where the disease is already present. 

In July, the World Health Organisation reported that dengue has surged eight-fold in just over two decades from around half a million cases in 2000 to more than 4.2 million in 2022. 

Around the world, Save the Children provides public healthcare for children and their families, including treatment for diseases like dengue, and works with schools and communities to improve awareness on how to prevent infection. The agency also works in partnership with the World Mosquito Programme in some countries to help reduce the spread of dengue.

- ENDS - 

NOTES TO EDITORS

[1] Save the Children identified countries that had reported at least 20 dengue deaths in 2023 as of 23 November and looked at the trends of deaths in these countries using data from governments, the World Health Organisation and other international bodies.  This analysis found at least 5,562 people had died of dengue during this period and 5,046,627 cases had been recorded.

[2] The 20 countries with the most reported deaths between January and November 2023, listed from highest to lowest, were: Bangladesh, Brazil, Philippines, Burkina Faso, Indonesia, Peru, Thailand, India, Mexico, Guatemala, Bolivia, Colombia, Malaysia, Argentina, Sudan, Sri Lanka, Cambodia, Vietnam, Ecuador and Nepal.

[3] The number of children living in countries at risk of dengue is based on the US CDC’s dengue risk classifications. The CDC defines a country or region with a frequent/continuous risk as one where there is evidence of more than 10 dengue cases in at least three of the previous 10 years. The share of children is based on the most recent UN population estimates as of 2023. 

[4]The Government of the People's Republic of Bangladesh reports figures of children only counted as 15 years and under, so children 16-17 are not included in this figure. 

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