Dengue in South America: incidence, clinical characteristics, and prevention strategies. An Overview

In 2023, Dengue experienced an unprecedented spread, with outbreaks and expansion into areas previously free of the disease worldwide. In the Americas, record-breaking figures from 2019 were surpassed. This review examines current evidence on Dengue in South America, focusing on the region's scientific contributions regarding incidence, clinical characteristics, and prevention strategies. Dengue, an endemic disease in much of South America, showed an alarming increase between 2023 and 2024, with surges in several countries. In recent years, rising incidence and the geographic spread of Dengue have been driven by the simultaneous circulation of serotypes, unregulated urbanization, and vector insecticide resistance. Additionally, increased rainfall and the El Niño–Southern Oscillation (ENSO) have played a key role. In some regions, dengue incidence correlated positively with rainfall and negatively with temperature. The clinical characteristics highlight the complexity of differentiating Dengue from other febrile illnesses, as well as between primary and secondary infections and among serotypes. Secondary infections and those caused by DENV-2 were associated with greater severity and complications. Coinfections with Zika, Chikungunya, and SARS-CoV-2 further complicate the diagnosis. In South America, studies evaluated the attitudes, beliefs, and effectiveness of dengue control measures, including insecticide use and resistance, public health strategies, educational practices, and vaccines. The findings underscore the importance of combining and adapting strategies to local contexts to achieve more sustainable and effective dengue control in the region.