Global spread of epidemic dengue: the influence of environmental change

Dengue/dengue hemorrhagic fever is the most important vector-borne viral disease globally, with over half of the world's population living in areas at risk of infection. Frequent and cyclical epidemics are reported throughout the tropical world, with regular importation of the virus via viremic travelers into both endemic and nonendemic countries. These events coincide with the recently observed global warming that is associated with climate change. Whether these events are coincidental is examined in this article. The history of dengue emergence is traced to determine the major drivers responsible for the spread of both the viruses and mosquito vectors to new geographic regions. We conclude that demographic- and anthropogenic-driven environmental changes, combined with globalization and inefficient public health measures rather than climate change, are the principal driving forces for the re-emergence and spread of epidemic dengue in the past 40 years. These trends are likely to continue given the global trends projected by the United Nations.