Like so many ailments, it begins with a fever. A crushing headache grips the afflicted, creating blurry vision alongside other trademark symptoms like joint pain, sick stomach, skin sensitivity, and extreme fatigue. After the first 24 hours, the fever won’t break and has soared past 102 F.

Luckily, it’s just a mild case of the mosquito-transmitted virus known as dengue. It’s the fastest-spreading tropical disease in the world, but unlike fellow vector-borne diseases like West Nile and Zika, dengue is much more dangerous.

A second infection increases the likelihood of developing internal bleeding and pushes the mortality rate of untreated cases to 50 percent.

By comparison, even the most damaging strains of COVID-19 carry an average fatality rate of less than 5 percent.

The rapid territory expansion of the mosquito that carries dengue—Aedes aegypti—has allowed dengue and similar viruses to spread alarmingly fast in places not normally associated with equatorial diseases, like the United States.

And though  Ghebreyesus noted COVID-19 is still a threat, he stressed other diseases could be far more challenging to global health care infrastructure.

In 2013, the WHO predicted dengue would become a “pandemic threat.” Ten years and one global pandemic later, the mosquito-transmitted pathogen is back on everyone’s radar as several countries in the Americas struggle to control massive dengue outbreaks.

But there’s a silver lining: the progression of dengue within U.S. borders will likely be gradual.

“This is going to be a slow-moving ‘pandemic’ if you want to call it that,” Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center, told The Epoch Times.

Schaffner noted warmer weather and rainfall volumes would be the biggest determining factors for the distribution and behavior of mosquito vectors.

“It not only gives the mosquitos a warmer environment to live, but also more pools to do their breeding,” Shaffner said.

“Increasing rainfall and advancing temperatures can expand the geographic area where the vector Aedes aegypti [mosquito] could flourish in the United States.”

Unlike most mosquitos, the Aedes aegypti is unique because it needs very little water to breed. Schaffner said an upturned bottle cap is enough to hatch dozens. The Aedes aegypti spreads dengue, along with diseases like yellow fever, chikungunya, and zika.

It’s also known as a “day biter.”

U.S. health care officials have kept a wary eye on the situation since most countries in Central and South America are pros at dealing with dengue. Rapid testing kits, education on which medications to use for supportive treatment, and vector elimination campaigns are well-established and funded.

Yet hospitals have been completely overrun.  Moreover, the dengue death toll this year from Bolivia and Peru’s outbreaks alone number in the hundreds.

This has prompted many health care providers to sweat over the damage a serious outbreak could cause in the United States.

“If a particularly virulent strain of dengue or chikungunya occurred, we would be hard-pressed to handle the emergency,” Dr. Joe Alton told The Epoch Times.

In addition to being a licensed physician, Alton is a medical preparedness advocate and bestselling author of health-related literature like “Alton’s Antibiotics and Infectious Disease.”

He noted it wouldn’t take much to overwhelm U.S. hospitals during a dengue outbreak. Alton pointed to a 2020 study that stated for every 10,000 U.S. residents, there are 24.2 inpatient beds, 2.8 adult ICU beds, and 1.4 isolation beds.

“Of these, 62.8 percent are occupied even without an outbreak of dengue or chikungunya,” he said.

Schaffner confirmed this, saying his hospital also carries a high bed occupation-to-patient ratio. “Most places in the United States have a very tight capacity in hospitals. There’s isn’t a lot of surge capacity,” he said, adding, ”If dengue started to spread beyond these small enclaves we have in Florida and along the Gulf Coast, we’d have real challenges to the health care system.”

But here’s the thing, It’s already happened.

While infected humans can’t spread diseases like dengue and yellow fever directly, the illness is passed to non-infected mosquitoes that bite someone carrying the virus, which then spreads to subsequent generations of the vectors.

So basically, we get mosquitos sick. Then infected mosquitoes get people sick. Coupled with an expanding mosquito territory, medical professionals say it’s a powder keg waiting to go off.

“Savannah, Georgia, was the site of a number of mosquito-borne yellow fever epidemics in the 18th and 19th centuries, killing thousands,” Alton said.

He also thinks there’s no reason to believe dengue won’t continue to spread. “Diseases passed by arthropod vectors are most certainly on the rise ... In twenty years, cases of the most common vector-borne disease, dengue fever, have increased ten-fold.”

Anything more than an isolated dengue outbreak could quickly spiral for health care providers and patients alike.

Schaffner said training and education of medical staff, along with eliminating mosquito breeding sites, are pivotal mitigation strategies.

He asserts that most medical professionals learned about diseases like dengue in school, but few have dealt with it hands-on. This could result in a delayed diagnosis. That could easily prove fatal for someone with a severe case or who develops internal bleeding symptoms.

Schaffner said vaccine science is racing to address the problem, “We have a dengue vaccine now. It’s had a bit of a false start and got a bad reputation. But now, in Puerto Rico, they’re starting to use the vaccine.”

Though fast, accurate testing and destroying mosquito breeding zones remain the most effective weapons to combat the virus. Schaffner gave examples of birdbaths, rain gutters, and outdoor sandboxes as everyday features around the home that should be monitored and sanitized to control mosquitos.

Alton also offered a ray of hope, “Dengue is less likely to reach worldwide pandemic levels than airborne viruses. Areas of the southern United States, however, can expect higher numbers of dengue cases in the future.”