The rapid spread of a painful tropical disease is alarming governments in Central America, where nearly 50,000 cases have been reported this year.
So far, only a handful of people in the region appear to have died of mosquito-borne dengue, sometimes known as “break-bone fever,” health officials say.
“It’s becoming endemic to many areas in the American tropics,” said Dan Epstein of the Pan American Health Organization.
Millions of cases - and thousands of deaths - are reported each year around the world, from Africa to the Pacific Islands, from Asia to the Americas.
Government health officials have reported 20,000 cases of classic dengue this year in Costa Rica, 15,000 in Honduras, and about 6,000 each in El Salvador and Nicaragua. Guatemala has reported 1,600 cases and Panama 890.
A deadlier cousin, hemorrhagic dengue, was reported in 263 people, most of them in Nicaragua.
Five people in the region have died so far.
Dengue is caused by four viruses spread largely by the Aedes aegypti mosquito, and sometimes by the Aedes albopictus. Sufferers who experience one virus remain vulnerable to the other three.
Classic dengue can produce fever and severe pain in the joints. Victims of hemorrhagic dengue suffer high fever, vomiting and bleeding from capillaries.
The disease is spreading primarily because of the erosion of eradication programs for the aedes aegypti mosquito, which breeds in water pooled in everything from trash heaps to the tops of bamboo fence poles, Epstein said.
He also blamed poverty for the resurgence of dengue, as well as cholera and yellow fever.
El Salvador declared a state of emergency this week to combat the diseases. The presidents of Honduras and Costa Rica began a joint campaign against them this month.