Introduction
Dengue fever is no longer confined to tropical regions it has become one of the fastest-spreading mosquito-borne diseases worldwide. In 2024, the Americas reported record-breaking case numbers, with the Caribbean and Central America among the hardest-hit regions. According to the CDC, outbreaks are continuing into 2025, with transmission persisting in Puerto Rico, Costa Rica, Honduras, and the Dominican Republic.
For pharmacists and travelers alike, preparation is now a medical priority. Dengue has no specific antiviral treatment, and prevention relies entirely on mosquito protection, early recognition of symptoms, and supportive care. A well-stocked pharmacy-based travel checklist, timely medical advice, and awareness of outbreak zones can dramatically reduce complications or hospitalization.
Dengue Epidemiology and Travel Risk 2025–2026
In 2024, the World Health Organization reported over 13 million dengue cases across the Americas, the highest ever recorded. Dengue is caused by four closely related viruses transmitted primarily by the Aedes aegypti mosquito, which breeds in standing water and bites during the day. The risk of severe disease rises with repeated infections by different dengue serotypes, making travelers to endemic areas particularly vulnerable if previously exposed.
CDC surveillance data confirm that the Caribbean and Central America remain persistent hotspots, particularly Puerto Rico, the U.S. Virgin Islands, the Dominican Republic, Belize, El Salvador, and Honduras. Urban outbreaks are increasingly common, with Aedes mosquitoes thriving even in air-conditioned cities and resort courtyards.
Pharmacy Prevention Toolkit and Repellent Strategy
When it comes to dengue, prevention is everything. There is no cure, no simple pill, and no guarantee of mild illness, so the most effective defense begins before departure, inside the pharmacy.
The cornerstone of prevention is an effective repellent. The CDC recommends products containing DEET or picaridin repellent (20–50% DEET or 20% picaridin), which provide 6–8 hours of protection and are safe for adults and children over two months old.
Travelers should also consider permethrin-treated clothing or gear, available pretreated or as sprays sold in pharmacies. Permethrin should never be applied directly to skin but works well on clothing and retains its effect through multiple washes.
A well-prepared dengue prevention kit should include:
- Acetaminophen (paracetamol) for fever or pain
- Oral rehydration salts (ORS) to prevent dehydration
- Digital thermometer
- Bite relief cream and basic first aid items
Critically, travelers must avoid aspirin, ibuprofen, or other NSAIDs, which increase bleeding risk if dengue infection occurs.
Warning Signs, When to See a Doctor, and Triage
Recognizing dengue early can save a traveler’s life. The disease often begins with fever, muscle aches, and fatigue but can progress rapidly between days 3 and 7 to a critical phase involving plasma leakage and bleeding.
Immediate medical assessment is required if a traveler experiences severe abdominal pain, persistent vomiting, unexplained bleeding, black stools, cold/clammy skin, or unusual drowsiness. During milder illness, supportive care remains the standard: hydration with oral rehydration salts (ORS) and fever management with acetaminophen only.
If symptoms occur within two weeks after returning from an endemic area, travelers should mention recent travel to their healthcare provider. For pharmacists, the role is to triage wisely: when fever follows tropical travel, recommend prompt medical evaluation rather than symptomatic treatment alone.
Current Warnings and Regional Updates for the Caribbean and Central America
As of late 2025, dengue transmission remains widespread across much of the Caribbean and Central America, prompting continued travel advisories from public health authorities. The 2024–2025 season marked the most active period on record, with sustained outbreaks in Puerto Rico, the U.S. Virgin Islands, Honduras, Nicaragua, Costa Rica, Belize, the Dominican Republic, Cuba, and Mexico’s Yucatán region.
These outbreaks reflect ideal mosquito breeding conditions and urban adaptation of the Aedes aegypti mosquito. Air-conditioned hotels do not provide complete protection mosquitoes can breed in ornamental plants, courtyards, and even discarded bottle caps. The risk is no longer limited to rural settings; it extends to city breaks and short cruises.
The CDC advises all travelers to use mosquito protection consistently and to monitor health for two weeks after returning home. Those who develop fever or body aches should seek medical advice promptly and mention travel history to ensure early diagnosis.
Conclusion
For travelers planning trips to the Caribbean or Central America in 2025–2026, dengue prevention is no longer an afterthought it is a vital part of travel health planning.
The pharmacy remains the traveler’s first line of defense. Choosing an effective repellent, packing a proper first-aid kit, and knowing when acetaminophen is safe but ibuprofen is not can make the difference between a mild illness and a medical emergency.
Ultimately, dengue is a disease of timing and awareness. The earlier it is prevented, identified, or treated supportively, the better the outcome. A well-prepared traveler who applies repellent daily, avoids mosquito bites during daylight hours, and recognizes the first signs of illness is far less likely to face complications.
In a world where global mobility and mosquito-borne infections intersect more than ever, preparedness begins not at the airport, but at the pharmacy counter. Knowledge, vigilance, and a small kit of essentials remain the most effective tools for staying safe abroad.
References
- Centers for Disease Control and Prevention. (2024, November 15). Dengue outbreaks in 2024. https://www.cdc.gov/dengue/outbreaks/2024/index.html
- Pan American Health Organization. (2025, September 26). Dengue epidemiological situation in the Region of the Americas Epidemiological Week 36, 2025. https://www.paho.org/en/documents/dengue-epidemiological-situation-region-americas-epidemiological-week-36-2025