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There are several types of Dengue, each caused by a different Flavivirus. Service (2005) distinguished four types. The disease is distributed in the tropics from Southeast Asia, the Pacific area, the East Indian subcontinent, sub-Saharan Africa, Central and South America, and the Caribbean islands.
Dengue as haemorrhagic fever (= involves bleeding in internal organs) is especially lethal to very young children. According to Service (2005) dengue type 4 was found in Cuba in 1981, but was followed by reports from over 26 other countries soon after. The haemorrhagic type was then found to occur in 18 countries. However, in 1965 there was an outbreak of dengue in Puerto Rico where some people of African heritage had to remain bed-ridden for over 4 months. Which type that caused that severe response is not known. Dengue has since been considered the most important viral disease transmitted by mosquitoes (Service 2008) as its occurrence has steadily increased. In the Americas transmission is by Aedes aegypti while in Southeast Asia also by Aedes albopictus and Aedes scutellaris. It remains to be seen if the newly arrived Zika virus disease in America will equal or overpass Dengue as the most important viral disease where mosquitoes are involved. Humans serve as principal reservoirs for the virus in most areas.
The vector mosquitoes all breed in natural and human-made container habitats, where quiet water persists. Although there are reports of Dengue in the wild Simian populations of Asia no epidemics have been associated with them as reservoir hosts. It is believed that all epidemics of Dengue are directly from mosquitoes to humans, which are the reservoir hosts.
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