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Volume 32, Number 2—February 2026

Research

Using Routine Surveillance Data to Assess Dengue Virus Transmission Risk in Travelers Returning to the United States

Kristyna Rysava1, Zachary J. Madewell1Comments to Author , Maile B. Thayer, Liliana Sánchez-González, Kamalich Muniz-Rodriguez, Ashley Brown, Julie Thwing, Laura E. Adams, Gabriela Paz-Bailey, and Michael A. Johansson
Author affiliation: University of Warwick, Warwick, UK (K. Rysava); Centers for Disease Control and Prevention, San Juan, Puerto Rico, USA (Z.J. Madewell, M.B. Thayer, L. Sánchez-González, K. Muniz-Rodriguez, L.E. Adams, G. Paz-Bailey, M.A. Johansson); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (A. Brown, J. Thwing)

Main Article

Figure 3

Monthly dengue risk classifications among travelers returning to the United States, by country, by using real-time data and dual-alert criteria, 2014–2024. Each tile represents 1 country-month and is colored according to the criteria met: dark green for months that met both criteria (dengue case counts exceeded the 80th percentile threshold and met the >10 case-criterion in the previous 3-month window), yellow for months exceeding the 80th percentile threshold only, and light green for months meeting the >10-case criterion but below the transmission threshold. Blank tiles indicate months that met neither criterion. The high transmission threshold was based on the 80th percentile of modeled country-specific traveler case distributions (real-time or annually updated). Countries are ordered by the total number of months that met both criteria.

Figure 3. Monthly dengue risk classifications among travelers returning to the United States, by country, by using real-time data and dual-alert criteria, 2014–2024. Each tile represents 1 country-month and is colored according to the criteria met: dark green for months that met both criteria (dengue case counts exceeded the 80th percentile threshold and met the >10 case-criterion in the previous 3-month window), yellow for months exceeding the 80th percentile threshold only, and light green for months meeting the >10-case criterion but below the transmission threshold. Blank tiles indicate months that met neither criterion. The high transmission threshold was based on the 80th percentile of modeled country-specific traveler case distributions (real-time or annually updated). Countries are ordered by the total number of months that met both criteria.

Main Article

1These first authors contributed equally to this article.

Page created: January 29, 2026
Page updated: February 19, 2026
Page reviewed: February 19, 2026
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