Dengue on the rise in Encarnación, Paraguay (2023-2024): an emerging threat to regional transmission dynamics

Dengue remains a public health concern in Paraguay. Paraguay´s 2023-2024 epidemic was examined, emphasizing on the Itapua department in the southern region bordering Argentina.

This retrospective, cross-sectional observational study analyzed confirmed dengue cases from 17 September 2023, to 4 May 2024. Demographic and clinical data of the participants were gathered from Paraguay's national surveillance system.

Among the 307,058 suspected dengue cases reported, 77,675 were confirmed through laboratory testing. The Itapua department contributed 8,310 (2.7%) and 1,910 (2.5%) of the suspected and confirmed cases; pediatric cases comprised 33% nationwide and 35% in Itapua. Intensive care needs were higher in Itapua (n = 18, 11.2%) than in other Paraguayan regions (n = 152, 2.0%). Mortality rates were also elevated in Itapua (n = 11, 0.6%) compared to the national average (n = 95, 0.13%). DENV-1 and DENV-2 were responsible for this epidemic. Encarnacion, the capital of Itapua State and a neighboring city to Posadas, Argentina, was the most severely affected (1,262 reported cases).

The elevated rates of pediatric cases, intensive care admissions, and mortality in Itapua highlight the need for multicomponent health strategies, including enhanced vector control through community-led Aedes aegypti elimination programs and insecticide residual spraying in high-incidence zones, vaccination campaigns targeting high-risk pediatric populations with World Health Organization (WHO)-approved dengue vaccines (e.g., TAK-003), and cross-border collaboration with Argentina (e.g., Posadas-Encarnacion) to synchronize outbreak surveillance, share real-time epidemiological data, and coordinate vaccine deployment in binational hotspots.