Dengue in the Pacific--an update of the current situation.

Dengue continues to be a threat to Pacific Island countries and territories (PICTs). The last DEN-1 epidemic reached 16 PICTs and in some of them it affected as much as 20 per cent of the population, aside from the massive impact on their fragile economies. Dengue is mostly introduced into PICTs from global travel, and many experts believe that it has a 3-4 year cyclical pattern of occurrence. All four virus serotypes (DEN-1, 2, 3 and 4) have caused epidemics, but those caused by DEN-1 and 2 have been somewhat larger. In light of this, dengue rightly remains a priority for the Pacific Public Health Surveillance Network (PPHSN). The paper updates the situation regarding dengue outbreaks in PICTs over the last four decades, describes the pattern of presentations in the recent past, and provides an update on the potential risk to PICTs for the near future. It follows on from an earlier dengue update written in 1998. The utility of PPHSN services is also demonstrated in the paper: PacNet for alerts and communication about dengue outbreaks (raising awareness and preparedness levels in the region) and LabNet for investigations relating to dengue. Creative interventions towards dengue control and prevention are being tried in PICTs and early assessment and evaluations of their effectiveness in the field are being examined.