Dengue and dengue-like outbreaks in the past: the case of the Macau epidemic fever of 1874.

Historical sources abound in references to outbreaks of a disease resembling dengue fever. Medical observers reported on its rapid onset and great expansion in the population, the diversity and changeability of its clinical features and its overall mildness. In 1874, an epidemic disease with fever, rash and rheumatic pains as main symptoms broke out in the Portuguese colony of Macau, South China. It was similar to the epidemic disease which swept the colony 2 years before during the socalled dengue pandemic of 1870-1873. The 1874 epidemic disease was variously labeled by local physicians, including dengue fever. In his report on the disease, Dr. Lúcio Augusto da Silva, hence at the head of the health services of Macau, discussed on the nature of the epidemic febrile disease. Here, I review the data on the 1874 epidemic outbreak and put them in the context of historical dengue-like outbreaks. A possible Chikungunya etiology of the disease is postulated.