Although epidemics of a dengue like virus occurred before the 18th century, the accepted earliest occurrences were three epidemics in Cairo, modern day Jakarta, modern day Indonesia, and Philadelphia (Encyclopedia Britannica 2013). The vector of mosquitoes most likely traveled to these port cities via ship (ibid). This illustrates the effect of globalization on the spread of disease. Slave trade allowed for dengue carrying mosquitoes to reach foreign regions (Basnyat 2012). Cases of Dengue fever are most often seen in tropical urban regions, for example in the Philippines, India, sub Saharan Africa, and in Latin America (CDC 2013c). The Figure above shows the spread of dengue throughout recent decades. This illustrates how Dengue fever has grown endemic in more regions over the years, meaning that there are a greater number of regions in which people are exposed to Dengue.
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