From September 23 to 28, 2001 , HDOH contacted all licensed physicians in the state by email or facsimile to request that any patient with a denguelike illness (DLI) be tested for dengue, regardless of travel history. DLI was defined as fever or chills plus 2 or more of the following symptoms (6): myalgia, headache, arthralgia, eye or retroorbital pain, rash, or hemorrhagic manifestation (e.g., petechiae, hematuria, hematemesis, menorrhagia, melena).