Dengue is spread by the bite of an Aedes mosquito. The mosquito transmits the disease by biting an infected person and then biting someone else. Dengue viruses occur in most tropical areas of the world. Dengue is common in Africa, Asia, the Pacific, Australia, and the Americas. It is widespread in the Caribbean basin.
Dengue is most common in cities but can be found in rural areas.
It is rarely found in mountainous areas above 4,000 feet. The mosquitoes that transmit dengue live among humans and breed in discarded tires, flower pots, old oil drums, and water storage containers close to human dwellings. Unlike the mosquitoes that cause malaria, dengue mosquitoes bite during the day. Dengue fever usually starts suddenly with a high fever, rash, severe headache, pain behind the eyes, and muscle and joint pain. Nausea, vomiting, and loss of appetite are common.