You’ve probably seen the headlines about “breakbone fever” and the new CDC travel alert. If you have a trip planned to places like Vietnam, Cuba, Colombia, or other tropical destinations, it can feel unsettling—especially when words like “potentially fatal” are involved.

“Breakbone fever” is the nickname for dengue, a mosquito-borne viral infection that can cause severe joint and muscle pain, high fever, and in rare cases, life-threatening complications. The U.S. Centers for Disease Control and Prevention (CDC) is now warning about a higher-than-expected number of dengue cases in travelers returning to the United States, prompting many people to ask: Is it still safe to travel, and how can I protect myself?

In this guide, we’ll break down what the CDC alert actually means, where the risks are highest, how dengue spreads, and the most practical, science-backed steps you can take to lower your risk—before, during, and after your trip. The goal isn’t to scare you away from travel, but to help you travel smarter and safer.

A mosquito on human skin representing dengue or breakbone fever risk
Mosquitoes that spread dengue are common in tropical and subtropical regions—and increasingly, in parts of the Americas.

Why the CDC Is Issuing a Dengue Travel Alert Now


What Is ‘Breakbone Fever’ and Why Are Cases Increasing?

“Breakbone fever” is an informal name for dengue fever, caused by the dengue virus, which is spread mainly by Aedes aegypti and Aedes albopictus mosquitoes. These mosquitoes bite during the day and thrive in warm, humid, urban environments.

The nickname comes from the intense muscle and joint pain some people experience. While many infections are mild, dengue can occasionally progress to severe dengue, a medical emergency that may cause bleeding, organ impairment, and dangerously low blood pressure.

According to recent CDC alerts and global surveillance data:

  • Countries such as Vietnam, Cuba, Colombia, Brazil, and other parts of Latin America and Southeast Asia have reported unusually high dengue activity.
  • More U.S. travelers are returning with dengue infections, increasing concern about both individual illness and local transmission in areas where the mosquito is present.
  • Climate factors, urban crowding, and mosquito habitat expansion are contributing to higher case numbers worldwide.
“Dengue is no longer a rare ‘tropical’ disease. We’re seeing larger and more frequent outbreaks across the Americas, and travelers need to think about dengue prevention the same way they think about malaria or COVID-19 precautions.”
— Infectious disease specialist, academic medical center (paraphrased from current literature)

The key point: The CDC alert doesn’t mean you must cancel your trip. It does mean you should take dengue seriously and plan ahead.


Dengue Symptoms: How to Recognize ‘Breakbone Fever’

Dengue symptoms usually start 4–10 days after a mosquito bite and can last about a week. Many people have mild or no symptoms, but others feel very ill.

Common dengue symptoms

  • Sudden high fever (often above 102–104°F / 38.9–40°C)
  • Severe headache, especially behind the eyes
  • Strong muscle, joint, and bone pain (“breakbone” sensation)
  • Nausea, vomiting, or loss of appetite
  • Extreme fatigue or weakness
  • Skin rash that may appear a few days after the fever

Warning signs of severe dengue (medical emergency)

These can develop around the time the fever begins to drop, often 3–7 days after symptoms start:

  • Persistent vomiting or severe abdominal pain
  • Bleeding gums or nose, vomiting blood, or blood in stool
  • Rapid breathing, difficulty breathing, or chest discomfort
  • Extreme restlessness, confusion, or drowsiness
  • Cold, clammy skin, especially in hands and feet

An important detail: Avoid taking ibuprofen (Advil, Motrin), aspirin, or other NSAIDs if dengue is suspected, because they can increase bleeding risk. Acetaminophen (paracetamol) is generally preferred for fever and pain unless your clinician advises otherwise.


Who Is Most at Risk from Dengue Complications?

Anyone can get dengue, but certain groups have a higher risk of severe illness:

  • People who have had dengue before (a second infection can sometimes be more severe)
  • Older adults, especially with underlying heart, lung, or kidney disease
  • People with chronic conditions like diabetes or hypertension
  • Pregnant individuals
  • Infants and young children

If you or someone in your travel group falls into one of these categories, it’s especially important to:

  1. Consult a travel medicine or primary care clinician 4–6 weeks before departure, if possible.
  2. Have a plan for medical care at your destination (clinic locations, insurance coverage, emergency numbers).
  3. Use multiple layers of mosquito protection, not just repellent.
Traveler applying mosquito repellent spray on arm
For higher-risk travelers—such as older adults or those with chronic conditions—mosquito protection is essential, not optional.

What the CDC Dengue Travel Alert Actually Means

CDC travel alerts vary in level. For dengue, the agency typically issues alerts when:

  • A country or region is having higher-than-expected dengue activity or a significant outbreak.
  • Travelers are more likely than usual to be exposed during routine activities (e.g., staying in cities, staying with family, or outdoor tourism).
  • U.S. clinicians need to be on the lookout for dengue in returning travelers who present with fever.

An alert does not mean:

  • All travel should stop.
  • You are guaranteed to get dengue if you visit.
  • There is widespread, uncontrolled transmission in the United States.

It does mean you should:

  1. Check the CDC Travel Health Notices for the latest country-specific guidance.
  2. Take mosquito prevention seriously, even in cities and resorts.
  3. Be aware of dengue symptoms and seek care early if you feel ill after travel.

Before You Go: Smart Pre-Travel Planning for Dengue Prevention

A bit of preparation before your trip can significantly cut your risk. Think in terms of three layers of protection: information, immunization where appropriate, and gear.

1. Get informed about your destination

  • Check dengue activity for your destination on:
    • CDC Travelers’ Health
    • Your country’s public health or foreign affairs website (e.g., Public Health Agency of Canada, ECDC in Europe)
  • Look for:
    • Current outbreaks or recent surges
    • Regions within the country with higher risk (coastal vs. inland, rural vs. urban)
    • Seasonality (rainy season often means more mosquitoes)

2. Talk to a travel medicine or primary care clinician

Aim for an appointment 4–6 weeks before departure. Discuss:

  • Your itinerary (cities, rural areas, duration, time of year)
  • Your medical history and medications
  • All recommended vaccines and preventive medications for your destination (e.g., routine vaccines, hepatitis A/B, typhoid, malaria prophylaxis if indicated)
  • Your risk level for severe dengue and any precautions specific to pregnancy, older age, or chronic disease

3. Pack a dengue-prevention kit

Consider bringing:

  • EPA-registered mosquito repellent with:
    • DEET (20–30%)
    • or Picaridin (20%)
    • or IR3535, oil of lemon eucalyptus, or PMD (per label instructions)
  • Permethrin-treated clothing or spray to treat outerwear, socks, and gear (never apply permethrin directly to skin).
  • Long-sleeved, lightweight, breathable shirts and long pants, ideally light-colored.
  • Travel-size mosquito coils or plug-in devices if allowed, for outdoor seating areas.
  • Bed net (insecticide-treated) if you’ll stay in basic accommodation without screened windows or reliable air conditioning.

During Your Trip: Day-to-Day Strategies to Avoid Dengue

Dengue mosquitoes bite mostly during the daytime, especially early morning and late afternoon. Protecting yourself means thinking about mosquitoes from the moment you wake up until you go to sleep.

1. Protect your skin

  1. Apply mosquito repellent to all exposed skin, following the product label.
  2. Reapply every few hours, especially after sweating, swimming, or showering.
  3. Use sunscreen first, let it absorb, then apply repellent on top.

2. Dress with mosquitoes in mind

  • Wear long sleeves, long pants, and socks when possible, especially during peak biting hours.
  • Opt for loose, light-colored clothing, which is a bit less attractive to mosquitoes and more comfortable in the heat.
  • Consider permethrin-treated clothing, particularly for outdoor excursions or evening activities.
Long sleeves, long pants, and light fabrics help reduce mosquito bites without sacrificing comfort or style.

3. Choose safer sleeping environments

  • Stay in rooms with air conditioning when possible; mosquitoes are less active in cooler, enclosed environments.
  • Ensure window and door screens are intact; report or repair tears if you can.
  • Use a bed net if sleeping in unscreened rooms, open-air accommodations, or if mosquitoes are present indoors.

4. Watch your surroundings

Dengue mosquitoes breed in standing water, even in very small amounts.

  • Avoid sitting near containers of stagnant water such as buckets, plant saucers, discarded tires, or open barrels.
  • Ask hosts or property managers to empty or cover standing water around living areas.
  • If you’re staying somewhere longer-term, do a quick “water check” around your living area once or twice a week.

After You Return: Monitoring Your Health and Protecting Others

Dengue has an incubation period of several days, so you might feel well on the plane home and then develop symptoms later. Paying attention to your body after travel is an important—and often overlooked—part of dengue prevention.

1. Watch for fever and related symptoms

For two weeks after you return from a dengue-affected area:

  • Monitor for fever, severe headache, muscle or joint pain, rash, or unusual fatigue.
  • If you develop symptoms, contact a healthcare provider and mention:
    • Your recent travel (countries, dates, and any known mosquito exposure)
    • Any underlying medical conditions

2. Reduce the risk of local spread

In rare cases, infected travelers can contribute to local dengue transmission if bitten by mosquitoes after returning home, especially in areas where Aedes mosquitoes are present (parts of the southern U.S. and other warm regions).

  • If you feel sick after travel:
    • Use mosquito repellent even at home to reduce the chance that local mosquitoes bite you and spread the virus.
    • Stay in well-screened or air-conditioned spaces as much as possible while you’re febrile.
  • Follow your clinician’s instructions for testing, home care, and follow-up.
Monitor your health for about two weeks after returning from a dengue-affected area, and don’t ignore new fevers.

Common Obstacles to Dengue Prevention—and How to Overcome Them

Even with the best intentions, travelers often run into practical challenges. Here are some of the most common barriers—and realistic ways to handle them.

“Repellent feels sticky and smells bad.”

  • Try different active ingredients (e.g., picaridin instead of DEET) or alternative formulations like lotions or wipes.
  • Apply repellent mainly when you’ll be outdoors or near mosquitoes, and wash it off before bed if you’re in a screened or air-conditioned room.

“It’s too hot for long sleeves and pants.”

  • Choose lightweight, breathable fabrics like linen or moisture-wicking synthetics.
  • Use clothing with built-in insect repellent or apply permethrin to outer layers so even thinner items provide protection.

“I’m staying with family—they don’t worry about mosquitoes.”

  • Frame your concerns in terms of your own health needs (“My doctor advised me to be careful because I’m not used to local infections.”).
  • Offer to help with simple measures like emptying standing water or buying a fan, repellent, or a bed net.

The Science Behind Dengue Prevention: Why These Steps Work

Dengue control strategies are grounded in decades of research on mosquito behavior, virology, and outbreak patterns.

  • Vector behavior: Aedes mosquitoes typically bite during the day, prefer humans, and breed in artificial containers with clean standing water. That’s why daytime protection and environmental control are crucial.
  • Source reduction: Removing standing water interrupts the mosquito life cycle and is one of the most effective community-level interventions.
  • Personal protection: Studies have repeatedly shown that consistent use of DEET, picaridin, and permethrin-treated fabrics reduces mosquito bites and mosquito-borne infections.
  • Early clinical care: Evidence indicates that early recognition of warning signs and appropriate fluid management can significantly reduce deaths from severe dengue.
Doctor consulting with a patient, reviewing medical information
Early medical evaluation for fever after travel to dengue-affected areas can help identify serious illness before it becomes life-threatening.

For readers who like to dive deeper, reliable information is available from:


Key Takeaways & Your Next Steps

Dengue—“breakbone fever”—is a serious, sometimes life-threatening mosquito-borne disease. The recent CDC travel alert reflects rising global case numbers, particularly in destinations like Vietnam, Cuba, Colombia, and other tropical or subtropical areas that are popular with U.S. travelers.

You don’t have to give up your travel plans, but you do need a thoughtful, proactive approach.

Your action checklist

  1. Check the latest CDC travel notices for your destination.
  2. Schedule a pre-travel visit with a clinician—ideally a travel medicine specialist—4–6 weeks before departure.
  3. Pack and use EPA-registered repellent, mosquito-protective clothing, and bed nets when needed.
  4. Minimize exposure to standing water and unprotected outdoor areas during peak mosquito hours.
  5. Monitor your health for two weeks after returning, and seek care promptly if you develop fever or other dengue-like symptoms.
“In travel medicine, the goal isn’t to scare people away from exploring the world. It’s to give them the tools to do it safely.”

If you have an upcoming trip to a dengue-affected region, consider today your starting line. Make your clinician appointment, assemble your dengue-prevention kit, and share what you’ve learned with your travel companions. With informed choices and a few simple habits, you can respect the risk without losing the joy of travel.