Urban is growing behind the rise of dengue fever

DBobby Reiner, one of the study's authors and assistant professor at Washington University, said the reason for the increase in the disease was due to a large shift from rural to urban life. Those who live in bad conditions in "unplanned megacities" in the world are particularly at risk.

Dengue is a mosquito-borne disease in the city, where there are growing numbers of people living in poor urban areas, where there are no windows on screens, air conditioning and lots of standing water, which is the ideal condition for mosquitoes, "he said.

Dr. Reiner said there are few proven treatments to fight the disease – the only dengue vaccine is imperfect, and research on control measures, such as insecticides, was scarce.

"There is a lack of evidence of what to do about it," he said.

There are four different dengue serotypes – or strains – and a person who has been infected with one serotype is more likely to develop a serious form of the disease if they are again infected with others.

Rachel Lowe, a London School of Hygiene and Tropical Medicine researcher who did not participate in the study, said people are moving around the globe in large numbers, increasing the chances of being exposed to different serotypes.

She added: "More frequent interactions between different serotypes can lead to more people developing a serious dengue that may be fatal in some cases.

"When you have these vast urban areas where poor sanitation and close human-to-human contact are involved, you need to increase the number of cases."

Daily mosquito bites during the day, so malaria control efforts, such as bedding, do not work, she added.

"It is extremely difficult to manage the vector and when it is found to be very difficult to get rid of it. Things like better sanitation and infrastructure are the key to people having the right flowing water so they do not rely on temporary water reservoirs," he said Dr. Lowe.

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