00000000Dengue fever also occurs in geographical regions other than South-East Asia. Dengue occurred in epidemic form on many of the islands in the eastern part of the Pacific Ocean during 1943 and 1944. Type 1 dengue virus was isolated on one of those islands, that of Oahu, Hawaii. It is believed that this serotype was responsible for al dengue outbreaks in this geographical area at that period of time. After that, the disease disappeared and was not recognized again until the latter half of 1964 when it occurred on the island of Tahiti in French Polynesia(24). Ten years later, dengue activity had increased in the South Pacific area and had spread widely(25).

00000000During the period 1974 - 1980, three epidemics of dengur fever occurred in the southern coastal area of the People's Republic of China. Over 11 per cent of the patients developed severe haemorrhage(26,27)

00000000In 1977, a dengue pandemic began in the Caribbean. Following outbreaks on many islands, including Puerto Rico, classical dengue was introduced into South-eastern Mexico in 1978 at Tampico on the coast of the Gulf of Mexico(28). In September 1980, the US Center for Disease Control (CDC) reported the first case of dengue in continental USA since 1945(29). It occurred in Brownsville, Texas. In 1981, DHF was reported from Cuba, the first outbreak of the haemorrhagic form in the American region(30).

00000000In Africa, less information has been collected. So far, however,DHF/DSS is not a major health problem of this region(31). DHF has not been regarded as a significant problem in either the European or the Mediteranean region.