Reappearance of Chikungunya, Formerly Called Dengue, in the Americas

Scott B. Halstead


Emerging Infectious Diseases. 2015;21(4):557-561. 

In This Article

Origin of the Term Dengue

Christie explicitly linked the 1827–1828 epidemic of kidinga pepo in the Americas to the 1823 epidemic on Zanzibar. He noted that published reports indicated that the 1823 epidemic soon spread from Zanzibar to Gujarat, India, and then to Calcutta, India, and by 1824 it had spread to Rangoon in present-day Myanmar. In 1827, there were reports of a similar disease in St. Thomas in the West Indies. Christie stated, "I am of the opinion that both the disease and its designation were imported in the West Indian Islands direct from the East Coast of Africa".[5] It was in the West Indies, as Christie observed, that the medical term dengue was introduced. Dumaresq, an observer of the dengue epidemic in New Orleans, Louisiana, USA, in 1828 commented, "The disease alluded to is supposed to have been brought from Africa, with some slaves imported into the Havana. In that place it obtained the name of Dingee, Dengue, Danga, etc. It was there very prevalent, and also in Barbadoes [sic], where it received the name of Dandy fever, from the stiffened form and dread of motion in patients".[6] In New Orleans, the disease "spread was so rapid among the inhabitants that in eight or ten days at least one third of the population was laboring under its influence, including persons of all ages and different sexes".[6] Dumaresq goes on to say,

"A person on the disappearance of this fever would attempt to rise from bed, feeling not much loss of strength, and a consciousness of being able to move about and attend to a little to business; but how egregiously would he be mistaken when he assumed the upright posture! The joints felt as if fettered or anchylosed, and the advance of one foot or leg beyond the other, would cost more pain and effort than the purpose for which it may have been advanced was worth, —aye,—a thousand times told!" [6]

The arthritic component of this febrile exanthem is unique to epidemic human chikungunya infections. It has been variously called scarlatina rheumatica, exanthesis arthrosia, and an eruptive articular or rheumatic fever.[7]

An interesting further insight into the colloquial Spanish meaning of dengue may contribute to an understanding why this term prevailed so quickly. In 1952, when Sabin inquired into the etymology of the term dengue, the standard Spanish dictionary meaning was affectation.[8] Dengue researchers at that time were unable to make a connection between this term and characteristic signs and symptoms of dengue. However, an interesting connection does exist, but it is to the disease caused by what we now call chikungunya, not dengue. In 1828, contemporary observers were struck by the post-illness arthralgia and disability caused by dengue (i.e., present-day chikungunya), including the post-illness symptoms cited above in comments by Dumaresq.[6] Stedman noted an even more extreme manifestation of dengue, reporting, "It is even said that when the disease first appeared in St. Thomas, several negroes, who, being all at once attacked with pain in the knees, had fallen down, were actually apprehended by the police for drunkenness".[9] Lehman, the lazaretto (i.e., quarantine station) physician for the port of Philadelphia, Pennsylvania, USA, interviewed a ship captain from Cuba who declared that, "It [dengue] is a vulgar phrase, and implies a 'staggering weakness,' and is somewhat similar in its import to our term of 'corned' [drunk] as applied to a man reeling about from intoxication".[10] The original meaning of kidinga pepo has been consistently maintained from Swahili to the colloquial eighteenth century Spanish term dengue as an apt name for a disease that produces a post-illness stagger.