Dengue is the world's most important human arboviral disease with indigenous and endemic transmission in more than 100 tropical and subtropical countries. There are numerous other locales that experience non-sustained epidemic transmission with cases in returning travelers or military personnel. More than half the population of the world is at risk of being infected with a dengue virus (DENV). Despite its importance dengue is under-recognized and underreported with current literature estimating 400 million infections each year with 100 million being clinically apparent. The human, community, country, and regional cost of dengue in terms of mortality, morbidity, and health care resource utilization is significant and growing in scope. There are numerous factors that are believed to contribute to the increase in dengue burden, which include (1) rising number of susceptible hosts (population growth), (2) expanding Aedes mosquito vector populations (ineffective vector control, increasing breeding sites, changing ecology), (3) increasing DENV distribution (travel), and (4) the convergence of the these three: urbanization, poverty, and decaying infrastructure