Date of Conferral



Doctor of Public Health (DrPH)


Health Services


Robert Marino


Dengue fever is a debilitating, viral, mosquito-borne disease occurring in tropical and subtropical areas in the world. The majority of dengue cases in the United States were acquired in endemic areas by travelers or immigrants. However, in recent years, autochthonous (locally acquired) dengue cases have been diagnosed in Florida. The purpose of this study was to find an association between potential risk factors and the expansion of dengue fever in the United States. Guided by the eco-bio-social framework, which offers a broad assessment of risk factors for the illness, a retrospective design was used with archival data to correlate changes in climatic variables and imported dengue cases with autochthonous dengue cases in Southeast Florida from 1980 to 2013. A Spearman correlation indicated weak correlations between temperature and autochthonous dengue cases (rs = .999, p = 000) and imported dengue cases with autochthonous dengue cases (rs = .162, p = 000). A negative binomial multivariate regression was used to analyze the expansion of dengue to each monthly unit of temperature, rainfall, and imported dengue cases over 34 years. The results indicated that temperature (IRR = 2.198; 95% CI [1.903, 2.538]) and precipitation (IRR = .991; 95% CI [.988, .994]) were predictors for the geographic expansion of dengue fever in Southeast Florida. The positive social changes include the use of the results to develop an understanding of how climatic variables and migration may influence the expansion of dengue fever to nonendemic regions. The results can be used by public health authorities to address risk factors and to formulate evidence-based decisions in regard to prevention and education concerning dengue fever.