Ankle-biting mosquitos that can spread dengue fever are now more common in the Los Angeles area partly due to climate change, say Cedars-Sinai infectious disease experts. Photo by Getty.

New Cases of Mosquito-Spread Dengue Fever Highlight Local Effects of Climate Change

Amid Southern California’s recent record-breaking heat wave and fast-moving wildfires,  public health officials reported the third locally-acquired case of dengue fever in the Los Angeles area. Although the events seem unrelated, they actually are connected—and for troubling reasons.

That’s because global warming causes temperatures to rise which, in turn, expands the reach of insects carrying infectious diseases. Species of mosquitoes that thrive in warmer environments are finding newly hospitable homes in places where the climate is warming and the summer heat lingers longer. As a result, physicians in once mild parts of the U.S. are seeing increasing cases of mosquito-borne diseases such as Zika virus, West Nile virus and now dengue fever.

“Warmer weather means warmer pools of standing water, a friendlier environment for breeding mosquitos, especially without very cold winters to kill off the eggs,” said Kimberly Shriner, MD, medical director of Infection Prevention and Control at Huntington Health, a Cedars-Sinai affiliate. “There is no question that we’re seeing more Aedes mosquitos—the species that carries dengue—because of hotter temperatures.”

Another cause: people are traveling more widely and frequently, said Michael Ben-Aderet, MD, associate medical director of Hospital Epidemiology at Cedars-Sinai. He explained that this increases the odds that a traveler returns home with an mosquito-borne infectious disease, gets bit by one of the many Aedes mosquitos now thriving in Southern California, and that bug carries that disease to someone else.

“Dengue is well known in tropical places like South America, Central America and Puerto Rico,” Ben-Aderet said. “We’ve always had cases in Los Angeles associated with travel, but now we’re seeing dengue patients who didn’t travel—they never left Los Angeles. They were bit by a mosquito locally, which means there likely are other mosquitos with dengue that we haven’t found because we’re not testing for it a lot and many people who get dengue don’t get very sick.”

He added that Southern California is a perfect environment for dengue transmission. “We have mosquitos, a big population and people have been travelling more this year than ever before,” he said.

Bone-Break Fever

The Aedes mosquitos that can spread dengue, as well as Zika and West Nile viruses, started showing up in Southern California about a dozen years ago. While most people are familiar with the ankle-biting tendency of these mosquitos and the proliferation of West Nile virus, they’re likely less aware of dengue and the disease’s symptoms.

Dengue can cause a wide range of symptoms from none at all to very severe, Ben-Aderet said. It  starts with a high fever and severe muscle pain, giving it the nickname “break-bone fever.”  Dengue often appears with a diffuse red rash that blanches, turning white or the color of one’s skin after pressing on the rash and releasing pressure. Patients can also experience gastrointestinal symptoms like nausea.

The second time someone gets dengue, it can be much worse, said Shriner, who has treated patients with disease during annual medical mission trips to Tanzania with a nonprofit that provides clinical care and medical education. Dengue is a hemorrhagic fever, like the Ebola virus, that can cause bleeding—in this case bruises bloom under the skin from “leaky” blood vessels.

For mild cases, treatment is supportive care: fluids, rest and Tylenol. More severe cases might need intensive care in a hospital. Highly specialized vaccines exist, but they’re primarily intended to help children avoid a dangerous second infection in places like the Philippines where the disease is endemic.

Canary in the Coalmine

For local physicians, the spread of tropical diseases in once milder climates means they must think more broadly when diagnosing a sick patient.

“Whenever I see a patient in today’s world, I need to keep a very open mind about what they might have,” Ben-Aderet said. He added that the sporadic dengue infections we’ve seen from area mosquitos indicate we don’t yet have a “reservoir,” a sustained source of infections to make dengue endemic to Los Angeles. But it could happen in the not-too-distant future, he said.

Shriner emphasized that she doesn’t want people to panic. “We should be worried more about COVID-19 and the flu,” she said.

Still, she cautioned that smaller, novel outbreaks—like the emergence of dengue in Los Angeles—are “canaries in the coalmine” sending a message that we need to pay attention.  

“We live in an interconnected world with a fragile climate that is changing,” Shriner said. “We want to approach this scientifically, compassionately and with humanity. This is why curing diseases like malaria in Africa will help us all too.”

Read more on the Cedars-Sinai Blog: Everything You Need to Know About Bug Bites

Cedars-Sinai Will Provide Medical Services and Clinics at LA28 Games, and Is Caring for Team USA Athletes Through Affiliation With U.S. Olympic & Paralympic Medical Network

Cedars-Sinai today announced a partnership with the LA28 Olympic and Paralympic Games to serve as the Official Medical Provider for the 2028 Games, providing the highest-quality care for athletes, coaches, team personnel and visitors who travel across the world for the competitions in Los Angeles.

Cedars-Sinai will be a critical resource and medical adviser to LA28 in establishing medical services in the Olympic and Paralympic village and at sporting venues for the 2028 Olympic and Paralympic Games. Cedars-Sinai is also a member of the U.S. Olympic & Paralympic Medical Network, supporting medical treatment of athletes as they prepare to compete in national and international competitions leading up to the 2028 Games.

These partnerships underscore Cedars-Sinai’s commitment to the health and wellbeing of Angelenos and the athletes and visitors globally who will benefit from world-class care at one of the premier academic medical centers in the U.S.

“We’ve been training for this,” said Thomas M. Priselac, president and CEO of Cedars-Sinai. “Team USA’s pursuit of greatness drives them to never stop pushing what’s possible. Cedars-Sinai’s team shares this pursuit of greatness and is continuously expanding the boundaries of what’s possible for our patients and community.”

As one of the leading medical providers in the country with more than 200 locations in Southern California, Cedars-Sinai is at the forefront of innovation in clinical care and medical research, combining expertise in orthopedics, cardiology and numerous other specialties with the most advanced facilities and technology to keep athletes healthy as they compete.

“Cedars-Sinai has been a cornerstone of the Los Angeles community for more than 120 years. LA28 is already creating a legacy driving community benefit, and we don’t need to wait until 2028 to make an impact,” said Chris Pepe, chief commercial officer at United States Olympic and Paralympic Properties and LA28. “This partnership will enhance our collective efforts to drive progress, reimagining the way the Olympic and Paralympic Games serve the world. We have a unique opportunity together to have everyone be a part of the LA28 story.”

Cedars-Sinai is one of nine medical institutions in the U.S. Olympic & Paralympic Medical Network and has already begun offering care for Team USA athletes. Cedars-Sinai is the exclusive provider in Los Angeles and surrounding areas of Southern California.

“Cedars-Sinai brings remarkable healthcare skill and knowledge to Team USA athletes as they train and compete,” said Jonathan Finnoff, DO, chief medical officer of the U.S. Olympic & Paralympic Committee (USOPC). “As a member of the USOPC’s Medical Network, Cedars-Sinai offers critical support to Team USA athletes, elevating the quality of care we offer to our athletes, and we look forward to continuing this partnership on the road to LA28.”  

Cedars-Sinai is excited to be gearing up for the 2028 Games.

“Athletes push the boundaries of human potential, breaking records and setting new standards,” said Priselac of Cedars-Sinai. “Similarly, our Cedars-Sinai team leads in medical innovation, constantly advancing the field. Just like Olympic athletes, our Cedars-Sinai staff are dedicating themselves to serve our community and our country as the Games come to Los Angeles.”

About Cedars-Sinai

Cedars-Sinai is a leader in providing high-quality healthcare encompassing primary care, specialized medicine and research. Since 1902, Cedars-Sinai has evolved to meet the needs of one of the most diverse regions in the nation, setting standards in quality and innovative patient care, research, teaching and community service. Today, Cedars-Sinai is known for its national leadership in transforming healthcare for the benefit of patients and in developing new approaches to treatment and educating tomorrow’s health professionals. Cedars-Sinai serves as the official health partner for the Los Angeles Rams and the Angel City Football Club and treats professional and elite athletes throughout the world to ensure they perform at the highest levels. Additionally, Cedars-Sinai demonstrates a commitment to the community through programs that improve the health of its most vulnerable residents.

About LA28 Olympic and Paralympic Games

The LA28 Games will mark Los Angeles’ third time hosting the Olympic Games, previously hosted in 1984 and 1932, and first time to host the Paralympic Games. Los Angeles will host the world’s most elite athletes in 2028 as it welcomes Paralympians and Olympians from around the world to compete on the biggest stage in sports. The LA28 Games are independently operated by a privately funded, nonprofit organization, with revenue from corporate partners, licensing agreements, hospitality and ticketing programs and a significant contribution from the International Olympic Committee. For more information, visit LA28.org.

Legends, a global premium company, helped source the partnership between Cedars-Sinai and LA28.

About Team USA

Team USA is the world’s largest and most diverse team of athletes from across the United States who compete at the Olympic, Paralympic, Youth Olympic, Pan American and Parapan American Games. The United States Olympic and Paralympic Committee, founded in 1894, serves as the National Olympic Committee and National Paralympic Committee for the United States and is responsible for protecting, supporting and empowering Team USA athletes. For more information, visit TeamUSA.org.

Kimberly Shriner, MD, FACP, medical director of infection prevention and control, Huntington Health, recently spoke on AirTalk about a breakthrough in HIV prevention. Lenacapavir, an antiretroviral medication used to treat HIV/AIDS, has been shown to prevent HIV in young women and girls. (Drug trials are also underway for men and gender-diverse individuals.) Because the drug is highly potent, it can be injected just twice a year.

That’s great news, especially for countries in sub-Saharan Africa, where girls and women accounted for 62% of all new HIV infections in 2023.[1] Lenacapavir might just be the way to harness the disease there and globally. “When you control HIV, you also prevent individuals from being infectious and transmitting disease to other people,” Dr. Shriner explained.

One challenge, however, is giving these countries access to the drug. Because of the high cost of pharmaceuticals, these countries are dependent on global AIDS outreach (e.g., the World Health Organization) to provide the medication. “We all have to join forces to try to overcome some of the economic obstacles that stand in the way of care for everyone,” Dr. Shriner said.

Also on the show, Moupali Das, MD, executive director, HIV Clinical Development at Gilead Sciences, research-based pharmaceutical company and maker of Lenacapavir, explained how Gilead is addressing these high costs (Lenacapavir can cost up to $42,000 per patient per year for HIV treatment). She said that Gilead offers tiered pricing for non-commercial markets like sub-Saharan Africa where people receive drugs through government programs, helping make the drug accessible to people in these regions.

Another challenge is getting people to test for HIV. “The most important thing is for people to be tested,” Dr. Shriner emphasized. “Sometimes people don’t know that they’re infected, so they haven’t had access to medications to control their disease and prevent transmission.”

Despite the challenges, Dr. Shriner is optimistic: “I’m hopeful that we’re going to make some significant advances in antiviral therapy for all kinds of diseases in large part due to the commitment of pharmaceutical companies, patients, clinicians and countries to the HIV pandemic.”    

To listen to the full discussion, go to AirTalk: A new study offers a breakthrough in HIV prevention.

[1] Global HIV & AIDS statistics — Fact sheet, UNAIDS website.

[1] Global HIV & AIDS statistics — Fact sheet, UNAIDS website.

In July, Huntington Health proudly launched its Patient Family Advisory Council (PFAC). The inaugural event brought together a diverse group of patients, family members, caregivers and health care providers who are committed to collaborating and improving patient care. This initiative marks a significant step forward in Huntington’s mission to prioritize patient-centered care by providing a platform to actively listen to our patients and their families. Recognizing their experiences is vital to continuously enhancing the quality of care we provide. 
 
“We are thrilled to launch our new Patient Family Advisory Council,” said Debbie Jackson, associate director, patient experience, Huntington Health. “It will be instrumental in bringing the patient and family perspective to the forefront of our decision-making. Their insights will be invaluable as we work to improve the overall patient experience and create a health care environment centered around the needs of those we serve.” 

The council members are former patients and family members served by Huntington Health, Huntington leadership and members of the patient experience team. They will meet regularly to discuss various aspects of patient care. Through open dialogue and partnership with health care professionals, the PFAC will identify areas for improvement and implement patient-centric solutions. 

In keeping with Huntington’s dedication to continuous improvement and excellence in health care, the PFAC promises to elevate the standard of care and enhance the overall patient experience. 

For more information about the PFAC, go to: Patient and Family Advisory Council (PFAC) | Huntington Hospital (huntingtonhealth.org)

If you’re a caregiver, you may have wondered what would happen to your loved one if you became unable to provide care. What would you do if you suddenly got sick or if you had an accident? It’s unpleasant to think about, but creating a plan B can make your sudden absence, or need for additional support, a smoother transition. It can also bring you peace of mind. Read on to learn about what to consider when creating a contingency caregiving plan.

Rely on your team.

Build a support system before an emergency happens. Caregiving works best when friends or family members can pitch in, so the burden isn’t solely on your shoulders. Start by creating a list of tasks others you trust can assist you with, like buying groceries or picking up prescriptions. If they’re comfortable doing more, ask about what specific help they can offer if something were to happen to you.

Make your plan B official.

Review financial documents, insurance forms, living wills and other official documents. Make sure your loved one has a designated power of attorney, health care proxy or conservator. If you’re that person, work to update your loved one’s paperwork to list someone else who can take over your duties in an emergency. Also, make sure others on your trusted caregiving team have access to important online accounts and passwords.

Stay organized.

Important documents should be stored in a specific location. Create a folder or binder that also includes essential information like phone numbers of family members and doctors, medication lists, daily routines and preferences such as food likes/dislikes. Keep this information in your kitchen or other central location — and create a secure digital copy.

Take care of yourself.

It’s easy to neglect yourself when caring for others. But this can worsen existing health problems or lead to burnout (or both). To maintain good health, try your best to eat a healthy diet, get enough sleep and exercise regularly. Don’t have time for an hour workout? Take the stairs, go on a 20-minute brisk walk or take a free online yoga class. Practice wellness through a relaxing evening routine such as taking a warm bath, reading a book, meditating, listening to music, knitting — anything that quiets your mind. Finally, don’t put off preventive care and screenings, like your annual physical, colonoscopy, mammogram and flu shot. Your health is worth it — for both you and your loved one.

Sources: AARP and CDC.

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Are you a family caregiver? Senior Care Network (SCN) offers professional assistance; referrals to important resources; and support and educational groups specifically designed for family caregivers, including our Powerful Tools for Caregivers class. For more information, call SCN at (626) 397-3110 or (800) 664-4664 or email us at [email protected]. See also Calendar of Events for information about Powerful Tools for Caregivers.

(This statement as been updated as of July 22, 2024, 10 a.m.)

Thanks to the outstanding work of our staff members, Huntington Health, a Cedars-Sinai affiliate, has addressed the issues we experienced after the CrowdStrike outage that affected computer systems worldwide. 

We remain open and continue to provide quality care to our patients.