THE IMPERATIVE OF AEDES MOSQUITO TESTING FOR ENHANCED DENGUE SURVEILLANCE IN THE UNITED STATES.

Dengue virus (DENV) poses an escalating public health threat in both endemic and non-endemic regions, driven by globalization, urbanization, and climate change. Early detection of dengue outbreaks remains a critical component in mitigating the impact of this rapidly spreading arboviral disease. Traditional surveillance approaches rely primarily on clinical case reports, which often lag behind the actual onset of transmission. Because of the lag, intensive vector control response would be delayed and become ineffective to contain the transmission promptly. This calls for the need for mosquito-based DENV surveillance even in low transmission or epidemic-prone settings. This review explores the growing body of evidence supporting mosquito-based DENV detection as a proactive surveillance method, particularly in areas with low transmission or at risk of outbreak due to travel-associated cases. A comprehensive literature search was conducted using several academic and public health databases, including PubMed, Web of Science, Scopus, Google Scholar, and ProQuest. Seventeen studies showed presence of DENV in Aedes mosquitoes in the absence of reported human cases. In the United States, four studies reported DENV positive Ae. aegypti in places where there were no reported human cases. Among various mosquito surveillance tools, BG-Sentinel traps have been indicated to be effective in capturing host-seeking invasive Aedes mosquitoes. Increasing evidence indicates that detecting DENV in field-caught mosquitoes can serve as an early warning signal-preceding reported human dengue cases by several weeks. This entomological approach provides direct insights into the virus's presence in mosquito populations before human infections are formally diagnosed. The review recommends integrating mosquito-based DENV detection into local, state and national arbovirus surveillance systems, especially in non-endemic regions vulnerable to autochthonous transmission. This approach can enhance the timeliness and precision of outbreak responses.