Health and Me

Ishita Roy

Long-term Exposure To Air Pollution Increases Fatality Rates In Dengue: Study

In 2024, there were around 14 million <span><a href="https://www.healthandme.com/health/dengue">dengue</a></span> cases worldwide, with more than 11,000 global deaths. In India, as per Gavi, the Vaccine Alliance, there were over 230,000 cases of dengue fever in 2024. In the same year, the World Air Quality Report 2024 ranked India in the 5th position for the most polluted country. Health and Me has previously reported on India's AQI and how it has led to severe health problems. Now, a study across 20 dengue-endemic countries found that higher ambient PM2.5 exposure could increase dengue mortality. 

The study's author wanted to understand if long-term exposure would contribute to an increases fatality rates in dengue. In collaboration with researchers from Japan, Bangladesh, and the United Kingdom, the study, led by Sakirul Khan from the Research Center for Global and Local Infectious Diseases, Oita University, Japan, reported that higher ambient PM2.5 increases dengue mortality. 

The study was conducted across 20 dengue-endemic countries, including India. The region covered were Asia, Africa, and Latin Africa, during the period 2020-2024. The study found that countries with annual mean particulate matter over 35 μg/m3 had three to five times higher dengue fatality rates than countries with mean PM2.5 below 15 µg/m³.

<h2>Air Pollution Worsens Dengue Outcomes</h2>

Air pollution is increasingly being linked to the severity of dengue infections. The State of Global Air 2025 report estimated that nearly 8 million deaths worldwide in 2023 were linked to air pollution, including 4.5 million from exposure to fine particulate matter (PM2.5).

Long-term exposure to PM2.5 can weaken the body in several ways. Research shows that these tiny particles trigger inflammation and damage the inner lining of blood vessels, a condition known as endothelial dysfunction. This disrupts the immune, cardiovascular and respiratory systems. Dengue itself is associated with similar damage to blood vessels, which can cause plasma leakage and lead to severe complications such as shock. Scientists suggest that prolonged pollution exposure may therefore worsen dengue outcomes by weakening immune responses and vascular health even before infection occurs.

Studies from tropical regions such as Taiwan and Singapore have also reported a strong association between air <span>pollution and <a href="https://www.healthandme.com/health/dengue">dengue</a></span> cases, indicating that pollution may influence mosquito life cycles, virus activity and human immunity.

<h2>Are There Any Limitations In The Study?</h2>

Despite these findings, some researchers caution against drawing direct conclusions. Experts studying arboviruses note that many countries included in such analyses have weaker healthcare systems and inconsistent disease surveillance. Underreporting of dengue infections is common, which can inflate fatality rates and complicate comparisons between regions.

Researchers behind the global study attempted to account for several factors including rainfall, temperature, population density and economic indicators. Even after these adjustments, PM2.5 levels still emerged as a significant predictor of dengue fatality.

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In 2024, there were around 14 million dengue cases worldwide, with more than 11,000 global deaths. In India, as per Gavi, the Vaccine Alliance, there were over 230,000 cases of dengue fever in 2024. In the same year, the World Air Quality Report 2024 ranked India in the 5th position for the most polluted country. Health and Me has previously reported on India's AQI and how it has led to severe health problems. Now, a study across 20 dengue-endemic countries found that higher ambient PM2.5 exposure could increase dengue mortality. The study's author wanted to understand if long-term exposure would contribute to an increases fatality rates in dengue. In collaboration with researchers from Japan, Bangladesh, and the United Kingdom, the study, led by Sakirul Khan from the Research Center for Global and Local Infectious Diseases, Oita University, Japan, reported that higher ambient PM2.5 increases dengue mortality. The study was conducted across 20 dengue-endemic countries, including India. The region covered were Asia, Africa, and Latin Africa, during the period 2020-2024. The study found that countries with annual mean particulate matter over 35 μg/m3 had three to five times higher dengue fatality rates than countries with mean PM2.5 below 15 µg/m³.Air Pollution Worsens Dengue OutcomesAir pollution is increasingly being linked to the severity of dengue infections. The State of Global Air 2025 report estimated that nearly 8 million deaths worldwide in 2023 were linked to air pollution, including 4.5 million from exposure to fine particulate matter (PM2.5).Long-term exposure to PM2.5 can weaken the body in several ways. Research shows that these tiny particles trigger inflammation and damage the inner lining of blood vessels, a condition known as endothelial dysfunction. This disrupts the immune, cardiovascular and respiratory systems. Dengue itself is associated with similar damage to blood vessels, which can cause plasma leakage and lead to severe complications such as shock. Scientists suggest that prolonged pollution exposure may therefore worsen dengue outcomes by weakening immune responses and vascular health even before infection occurs.Studies from tropical regions such as Taiwan and Singapore have also reported a strong association between air pollution and dengue cases, indicating that pollution may influence mosquito life cycles, virus activity and human immunity.Are There Any Limitations In The Study?Despite these findings, some researchers caution against drawing direct conclusions. Experts studying arboviruses note that many countries included in such analyses have weaker healthcare systems and inconsistent disease surveillance. Underreporting of dengue infections is common, which can inflate fatality rates and complicate comparisons between regions.Researchers behind the global study attempted to account for several factors including rainfall, temperature, population density and economic indicators. Even after these adjustments, PM2.5 levels still emerged as a significant predictor of dengue fatality.