Fig. 3: Travel infection rates provide an estimate of local dengue infections.

A Local and travel-associated dengue infection rates from the Dominican Republic, Jamaica, and Puerto Rico were used as predictors in a negative binomial regression model due to the strong correlations between local and travel-associated cases. The red lines indicate the predicted mean infection rates, and the shaded area indicates the 95% confidence interval, while the gray lines indicate the local dengue cases as reported to PAHO. B Local dengue infection rates in Cuba and Haiti from 2009 to 2022 were predicted using the model from panel A. The colored lines indicate the predicted mean infection rates, and the shaded area indicates the 95% prediction interval, while the gray lines indicate the local dengue cases as reported to PAHO. C Observed and predicted local infection rates for South American and Caribbean countries and territories with populations over one million inhabitants from 2009 to 2023. Within each box, thick vertical lines denote median values (50^th percentile); boxes extend from the 25^th to the 75^th percentile; horizontal lines extending from boxes denote mark the 5^th and 95^th percentiles, and the dots denote outliers, representing large outbreaks from any year. Locations in gray with observed cases were not included in our model.