Dengue fever, caused by the dengue virus, is primarily spread through mosquito bites. The majority of dengue infections are asymptomatic or mild. In severe cases, the infection can develop into dengue hemorrhagic fever or dengue shock syndrome, which can lead to death. Previous dengue infection increases the likelihood of severe disease. The disease is widespread in tropical and subtropical regions of Asia, South America, and Africa. The vaccine is not included in the national vaccination program, but it can be obtained with a prescription from a pharmacy or medical center.