As Florida Confronts Hundreds of Local Dengue Cases, Tampa Health Organizations Respond

Florida health officials have reported almost 300 locally acquired dengue cases as of Oct. 3 in what appears to be the largest outbreak of the mosquito-borne disease in the continental United States since at least the 1940s.

Most of those cases have been confirmed in Hillsborough County, home to Tampa, where vulnerable residents have long had to contend with high temperatures and other elements related to its humid subtropical climate.

Now people at risk, including older adults, children, people with chronic conditions and other comorbidities, and those who are unhoused must now consider exposure to the dengue virus, which is mosquito-borne, in their calculus.

Covering up in Florida's heat and finding money for insect repellent can present additional hurdles for some, in addition to the increased time spent outdoors for those without access to vehicular transportation, making even a visit to the doctor a potentially fraught affair, said Dr. Ashley McPhie, chief medical informatics officer at Tampa Family Health Centers.

"Being a [federally qualified health center], we're already servicing a population that may have the least resources, no place to stay, no transportation, and then we hit them with dengue," McPhie said.

Those pre-existing constraints are shaping the health center's response to a dengue outbreak that has made Hillsborough County the focus of local transmission in Florida. The federally qualified health center is testing patients, educating medical providers and coordinating with state health officials while getting prevention supplies into patients' hands.

Dengue symptoms can include fever, headache, pain behind the eyes, and muscle or joint pain. There is no specific medicine to treat the infection; care focuses on managing symptoms and maintaining hydration. Severe dengue can become life-threatening and requires immediate medical attention.

Florida reported 296 locally acquired dengue cases this year in its surveillance report covering the week ending Oct. 3. Of those, 259 were in Hillsborough County. On Oct. 8, the county extended its local state of emergency through Oct. 15, as crews continued mosquito treatments by air and ground. 262 cases of travel-acquired cases have also been reported for 2026. Dengue fever is a non-communicable disease.

"This is unprecedented for us," McPhie said.

At the health center, dengue had previously appeared in a handful of travel-related cases, she said. Locally acquired cases have broadened the response, requiring clinicians to consider dengue when patients arrive with symptoms that could resemble other viral illnesses.

TFHC had tested 22 people for dengue, with seven positive results referred to the Florida Department of Health for confirmation, McPhie said. State health officials investigate travel histories and other information to determine whether infections were acquired locally or elsewhere.

McPhie and the center's quality staff have stayed in contact with health officials through calls and emails. State educational materials help clinicians recognize symptoms and give patients information about protecting themselves.

McPhie said the center can provide supportive care through its primary care services, although patients who become seriously ill may need hospital treatment.

"It really does deal with the realm of primary care, until it doesn't," she said.

Direct Relief has supplied TFHC with over 1,000 units of requested PMD 20% insect repellent to help support its response to combat the outbreak. Staff have set up tables to distribute repellent and prevention information, McPhie said. The center also operates a mobile medical unit and works with people experiencing homelessness, providing them with repellent when supplies are available.

The difficulty of avoiding bites is especially apparent to Devan Mathur, a fourth-year University of South Florida medical student who directs street outreach for Tampa Bay Street Medicine.

"We meet them where they are, and help them survive in the elements," he said. "Homelessness compounds mental and physical illness, and they end up in these vicious cycles. Our role is risk reduction, education, and helping people get the care they need when we meet them or with community partners."

The organization's volunteers bring medical and hygiene supplies to homeless people in downtown Tampa, working with licensed health care providers. For the people they serve, limited shelter and clothing can mean prolonged exposure to mosquitoes.

"The majority of folks I encounter are aware of the dengue outbreak at this point. They're always asking for bug spray," he said.

He has seen patients with dengue during hospital rotations, including people experiencing homelessness. Out on the street, identifying the illness is more difficult. People may already be coping with chronic pain and other medical conditions, and volunteers cannot confirm dengue without testing.

"There's no way for me to know if it's dengue or pneumonia," he said.

At TFHC, the response draws on relationships established long before this outbreak. McPhie said the center's more than 40 years in the community, along with services including pharmacies, dental care and pediatrics, have helped build patients' trust.

Those relationships give staff opportunities to explain the risk and help patients protect themselves while continuing to care for their other health needs. Getting prevention supplies to everyone who needs them remains a challenge. McPhie said the center was seeking additional repellent as it worked with the wider community response.

"I think FQHCs, and specifically TFHC, is the heart of the community. We've been in the community over four decades. We have the trust of the community, and they know that we provide whole person care. We coined a term: healthcare as it should be," she said, referring to the range of healthcare services TFHC provides.

"We're here to take care of the people," she said.

Since Sept. 1, 2026, Direct Relief has shipped insect repellent to health organizations in 26 Florida counties, including Hillsborough County, where Tampa Family Health Center and Tampa Bay Street Medicine operate.