Other reported cases
86,196 cases
5 days × average intensity 3
86,196 × 5 × 24 × 3 ÷ 47.25
656,731.4 USU7.62 USU per course
Disease outbreak
Experimental estimate · v0.9Bangladesh dengue: the 2026 surge
Estimated USU0.66 million
Acute illness, including fatal cases
Reported deaths262
Same reporting period. Source context
Population modeled86,458
reported hospital cases
A dated snapshot based on WHO’s 7 October bulletin, not a live total. USU is assumption-based; deaths remain separate. Includes fatal illness.
Reading the result
The burden behind the case count
A short illness can add up to substantial suffering when many people experience it. Applying WSI’s shared dengue assumptions to this snapshot gives about 661,389 USU.
The 86,196 cases not reported dead account for about 656,731 USU. This shows why a death toll alone cannot describe the pain and distress during an outbreak. It does not make preventing a death less important: death itself and lost life years are outside the USU calculation.
These are modeled courses, not measured patient experiences. The other-case group includes unresolved outcomes and severe cases, not just mild illness or known survivors.
The calculation
Two groups, one course per case
86,458 reported cases = 86,196 other reported cases + 262 reported fatal cases. We use the same two courses as the earlier dengue reports.
Reported fatal cases
262 cases
7 days × average intensity 5
262 × 7 × 24 × 5 ÷ 47.25
4,657.8 USU17.78 USU per course
Combined estimate661,389 USU
Total to six decimal places: 661,389.206349 USU. Display rounding does not enter the calculation.
The fatal course replaces the ordinary allowance for those cases. It covers the full illness ending at death, with no extra terminal-period charge.
Intensity is a combined 0–10 average across the whole course, including relief, sleep and intervals without experience. Why divide by 47.25?
Why these durations and intensities?
Dengue: other reported cases
The existing five-day acute course is retained for cases not reported dead at the snapshot cutoff. WHO gives a 2-7-day symptom window. Five days is a representative choice, not a measured mean or a survivor-specific estimate. Other cases include unresolved outcomes and severe cases not reported dead; no future deaths are imputed. Later fatigue is excluded. [S2]
Fever, headache, body/joint aches and nausea support a meaningful acute symptom burden. Assigned intensity 3 is a working average across the whole day, including relief and sleep. It is lower than a severe-pain peak. WHO does not establish the value 3 or its ratio to the reference. [S2]
Dengue: fatal illness
Seven days is a provisional representative course from symptom onset to death. A Puerto Rico series of 58 fatal laboratory-positive cases reported a median of 7.1 days; in a Malaysian review of 322 deaths, 66.5% occurred on illness days 4-7. A Singapore series of 28 adults reported a longer median of 12 days. These differing populations support testing alternatives. Seven days is our choice, not a pooled mean or an observed average for the listed outbreaks. [S18] [S19] [S20]
We assign intensity 5 as one combined average for pain and other experienced distress throughout the fatal illness. Clinical descriptions of abdominal pain, vomiting and breathing difficulty motivate testing a higher average than the ordinary value 3. The exact value 5 and its ratio to 3 are judgments, not measured USU conversions. This elapsed-time average allows for earlier milder illness, treatment, relief, sleep and periods without experience; it is not a constant severe-pain score. [S17]
How sensitive is the estimate to the assumptions?
Most of this estimate comes from the other-case group. Holding the fatal course fixed, changing one assumption for those 86,196 cases gives these event totals:
- 3 days at intensity 3: 398,697 USU (Shorter ordinary course)
- 5 days at intensity 2: 442,479 USU (Lower ordinary intensity)
- 5 days at intensity 3: 661,389 USU (Central assumption)
- 5 days at intensity 4: 880,300 USU (Higher ordinary intensity)
- 7 days at intensity 3: 924,082 USU (Longer ordinary course)
Holding the ordinary course fixed, changing the fatal-course assumptions gives:
- 5 days at intensity 5: 660,058 USU (Shorter fatal course)
- 7 days at intensity 5: 661,389 USU (Central assumption)
- 12 days at intensity 5: 664,716 USU (Longer fatal course)
- 7 days at intensity 4: 660,458 USU (Lower fatal intensity)
- 7 days at intensity 6: 662,321 USU (Higher fatal intensity)
These are one-input-at-a-time illustrations, not confidence intervals or a complete range. Case coverage, symptom intensity and duration remain uncertain.
From burden to prevention
What would preventing 1,000 cases mean?
If 1,000 cases assigned our five-day, intensity-3 course were prevented, the modeled acute suffering averted would be about 7,619 USU.
1,000 × 5 × 24 × 3 ÷ 47.25 = 7,619.0 USU
This is a hypothetical arithmetic example. It does not estimate what a particular dengue program would achieve, what it would cost, or how many deaths it would prevent. Those questions need separate intervention evidence.
Coverage
What goes into this number?
Included
One complete acute course per reported hospital case. The 86,196 cases not reported dead receive five days at average intensity 3. The 262 reported fatal cases receive seven days at average intensity 5 instead. Other cases include unresolved outcomes and are not all known survivors or mild cases.
Source population and period
WHO’s 7 October 2026 bulletin reports 86,458 cases and 262 deaths for the year through 5 October. Its dengue surveillance notes state that Bangladesh reports only hospitalized cases. This is a dated hospital-based snapshot, not all infections or a full-year total. [S30]
Outside this estimate
Unreported illness, later fatigue and prolonged recovery, caregiver distress, bereavement, death itself and lost life years. Omitted experiences are unestimated, not assumed to be zero.
A note on the source’s case labels
The bulletin labels Bangladesh reporting hospital-only and confirmed on page 12, but calls the weekly cases suspected on page 13. We use reported hospital cases, without claiming all are laboratory-confirmed. This wording issue does not change the selected count. No correction for missed or misclassified cases is applied. [S30]
Full representative courses are assigned to reported cases. Their duration can extend beyond the reporting cutoff. Individual symptom histories are not reconstructed, and no future deaths are imputed. This is not a complete outbreak total or a guaranteed lower bound.
Reading this alongside the 2023 report
The 2023 Bangladesh snapshot ends on 7 August; this one ends on 5 October. Their reporting labels also differ. Comparing the headlines alone cannot establish a year-on-year change in total suffering.
Deaths remain separate
Mortality source context
The 262 reported dengue deaths are used within the 86,458-case population to assign a complete fatal illness course. Those cases are removed from the ordinary group. Deaths remain a separate outcome. [S30]
Suffering before death: included
WHO reports the year-to-date cases and dengue deaths together for Bangladesh as of 5 October 2026. The 262 reported deaths are treated as a subset of that same 86,458-case surveillance population; they are removed from the ordinary group. [S30]
The fatal course uses historical duration evidence and WSI’s assumed average intensity. It is not a measurement of these patients’ final days. Death itself, lost life years and bereavement are not assigned USU.
See the two-group calculation →Trace the estimate
Sources and calculation data
- [S30] WHO South-East Asia Region. Epidemiological Bulletin, 20th edition, 7 October 2026, pp. 2, 12–13.
Page 2 supplies the year-to-date count and deaths through 5 October. Pages 12–13 describe hospital-only coverage but use inconsistent confirmed/suspected terminology. WSI retains a neutral reported-hospital-case label.
- [S2] WHO. Dengue. Fact sheet, 21 August 2025, Symptoms section.
Acute symptom descriptions and 2-7-day duration context; does not estimate an average USU intensity.
- [S8] WSI event list v0.9: USU reference convention (unchanged from v0.1).
Stipulated six-hour kidney-stone reference: 47.25 modeled intensity-hours, with linear weighting. This convention defines the unit; it is not a measured equivalence between conditions.
- [S17] CDC. Clinical Features of Dengue. 24 February 2026.
Describes febrile and critical phases, abdominal pain, vomiting, respiratory distress and severe complications. Does not establish a USU intensity or complete fatal-course average.
- [S18] Tomashek KM et al. Enhanced Surveillance for Fatal Dengue-Like Acute Febrile Illness in Puerto Rico, 2010-2012. PLOS Neglected Tropical Diseases 2016;10:e0005025.
58 fatal laboratory-positive cases; median onset-to-death interval 7.1 days, range 1.2-28.4. Historical duration context; comorbidities and some coinfections limit attribution and transfer to other outbreaks.
- [S19] Woon YL et al. A Two-Year Review on Epidemiology and Clinical Characteristics of Dengue Deaths in Malaysia, 2013-2014. PLOS Neglected Tropical Diseases 2016;10:e0004575.
National retrospective review of 322 deaths; 66.5% occurred on illness days 4-7. Supports a roughly week-long scenario, not a universal duration or USU mapping.
- [S20] Leo YS et al. Confirmed adult dengue deaths in Singapore: 5-year multi-center retrospective study. BMC Infectious Diseases 2011;11:123.
28 adult fatal cases; median onset-to-death duration 12 days, range 2-38. Provides a longer-course contrast and motivates a duration alternative; selected hospital population with frequent comorbidity.