A vast majority of cases are asymptomatic or mild and self-managed, and hence the actual numbers of dengue cases are under-reported. Many cases are also misdiagnosed as other febrile illnesses. The number of dengue cases reported to WHO increased over 8 fold over the last two decades, from 505,430 cases in 2000 to over 2.4 million in 2010, and 4.2 million in 2019. Reported deaths between the year 2000 and 2015 increased from 960 to 4032. This alarming increase in case numbers is partly explained by a change in national practices to record and report dengue to the Ministries of Health, and to the WHO. But it also represents government recognition of the burden, and therefore the pertinence to report dengue disease burden. Therefore, although the full global burden of the disease is uncertain, this observed growth only brings us closer to a more accurate estimate of the full extent of the burden.