The role of climate and immunity in Brazil unprecedented outbreak of dengue in 2024

Brazil experienced a large dengue epidemic during the 2024 season, with almost 5.7 million total cases (compared to under 1.3 million in 2023), raising questions about underlying drivers, including rising temperatures, expansion into susceptible populations, changes in reporting, and novel strains. We compared state-level 2024 incidence with 2000 - 2023 data to quantify anomalies. Nine of 27 states, primarily in the Southeast, recorded their highest incidence in 25 years, accounting for 97% of cases while comprising only 67% of the population. In contrast, nine states (mostly in the North and

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