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Dengue is the fastest spreading mosquito-borne viral disease worldwide.1 European travellers have contracted dengue while visiting South America, The Caribbean, Africa, Asia, Oceania and in Europe itself.2,3
Dengue is a viral disease spread to humans through mosquito bites and there’s no specific treatment. It’s endemic in more than 100 countries worldwide.4 Dengue is usually a mild illness but in rare cases it could lead to hospitalisation.5
Symptoms of dengue
According to the World Health Organization (WHO), those presenting with a high fever and any of the below symptoms could have a dengue infection:4
- Severe headache
- Swollen glands
- Rash
- Muscle and joint pain
- Pain behind the eyes
- Nausea and vomiting
For an accurate diagnosis of dengue, laboratory or point-of-care diagnostics are often recommended in combination with clinical assessment. As the symptoms of dengue can be diverse, laboratory or point-of-care diagnostics are often recommended in conjunction with assessment of clinical presentation to achieve an accurate diagnosis.5
Severe dengue symptoms
Many travellers might not be aware that, according to WHO individuals who are infected for the second time are at greater risk of severe dengue and that severe dengue symptoms often come after the fever has gone away:4
- Severe abdominal pain
- Persistent vomiting
- Rapid breathing
- Fatigue
- Restlessness
- Blood in vomit or stool
- Weakness
- Increase in thirst
- Pale and cold skin
As the symptoms of dengue can be diverse, laboratory or point-of-care diagnostics are often recommended in conjunction with assessment of clinical presentation to achieve an accurate diagnosis.4
The effects of dengue can often persist even after returning home from a trip; in one study conducted in Sri Lanka regarding symptomatic cases, around 1 in 3 (32%) people ill with dengue had post-infection fatigue two months after the acute infection.6
“Post dengue fatigue syndrome” comprises a spectrum of complex symptoms ranging from fatigue, muscle weakness and variable neurological abnormalities.7
How to protect yourself against dengue
- Use insect repellent that contains the active ingredient DEET. The Health Service Executive in Ireland reccomend using products with 50 per cent DEET for adults and 15 to 30 per cent DEET for children to avoid being bitten by mosquitos .9,10
- Mosquitoes are present in both urban and rural areas and can be more active early in the morning and before dusk, so it’s a good idea to wear loose-fitting clothes that cover up your skin at these times of the day while travelling.9,11
- Use a mosquito net to protect you from dengue-carrying mosquitoes while you sleep.9
- Mosquitoes lay their eggs in water, so be vigilant of water containers in and around your accommodation – keep them clean and empty to reduce the chance of egg laying.12
- Speak to your healthcare professional(s) about dengue before travelling.
References
- Yang X, et al. J Travel Med. 2021;28(8):taab146
- Gwee, X.W.S., Chua, P.E.Y. & Pang, J. Global dengue importation: a systematic review. BMC Infect Dis 21, 1078 (2021)
- Gossner CM et al. Dengue virus infections among European travellers, 2015 to 2019. Euro Surveill. 2022;27(2):2001937.
- WHO. Dengue and severe dengue factsheets. Available at: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue Last accessed: October 2023.
- Muller DA, et al. Clinical and Laboratory Diagnosis of Dengue Virus Infection. J Infect Dis. 2017;215(S2):S89-95.
- Sigera PC, et al. Dengue and post-infection fatigue: findings from a prospective cohort- the Colombo Dengue Study. Trans R Soc Trop Med Hyg. 2021;115(6):669-676.
- Umakanth M. Post Dengue Fatigue Syndrome (PDFS) among Dengue IgM-Antibody Positive Patients at Batticaloa Teaching Hospital, Sri Lanka. Open Access Library Journal. 2018;5:1-6.
- Bao-Linh Tran, Estimating the threshold effects of climate on dengue, a case study of Taiwan, Int J Environ Res Public Health, February 2020. Retrieved January 2023.
- NHS. Conditions. Dengue. January 2023. Last accessed: October 2023
- Dengue (dengue fever). HSE.ie. Available from: https://www2.hse.ie/conditions/dengue-fever/. Last accessed: October 2023.
- Lowe R, et al. Combined effects of hydrometeorological hazards and urbanisation on dengue risk in Brazil: a spatiotemporal modelling study, Lancet Planet Health 2021;5:e209-19
- Centers for Disease Control and Prevention. Avoid Dengue by Preventing Mosquito Bites. Retrieved January 2023
C-ANPROM/GB/DENV/0176 | Date of preparation: October 2023