Dengue Fever has been in the news following two cases linked to travel to the Spanish island of Ibiza. This has sparked concerns about the spread of mosquito-borne illnesses in Europe, which is especially unusual for this time of year.

Dengue fever is a viral infection transmitted by the Aedes mosquito, which is found in tropical and subtropical regions worldwide. With rising temperatures and changing climates, there is a risk of mosquitoes and other disease vectors spreading to new areas, potentially causing outbreaks of diseases such as dengue fever.

The two cases of dengue fever in Ibiza were reported by the Spanish Ministry of Health and were both in residents of Germany who had visited the island before becoming ill. Each case was accompanied by two family members who were also suspected to have had dengue fever.

The risk of dengue fever in Spain is highest between the months of May and November, when mosquitoes are most active so to have cases at this time of year is uncommon.

So, why are we seeing cases outside of the usual infection months?
The reason is multi-facetted.

Our medical director and travel health specialist, Dr Richard Dawood explains:

“Firstly, there is the introduction or spread of mosquitoes to “pastures new” – places that might have been previously inhospitable, perhaps through temperature; or alternatively, that offer an environment with plenty of suitable breeding sites that they are suddenly able to take advantage of. These mosquitoes can bring disease with them, or can spread it around if there is a reservoir in the local population.

Secondly, there is the possibility of introducing disease to a vector population that is already established, ready and waiting. This is exactly the (long-standing) concern with yellow fever. There are mosquito species in Asia, for example, that are easily capable of spreading yellow fever were it to be introduced by an infected traveller – which is why Asian countries are so careful to insist on proof of yellow fever vaccination from travellers arriving from the endemic zones of Africa and South America. Asia is yellow fever-free, and wants to remain so. However, this type of introduction has already recently happened in Australia, where Japanese encephalitis (a virus infection that can cause rare but serious complications in humans) has recently established a reservoir of infection in farm animals, that may be impossible to reverse. It is also happening with Lyme disease spreading gradually into parts of Europe (and the UK) with a susceptible tick population.

Similar concerns apply to Zika – there is very large potentially susceptible mosquito population that could spread the virus in many tropical countries, if introduced; dengue fever; and also potentially malaria, in parts of the world that have been the target of successful elimination campaigns, but where mosquito populations could still spread it, were it to be reintroduced, if control measures are neglected or ceased.

With changing climates, a valid concern about global warming is that it could create conditions in which populations of mosquitoes and other vectors thrive and spread – hence the crucial importance of vigilance, surveillance, and early action if needed.”

How can you protect yourself from Dengue Fever?

There is no vaccine against dengue licensed in the UK, though several candidate vaccines are in development.

The best way to protect yourself against dengue fever is to take measures to avoid mosquito bites. This includes wearing protective clothing, using mosquito repellent, and staying in places with air conditioning or screens on windows and doors.

If you develop a high fever during or after travelling to an affected area, seek medical advice as soon as possible and provide details of your recent travel history. Dengue is often also accompanied by a rash and joint or muscle pain.

In conclusion, rising temperatures and changing climates have the potential to create conditions in which populations of mosquitoes and other disease vectors thrive and spread. It is crucial for public health authorities to remain vigilant and take early action if needed to prevent the spread of diseases such as dengue fever. By taking appropriate measures to protect against mosquito bites, travellers can reduce their own individual risk of contracting dengue as well as other insect-borne infections.

Suitable Medical Kits available to buy online

Buy: Ultimate Bug Kit

Buy: Essential First Aid Kit

Related services available at Fleet Street Clinic

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Have a bug-free beach life

Apart from causing an itch and inflammation, mosquitoes can leave more than just an irritation.

In the Caribbean, they have the ability to transmit diseases such as Dengue Fever, Zika Virus and Chikungunya.
Mosquito bite avoidance is recommended, here are our recommendations on how:

• Cover up with clothing
• Use insect repellents containing a minimum of 50% DEET on any exposed skin
• Consider treating clothes with permethrin
• Sleep under bed nets and use insect screens on doors.
• Reduce  mosquito breeding sites by removing any water containers from outdoor areas
• Use air-conditioning
• Consider the use of plug-in  electrical vaporisers which deter mosquitoes
• Use our Ultimate Bug Kit.

Dengue Fever & Chikungunya

There is currently no vaccine available to prevent either dengue nor chikungunya in travellers. However, without mosquitoes, individual sufferers are not directly contagious.

The risk for both diseases is thought to be higher during periods of intense mosquito feeding activity (two to three hours after dawn and during the early evening).

Zika

There is currently no vaccine available to prevent the ZIKV infection in travellers. Those infected with the infection normally have no symptoms. When symptoms do occur they are usually mild and short-lived. Serious complications and deaths are not common.
The concerns with the Zika virus and primarily to do with birth defects and as a result pregnant women should postpone non-essential travel until after pregnancy. More information on Zika Virus and pregnancy concerns from Public Health England.

So say ‘zip off’ to zika and ‘do one’ dengue and enjoy a bug-free beach life!

If you would like more travel advice we’d recommend an appointment with one of our travel nurses. You can book your travel appointment online.

By Anna Chapman |  Travel Nurse | November 2018

The popular Thai tourist resorts of Krabi and Phuket are reporting high incidences of dengue fever this year.

Since January 2015 over 400 cases of dengue fever have been reported, resulting in one fatality.

Cases of dengue fever also soared in Malaysia with over 40,000 reported cases this year.  It is estimated between 6-10 cases of dengue are diagnosed each day – double the rate of last year.  The most dramatic increases have been seen in Penang,  Johor and the state of Selangor.

Dengue Fever Advice for Travellers

Unfortunately, there is no vaccine or medication that can prevent dengue.  The only way to reduce the risk is to prevent mosquito bites, particularly during daylight hours.

If you are off on an Asian adventure this summer, follow these simple steps to reduce the risk of dengue fever:

• Cover up with clothing
• Use insect repellents containing a minimum of 50% DEET on any exposed skin
• Consider treating clothes with permethrin
• Sleep under bed nets and use insect screens on doors.
• Reduce  mosquito breeding sites by removing any water containers from outdoor areas
• Use air-conditioning
• Consider the use of plug-in  electrical vaporisers which deter mosquitoes

Our Ultimate Bug Kit contains everything you need to help keep mosquitos at bay and is available to purchase online.

Fleet Street Clinic

For more information on Dengue or any other travel-related topic, you can book travel consultation appointment online.