Dengue fever is the most common cause of fever in travelers returning from the Caribbean, Central America, and South Central Asia.1 Dengue infections are commonly reported from most tropical countries of the South Pacific, Asia, the Caribbean, the Americas, and Africa. This disease is caused by four similar viruses (DENV-1, -2, -3, and -4) and is spread through the bites of infected mosquitoes.
Although dengue transmission often occurs in both rural and urban areas, dengue infections are most often reported from urban settings.
Since early 2009, a higher number of dengue cases has been reported from countries throughout several regions of the world.
Africa
Cape Verde: In 2009, more than 21,000 suspected cases and 6 deaths (as of December 6, 2009) were reported. Approximately 60 cases were reported in nearby Senegal, according to the UN Office for the Coordination of Humanitarian Affairs.
Dengue activity has also been reported in Indian Ocean islands off the coast of Africa. Mayotte has reported 30 confirmed cases as of March 19, 2010, and Reunion has also identified 2 cases of dengue on the island.
South Pacific
Dengue continues to circulate throughout this region. Malaysia, Philippines, Singapore, Sri Lanka, and Vietnam are among the countries reporting dengue activity this year. Limited dengue activity has also been reported this year in northern Queensland, Australia.
Central and South America and the Caribbean
Certain countries in Central and South America as well as in the Caribbean, are reporting dengue activity. These areas include Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, El Salvador, French Guiana, Guadeloupe, Honduras, Peru, and Puerto Rico.
Middle East
Dengue activity has been reported in recent months in this region, including areas popular among travelers such as Jeddah in Saudi Arabia.
Advice for Travelers
Travelers can reduce their risk of getting dengue fever by protecting themselves from mosquito bites. The mosquitoes that spread dengue usually bite at dusk and dawn but may bite at any time during the day, especially indoors, in shady areas, or when the weather is cloudy.
Travelers should follow the steps below to protect themselves from mosquito bites:
Where possible, stay in hotels or resorts that are well screened or air conditioned and that take measures to reduce the mosquito population. If the hotel is not well screened, sleep under bed nets to prevent mosquito bites.
When outdoors or in a building that is not well screened, use insect repellent on uncovered skin. If sunscreen is needed, apply before insect repellent.
Look for a repellent that contains one of the following active ingredients: DEET, picaridin (KBR 3023), Oil of Lemon Eucalyptus/PMD, or IR3535. Always follow the instructions on the label when you use the repellent.
In general, repellents protect longer against mosquito bites when they have a higher concentration (percentage) of any of these active ingredients. However, concentrations above 50% do not offer a marked increase in protection time. Products with less than 10% of an active ingredient may offer only limited protection, often no longer than 1-2 hours.
The American Academy of Pediatrics approves the use of repellents with up to 30% DEET on children over 2 months old.
Protect babies less than 2 months old by using a carrier draped with mosquito netting with an elastic edge for a tight fit.
Wear loose, long-sleeved shirts and long pants when outdoors.
For greater protection, clothing may also be sprayed with repellent containing permethrin or another EPA-registered repellent. (Remember: don’t use permethrin on skin.)
Symptoms and Treatment
Symptoms of dengue include:
fever, severe headache, pain behind the eyes, joint and muscle pain, rash, nausea/vomiting, hemorrhagic (bleeding) manifestations
Usually dengue fever causes a mild illness, but it can be severe and lead to dengue hemorrhagic fever (DHF), which can be fatal if not treated. People who have had dengue fever before are more at risk of getting DHF.
No vaccine is available to prevent dengue, and there is no specific medicine to cure illness caused by dengue. Those who become ill with dengue fever can be given medicine to reduce fever, such as acetaminophen, and may need oral rehydration or intravenous fluids and, in severe cases, treatment to support their blood pressure. Aspirin (acetylsalicylic acid), aspirin-containing drugs, and other nonsteroidal anti-inflammatory drugs (e.g., ibuprofen) should be avoided because of the possibility of bleeding. Early recognition and treatment of severe dengue (e.g., signs and symptoms consistent with impending blood pressure failure) can reduce the risk of death.
If you return from a trip abroad and get sick with a fever, you should seek medical care. Be sure to tell the doctor or other health-care provider about your recent travel.
Information for Health-Care Providers
Proper diagnosis of dengue is important, as many other diseases may mimic dengue. Health-care providers should consider dengue, malaria, and (in south Asia and countries bordering the Indian Ocean) chikungunya in the differential diagnosis of patients who have fever and a history of travel to tropical areas during the 2 weeks before symptom onset.
Copyright © 2010, Centers for Disease Control and Prevention
If you are traveling to the Caribbean, Central America, and South Central Asia, then not only do we recommend taking the necessary vaccinations, but we highly advise purchasing a travel medical insurance policy which also covers emergency medical evacuation. For a couple dollars or less per day, you can purchase a travel health insurance policy which covers any local medical expenses as well as emergency medical evacuation which provides medical transporation in case you can’t receive proper local medical care. Get a Travel Health Insurance Quote Today