If you have flown into Rome’s Ciampino airport this summer, the first thing that may have greeted you in the arrivals hall is a big poster publicising the health risk of dengue, with imagery of mosquitoes accompanying the health advice notice.
This may have been your first introduction to dengue or, if you have heard of it, you may have associated it with geographical locations such as Africa. It may never have entered your head that you could face the risk of dengue fever in Italy.
The history of dengue in Europe and its worldwide prevalence
Its arrival in mainland Europe is not a new thing. The African Tiger mosquito reached the region some time ago and started to colonise Europe, having hitched a ride with plants and also on vehicles. It can be found not just in Italy, where there is ongoing transmission in both Lombardy and Lazio, but also in Germany, France and other Mediterranean countries. Cases were last year recorded just over the Channel in Paris.
What is alarming is the rate with which dengue is spreading worldwide. Since the beginning of 2024, there have been over 10 million cases of dengue and over 5000 dengue-related deaths. It is present in 80 countries and territories now. There are twice as many reported cases already in 2024 as there were throughout 2023.
Brazil is the worst-hit country, followed by Argentina, Peru, Colombia and Paraguay. Martinique was facing an epidemic, but cases have started to fall. There had also been an increase in the Maldives.
So, with posters now warning of this in one of Rome’s two airports, what can you do to protect yourself against the risk?
Vaccination and other measures to take against dengue
The first thing to stress is that there is a new vaccine for dengue but it was only licensed in the UK in August 2023 and it is not recommended for travellers, unless they have had dengue previously. There are four strains of dengue and a traveller who has had one of them may find that the vaccine offers protection against the other three. If you have travelled to South East Asia, you may have suffered dengue previously, with this being the most common cause of fever in travellers returning from that region.
Despite not being recommended for all travellers, the new Qdenga® dengue fever vaccine is on offer privately, in clinics in London and elsewhere, and some people are opting to have this vaccine. This is administered two weeks before departure for the first dose, with a follow-up dose three months later. The overall cost of this vaccination is around £240.
Do you require this vaccine?
As global health authorities do not currently deem it necessary to suggest that most travellers require this vaccine, it is unlikely that most vaccination services would recommend it or suggest that you consider it. However, that could be because most cannot benefit from analysing your situation as an individual or recognising that you have suffered dengue previously.
If you were to commission a Travel Health Brief from Pinpoint Travel Health, our in-depth screening process would identify that you had suffered dengue in the past and might well recommend that you consider the new vaccine.
However, for most of those who commission a Travel Health Brief, there would be no recommendation to have a dengue vaccine at the present time. For the majority of travellers, staying safe from dengue means exercising good anti-bite control and taking measures to deter mosquitoes. This means applying a good DEET-based insect repellent, wearing long-sleeved clothing and trousers, opting for accommodation with windows fitted with insect screens or boasting air-conditioning, and using mosquito nets, where you can.
If renting accommodation abroad, particularly in the longer-term, check there is no outdoor water source, such as a tank, flower pots or barrel, that is holding stagnant water in which mosquitoes could breed.
The issue with this mosquito is that it bites by day and not night, which can make the covering up with clothing strategy more difficult, particularly if temperatures are of heatwave proportions. DEET-based repellent may be the best ally.
Dealing with a dengue fever health issue
Even if bitten, for the majority of people, any symptoms of dengue fever can be treated with rest, good hydration and paracetamol. In around 1-2% of cases, the medical situation can become more serious, at which time it is necessary to quickly consult with a doctor or hospital.
If you have travelled abroad, even to a seemingly innocuous location in mainland Europe, have suffered mosquito bites and start, 3-14 days later, to suffer headaches, fever, muscle and joint pain, or flu-like systems, or perhaps also notice a rash developing, take action.
With dengue seemingly becoming more prevalent around the world, the situation with regard to the dengue vaccine could be one to watch. In fact, in late July 2024, the UK Government has issued an information notice about it and highlighted the steps being taken to try to prevent its arrival in the UK.
With Pinpoint Travel Health’s daily referral to the latest health advice coming out of major global health organisations, you can rest assured that a Travel Health Brief will always advise you of the most current recommendations for your travel vaccinations and antimalarials. If something does change with dengue, our customers will be swiftly advised of it and any new advice will be reflected in the Travel Health Brief produced. For now, however, most travellers should just make great efforts to keep those mozzies at bay.