Dengue Fever: Symptoms, Risks and Vaccination

Dengue Fever: Symptoms, Risks and Vaccination

The risk of contracting dengue fever varies depending on the season but is generally highest in the rainy season. Add in flooding, and the salty water is left in countless puddles, providing ideal breeding grounds for the mosquitoes that transmit the virus. Dengue fever is found in more than 100 tropical and subtropical countries outside of Europe.

The World Health Organization estimates the number of diseases worldwide to be around 50 million annually. Several hundred thousand diseases progress in the severe, hemorrhagic (bloody) form, from which about 20,000 people die each year. The disease is caused by the Flavivirus genus dengue virus and transmitted by mosquitoes. Although there is an approved vaccination in Germany, it is not used for travellers.

Flu or Dengue?

The symptoms of classic dengue fever are similar to those of the flu: a sudden rise in fever up to 40 °C with chills, severe headaches and body aches. A rash on the skin and red spots spread all over the body, except the face, are also possible. Since the disease breaks out 3 to 14 days after infection, travellers who develop flu-like symptoms after returning from vacation should seek immediate medical attention.

The virus can be detected within the first 3 to 7 days of illness, after which specific antibodies can be seen in the blood. In addition to the classic form of dengue fever, there is also an atypical form that is milder and lasts 72 hours.

 

serious complications

As a rule, dengue infections are not fatal. However, this risk increases dramatically if you are infected with two different types of virus simultaneously. Because the dengue virus that causes the disease comes in different subtypes.

And reinfection with another subgroup virus can lead to dengue hemorrhagic fever. In addition to a rapid increase in fever and severe headaches, severe bleeding of the internal organs occurs 2 to 6 days after the onset of the disease, which can lead to death. Signs of meningitis can also occur.

Therapy of dengue fever

Dengue fever can only be treated symptomatically, so only medicines for fever and pain are given. Acetylsalicylic acid is eliminated as an active ingredient because it supports the increased bleeding tendency that can occur with this disease. The fluid and electrolyte balance must also be balanced in the case of hemorrhagic dengue fever.

Anyone who suddenly falls ill with the symptoms on a tropical vacation should under no circumstances take an acetylsalicylic acid preparation but resort to another fever and pain-reducing agent such as ibuprofen or naproxen. This should be taken into account when putting together the first-aid kit.

 

Prevention through mosquito repellent and vaccination

Once you get dengue fever, you have lifelong immunity to the subtype of the virus that infected you. However, the occurrence of the four subtypes makes reinfection with the original subtype unlikely. Intensive mosquito protection, which includes skin protection products and puncture-resistant clothing, is recommended for prevention. Detailed travel planning, which excludes the rainy season as travel time as far as possible, can also reduce the risk of infection.

In addition, a vaccine against dengue fever has been approved in the European Union. The live attenuated vaccine is directed against all four subtypes of the virus and requires three vaccinations at six or twelve-month intervals. However, it is reserved for people between 9 and 45 who live in endemic areas and have already had a laboratory-confirmed infection. The vaccination is not permitted for travellers – this would be a so-called off-label use. Other vaccines are in development.

Dengue facts in brief

  • Pathogen:  Flavivirus, four subtypes are known
  • Distribution:  tropics and subtropics
  • Vectors:  Diurnal and nocturnal mosquitoes, mostly Aedes species
  • Incubation period:  two to ten days
  • Symptoms: fever, body aches, rarely haemorrhages or shock
  • Therapy:  Symptomatic, no acetylsalicylic acid
  • Prophylaxis: Protection against mosquitoes day and night and, if necessary, vaccination

 

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