Dengue Fever

Updated: February 02, 2007

The Public Health Agency of Canada is monitoring a number of dengue outbreaks. The Agency reminds travellers that dengue virus is present in many tropical and subtropical destinations and that the risk of becoming infected with this virus exists year-round.  Dengue virus is spread by the bite of an infected mosquito, mainly the Aedes aegypti – a day-time biter that lives in close proximity to humans in urban areas.  There is no vaccine that protects against dengue virus infection; using personal protective measures to prevent being bitten by an infected mosquito remains the only means to reduce your risk of exposure to the dengue virus, see: Recommendations below.

Puerto Vallarta, Mexico – Further to the Agency’s travel health advisory on dengue issued December 29, 2006, health officials in Mexico continue to report cases of dengue fever in Puerto Vallarta.  At this time, 215 cases of dengue fever have been reported for the month of January. Local public health authorities with support from the Federal government are undertaking intensive insect control measures to respond to this outbreak.  Source:  Government of Mexico – Ministry of Health

Paraguay – Health officials have confirmed that the country is experiencing increased transmission of dengue virus.  Between January 01 and January 29, 2007 a total of 1,394 cases were reported in the departments of Asuncion, Central, Amanbay, Alto Parana, Cordillera, Guaira.  Source:  Government of Paraguay - Ministry of Public Health and Social Welfare

India – Dengue virus transmission continues to be reported in a number of states/union territories.  India reported a total of 11,251 cases of dengue viral illness for 2006, which is consistent with the 11,985 cases reported in 2005.  Activity is being reported in Delhi, NCR, Rajasthan, Punjab, Kerala, Maharashtra, Uttar Pradesh, Gujarat, Haryana, Tamil Nadu, Chandigarh, Andhra Pradesh, Karnataka, J&K, Madhya Pradesh, Bihar and Orissa.   Source: Government of India - Ministry of Health and Family Welfare

Indonesia –The Indonesian Ministry of Health has reported 4,862 cases of dengue viral illness with the majority occurring in Jakarta (1,752 cases).   Case activity is being reported in NAD, Jambi, Bangka Belitung, Lampung, Banten, West Java, Central Java, Yogyakarta, East Java, South Kalimantan, East Kalimantan, Bali, and West Nusa Tengarra.  Source:  Government of Indonesia – Ministry of Health

Disease Information

Dengue fever is the most common mosquito-borne viral disease of humans and is the most common cause of febrile illness in returned travelers from the Caribbean, Central America, and South Central Asia.

Dengue fever (DF) is a severe, flu-like illness that seldom causes death.  The illness begins with the sudden onset of flu-like symptoms including fever, headache, muscle aches and joint pain, pain behind the eyes and a faint rash. The fever usually lasts from three to five days, and rarely more than seven days. 

Dengue haemorrhagic fever (DHF), a more severe and potentially deadly form of the disease is characterized by loss of appetite, vomiting, intense abdominal pain, shock and bleeding from the nose or under the skin. The occurrence of DHF may be associated with those either experiencing their second infection, being immuno-suppressed, or being under the age of 15. Dengue haemorrhagic fever can be fatal.

Dengue virus circulates throughout the tropical and sub-tropical areas of the world, predominantly in urban and surrounding areas, and has been reported in over 100 countries in the Caribbean, Central and South America (including Mexico); Africa; the Pacific Islands; South and South East Asia; Hawaii and Australia.  For a map of countries where dengue is a risk please refer to Figure 1:  Dengue Transmission Risk, reproduced from the World Health Organization’s: International and Travel Health Publication.

Figure 1:  Dengue Transmission Risk

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For additional information on dengue, visit the Public Health Agency of Canada's Disease Information Backgrounder on dengue fever at:
http://www.phac-aspc.gc.ca/tmp-pmv/info/dengue_e.html

Recommendations

The Public Health Agency of Canada reminds travellers that dengue virus occurs in many Tropical and Sub-Tropical destinations.  Travellers to areas where dengue virus transmission is known to occur (Figure 1) should take the following personal protective measures to reduce their exposure to day-time biting mosquitoes:

• remain in well-screened or completely enclosed, air-conditioned areas;
• wear light-coloured clothing with full-length pant legs and sleeves; and
• use DEET-based products as repellents on exposed skin.

Comprehensive information on mosquito-bite avoidance is detailed in the Committee to Advise on Tropical Medicine and Travel’s “Statement on Personal Protective Measures to Prevent Arthropod Bites".

If a fever develops within two weeks of leaving a dengue-endemic area, see a physician and indicate that you have recently travelled to tropical regions . As well, during or following travel to dengue-endemic areas, you should immediately report to a physician any fever that is associated with skin rash, bleeding or easy bruising, particularly if it occurs in children.

As a reminder…

The Public Health Agency of Canada routinely recommends that Canadian travellers consult their personal physician or a travel clinic four to six weeks prior to international travel, regardless of destination, for an individual risk assessment to determine their individual health risks and their need for vaccination, preventative medication, and personal protective measures.

PHAC recommends as well, that travellers who become sick or feel unwell on their return to Canada should seek a medical assessment with their personal physician. Travellers should inform their physician without being asked, that they have been travelling or living outside of Canada, and where they have been.

Additional information:

• For more information on dengue fever, visit the Public Health Agency of Canada's Disease Information Backgrounder on dengue fever at: http://www.phac-aspc.gc.ca/tmp-pmv/info/dengue_e.html
• For additional information on dengue fever activity in the Americas, visit the Pan American Health Organization's Dengue Feverpage at: http://www.paho.org/english/ad/dpc/cd/Dengue.htm
• For additional information on dengue fever activity in South East Asia, visit the World Health Organization Regional Office for South East Asia Dengue Feverpage at: http://www.searo.who.int/en/Section10/Section332.htm