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Dengue in Africa

26 July 2017

Cote d'Ivoire reported   481 suspected dengue cases (224 are confirmed, 2 deaths) from 1 January to 4 July 2017. Viral subtypes identified are: DENV 2 (102 cases), DENV 3 (36 cases) and DENV 1 (9 cases). Most cases have occurred in Abidjan.

Kenya reported   1 199 dengue cases, with 1 death, from 1 January to 11 July 2017. Cases have been reported in Mombasa (1 117) and Wajir (82) Counties.

La Reunion reported  54 dengue cases from 1 January to 12 July.

Togo reported   12 confirmed dengue cases from 1 January to 18 June 2017.

Advice for Travellers

Dengue is the second most common identified cause of febrile illness in returning travellers and the number of cases in travellers continues to increase. (8)(9)(12) All travellers to endemic regions are potentially at risk of dengue fever and should be aware of this infection. Prevention relies on avoiding mosquito bites.

Aedes mosquitoes are particularly persistent and aggressive and bite between dawn and dusk.
Methods of bite avoidance include:

• Wearing long, loose, lightly coloured clothing to cover up the skin during the day.
• The use of insect repellent containing DEET applied to any exposed skin between dawn and dusk.
• When sunscreen and DEET are used together, DEET should be applied after sunscreen. The effectiveness of repellent reduces more rapidly than sunscreen, therefore, repellent may have to be reapplied on top of sunscreen.
• The use of permethrin, impregnated mosquito nets protects against early morning bites and should also be used when sleeping during the day.
• The use of air conditioning if available and/or mesh screening of windows and doors.
• Eradication of mosquito breeding sites around accommodation/home (e.g. open containers, old tyres or flower pots that may collect water).

Vaccine

There is no vaccine against dengue fever licensed in the UK.

At present the World Health Organisation (WHO) is trialling several candidate vaccines against dengue fever.

  • Dengvaxia®, developed by Sanofi Pasteur MSD, is the first vaccine to be licensed for the prevention of dengue.
    • It is a live, attenuated, recombinant, tetravalent vaccine approved for use in people 9–45 years of age living in highly endemic regions on a 3 dose schedule.
    • Prior dengue infection increases the efficacy of the vaccine; efficacy is reduced in populations with low previous exposure to dengue and may lead to increased rates of hospitalisation due to severe dengue.
    • Mexico, Costa Rica, the Phillippines and Brazil are the first countries to have granted marketing authorization for Dengvaxia®

For further information see Dengue Fever.