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Dengue in Asia and the Pacific (Update 3)

15 November 2017

On 7 November 2017 the World Health Organisation (WHO) reported dengue continues to be transmitted in Asia and the Pacific.

Australia has reported 859 laboratory-confirmed dengue cases from 1 January to 30 October 2017.

Cambodia has reported 2 884 dengue cases from 1 January to 31 October 2017

China has reported 1 904 dengue cases from 1 January to 30 September 2017.

French Polynesia reported 16 cases of dengue between week ending 14 October 2017 and week ending 21 October 2017.

India has reported 129 329 cases including 200 deaths from 1 January to 12 November 2017

Laos has reported 10 302 cases of dengue (including 14 deaths) from 1 January to 27 October 2017. Dengue is at epidemic level in the country.

Malaysia has reported 74 348 cases (including 160 deaths) from 1 January to 28 October 2017.

New Caledonia has reported 4 405 dengue cases from 1 January to 31 October 2017.

The Philippines has reported 97 287 dengue cases (including 526 deaths) from 1 January to 30 September 2017.

Singapore has reported 2 364 dengue cases from 1 January to 28 October 2017.

Vietnam has reported 160 567 cases of dengue (including 30 deaths) from 1 January to 3 November 2017. In the same period there were 35 457 cases (including 7 deaths) in Hanoi. The Central-coastal and Southern regions have reported the highest incidence of dengue.

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. 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.