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Dengue in Pakistan (Karachi, Sindh)

21 February 2018

The Prevention and Control Program for Dengue in Sindh has reported (via media) up to 22 new dengue fever cases in Karachi from 12 February to 19 February 2018.

In 2018, 143 cases have been reported in Sindh province. Of these, 137 were in Karachi and 6 elsewhere in province.

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.M
    • Mexico, Costa Rica, the Phillippines and Brazil are the first countries to have granted marketing authorization for Dengvaxia®. December 2017 - use of this vaccine is currently under review due to safety concerns.

For further information see Dengue Fever.