Dengue Fever, Traveler's Alert

Last Editorial Review: 8/6/2003

While visiting tropical and subtropical regions of the world, travelers are reminded to take steps to prevent dengue fever, a serious mosquito-borne disease. Anywhere dengue occurs, the risk of infection for the international traveler is low as compared to resident local populations. This is because of the limited time travelers are exposed and the likelihood they will stay in hotels or resorts that are air conditioned and where measures are actively taken to reduce the mosquito population, such as spraying insecticide. However, travelers may become infected with dengue during visits to all tropical and subtropical regions of countries in Asia, the Pacific Islands, the Caribbean Islands, Mexico, Central and South America, and Africa, especially if an outbreak is in progress. The viruses that cause dengue are constantly circulating in these areas, many of which have had multiple epidemics. The risk for contracting dengue is greater in urban areas and lower in rural areas and areas at high altitude (above 4,500 feet [1500 meters]). Persons infected with dengue are at low risk of developing the severe form of the disease, dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). No vaccine is available for dengue, which is transmitted by day-biting mosquitoes. Travelers can protect themselves by using insect repellent containing up to 50% DEET and taking other measures to decrease their exposure to mosquito bites. 

Dengue fever and dengue hemorrhagic fever (DHF), a more severe form of the disease, are viral diseases transmitted by Aedes mosquitoes. Signs and symptoms of dengue fever include severe headache, fever, and rash. Dengue is rarely fatal, but DHF can have a case-fatality rate of 1 to 5%. 

Applying insect repellents containing 25% to 35% N, N-diethylmetatoluamide (DEET) on the skin, being sure to avoid the face and to follow label directions for use on children (no more than 10% DEET). Wearing long-sleeved shirts, long pants, and hats to minimize areas of exposed skin when outdoors in areas where mosquitoes are active. Applying repellents to clothing, shoes, tents, mosquito netting, and other gear will enhance protection. Using air conditioning and screening windows and doors to reduce the risk of being bitten by mosquitoes indoors. Additionally, not allowing water to collect in outdoor or indoor containers, where mosquitoes tend to breed, will diminish the numbers of mosquitoes in circulation.

State and local health authorities are responding by eliminating mosquito breeding sites, spraying insecticide, and increasing public education activities in areas affected by dengue. CDC and local health authorities have increased surveillance activities for the disease.

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Portions of the above information was provided with the kind permission of the Centers for Disease Control.

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