Health Professionals

Clinical Updates

9 October 2012

Dengue fever (presumed locally acquired): Autonomous Region of Madeira (Portugal)

On 3 October 2012, the Autonomous Region of Madeira notified the Public Health Authority of Portugal of cases of dengue fever in the Region, presumed to be locally acquired (autochthonous) [1].  Two cases have been reported in residents of Madeira who had no history of travel abroad, making these the first cases of locally acquired dengue reported in Madeira, although epidemiological investigations are ongoing to confirm this. A number of additional suspected cases are also under investigation [2].

Public health responses are underway including strengthening mandatory disinfection of aircraft, enhanced surveillance and reporting and raising awareness in both health professionals and the public of signs and symptoms of dengue [2-4].

The main mosquito vector for dengue, Aedes aegypti, was identified in Madeira in 2006 [5].  

Advice for travellers

The risk of travellers acquiring dengue fever in Madeira is extremely low; however, all travellers should practise mosquito bite avoidance when visiting the region, as Aedes mosquitoes are present. Aedes mosquitoes bite in the day, particularly around dawn and dusk. More information about mosquito bite avoidance is available on the NaTHNaC website.

There is no vaccine available to protect against dengue.

Further information about dengue can be found on the NaTHNaC Health Information Sheet on Dengue.

Advice for health professionals

Dengue does not occur in the UK. In 2010 there were 406 travel-associated cases of dengue fever reported in England, Wales and Northern Ireland; most were associated with travel to Africa, the Americas, Asia and the Caribbean [6]. 

As of 8 October 2012, there have been no confirmed or probable cases of dengue reported in England, Wales or Northern Ireland associated with travel to Europe, including Madeira [7]. Health professionals who suspect a case of dengue fever should send appropriate samples for testing (with full travel and clinical history) to the Health Protection Agency, Rare and Imported Pathogens Laboratory.

References

1. Minestério da Saúde. Comunicado do Director Geral Da Saúde, 3.10.2012. Casos de dengue na Região Autónoma da Madeira. In Portuguese. [Accessed 9 October, 2012]. Available at: http://www.dgs.pt/

2. European Centres for Disease Prevention and Control. Epidemiological update: Dengue in Madeira, October 2012. [Accessed 9 October, 2012]. Available at: http://ecdc.europa.eu/en/press/news/Lists/News/ECDC_

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3. Secretaria Regional dosm Assuntos Sociais (SRAS). Instituto de Administratcao da Saude e Assuntos Sociais. IP RAM. Microsite mosquito Aedes aegypti. In Portuguese. [Accessed 9 October, 2012]. Available at: http://iasaude.sras.gov-madeira.pt/mosquitos/

4. Minestério da Saúde. Comunicado do Director Geral Da Saúde, 3.10.2012. Abordagem de casos de dengue. In Portuguese. [Accessed 9 October, 2012]. Available at: http://www.dgs.pt/

5. Almeida AP, Gonçalves YM, Novo MT, Sousa CA, Melim M, Gracio AJ. Vector monitoring of Aedes aegypti in the Autonomous Region of Madeira, Portugal. Euro Surveill. 2007; 12(46):pii=3311. [Accessed 9 October, 2012]. Available at: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3311

6. Health Protection Agency. Dengue fever in England, Wales and Northern Ireland: 2009-10.5. Health Protection Report. 5;18, 5 May 2011 [Accessed 9 October, 2012]. Available at: http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C

/1296685588169

7. Health Protection Agency Travel and Migrant Health Section - personal communication 9 October 2012

 

Links

European Centres for Disease Prevention and Control: VBORNET Maps - Mosquitoes

Health Protection Agency: Dengue fever

NaTHNaC Health Information Sheet: Dengue

NaTHNaC Health Informaton Sheet: Insect bite avoidance