Health Professionals

Clinical Updates

18 February 2013

Dengue fever outbreak decline: Madeira, Portugal.

The Health Protection Agency (HPA) has reported that the locally acquired (autochthonous) dengue fever outbreak in Madeira, first confirmed by the Portuguese Ministry of Health in October 2012, is in decline [1]. As of 3 February 2013, a significant decline in case numbers in late January and early February 2013 has been reported. The total number of cases is 2164, with no fatalities [2].

As of 14 February 2013, 78 cases have been reported in other European countries in travellers who had recently travelled to Madeira [3]. Of the 23 reported UK cases associated with travel to Madeira during this outbreak, 52% were male, with a median age of 56.5 years [1]. The main mosquito vector for dengue, Aedes aegypti, was identified in Madeira in 2005 [4]. Although the current dengue risk for UK travellers to Madeira has decreased with lower winter temperatures, it is likely that seasonal vector activities will increase in May - June and further cases will be reported [3]. The HPA will continue to monitor this situation.

Advice for travellers

All travellers to regions where dengue is known or thought to occur should continue to follow mosquito bite avoidance advice. Aedes mosquitoes bite in the day, particularly around dawn and dusk. Bite avoidance advice is available on NaTHNaC’s website. There are no drugs or vaccines to protect against dengue. More information is available in NaTHNaC’s Dengue Information Sheet.

Any travellers with flu-like symptoms, such as fever, severe headache, muscle pain and a rash, within 21 days of visiting a dengue risk region should seek urgent medical advice, mentioning their travel history [1].

Advice for health professionals

Dengue does not occur in the UK. In 2011, there were 223 travel-associated cases of dengue fever reported in England, Wales and Northern Ireland. The majority of these cases were associated with travel to Africa, Asia, South America and the Caribbean [5]. 

Health professionals should be aware of the possibility of dengue fever in febrile travellers who have recently visited Madeira and, if they suspect a case, should send appropriate samples for testing (including a full travel and clinical history with relevant dates) to the Health Protection Agency, Rare and Imported Pathogens Laboratory [1].

 

References

1. Health Protection Agency. Dengue fever in Madeira – outbreak in decline, HPR weekly 15 February 2013; 7 (6): news. [Accessed 18 February, 2013] Available at: http://www.hpa.org.uk/hpr/

2. Portuguese Ministry of Health. Surto de dengue na Ilha da Madeira - situação em 3 de fevereiro de 2013 [in Portuguese]. [Accessed 18 February, 2013].  Available at: http://www.dgs.pt/?cn=683368347243AAAAAAAAAAAA

3. European Centre for Disease Prevention and Control. Epidemiological update: Outbreak of dengue in Madeira, Portugal. 14 February 2013. [Accessed 18 February, 2013]. Available at: http://ecdc.europa.eu/en/press/news/Lists/News/

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4. 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 18 February, 2013]. Available at: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3311

5. Health Protection Agency. Dengue fever in England, Wales and Northern Ireland: 2011. Epidemiological data. Annual Report. 07 December 2012 [Accessed 18 February, 2013]. Available at: http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/

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