Locally acquired cases of dengue in France
Cases of dengue have been reported in southern and northern France
On 11 October 2023, a case of dengue was confirmed in Limeil-Brévannes in the region of Île-de-France, northern France. This is the first locally acquired case in this region [1] and brings the total number of autochthonous (locally acquired) dengue cases in France to 36 so far this year [2].
Since 2010, sporadic dengue outbreaks have been reported in southern France in the region of Provence-Alpes-Côte d’Azur (PACA) (departments of Alpes Maritimes, Bouches-du-Rhone and Var, the region of Occitanie (departments of Gard, Haute-Garonne, Hautes-Pyrénées-Orientale), the region of Auvergne-Rhône-Alpes and the island of Corsica [2].
Dengue is an emerging disease outside of tropical areas, affecting parts of Europe, including France, Italy, Portugal, Spain and Croatia [3-5].
Dengue is transmitted to humans by the bite from infected Aedes mosquitoes. Aedes aegypti is the principal mosquito vector associated with dengue transmission and is closely associated with humans and urban areas. A. aegypti mosquitoes breed in stagnant water in containers (including buckets used to collect rainwater, cisterns and tyres). In forests, they can breed in water-filled tree holes. They are most active during daylight hours, when they feed from dawn to dusk, but can bite at night in well-lit areas [6].
Advice for travellers
Before you travel
See our Country Information 'Other Risks' section for individual country recommendations to check if there is a risk of dengue.
A dengue vaccine is licensed in the UK for the prevention of dengue disease in individuals from 4 years of age. The Joint Committee on Vaccination and Immunisation (JCVI) are in the process of reviewing the product information. Recommendations on the use of this vaccine will be published in due course.
While you are away
Mosquito bite avoidance is recommended. As dengue is spread by day-biting mosquitoes, particular care with bite avoidance is advised during the day, especially around dawn and dusk.
When you return
In about 75 percent of cases there are no symptoms [6]. When symptoms occur, illness begins abruptly after an incubation period of five to eight days. There may be high fever (up to 40°C) often accompanied by a severe headache and retro orbital (behind the eye) pain, muscle and joint pains, nausea, vomiting, abdominal pain and anorexia. High temperature can persist for five to six days. Around the third to fourth day, a maculopapular (flat, raised discoloured patches) rash may be seen on the chest, trunk and extremities [7].
If you think you, or anyone in your family has symptoms after you return to the UK you should seek medical advice. It is important to tell your healthcare provider about any recent travel to a dengue affected area.
Advice for health professionals
Health professionals should be alert to the possibility of dengue in those who have recently returned from a dengue risk area presenting with a fever or flu-like illness and/or signs of severe disease which include mucosal bleeding, abdominal pain, liver enlargement and fluid accumulations. [8, 9].
Health professionals who suspect a case of dengue in a returned traveller, should discuss this urgently with their local microbiology, virology or infectious diseases consultant, giving a full travel history. They may advise that appropriate samples are sent for testing to specialist laboratory facilities in the UK.
The Imported Fever Service offers health professionals a 24-hour, seven day a week telephone service with access to expert clinical and microbiological advice. This offers support in management of febrile patients, and with infection control and public health interventions.
Resources
References
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Agence Region de Sante Île-de-France. Vector control: the ARS confirms a first indigenous case of dengue in Île-de-France and initiates two mosquito control actions in Limeil-Brévannes (94). 17 October 2023. [Accessed 25 October 2023]
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Santé publique France. Chikungunya, dengue and zika - Data from reinforced surveillance in mainland France in 2023. 16 October 2023. [Accessed 25 October 2023]
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Rezza G. 2016. Dengue and other Aedes-borne viruses: a threat to Europe? Eurosurveillance 21:21. May 2016. [Accessed 25 October 2023]
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Schmidt-Chanasit J, Haditsch M, Schönenberg I et al. Dengue virus infection in a traveller returning from Croatia to Germany. Eurosurveil. 15(40): October 2010. [Accessed 25 October 2023]
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European Centres for Disease Prevention and Control. Autochthonous transmission of dengue virus in EU/EAA, 2010- present. [Accessed 25 October 2023]
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Sharp TM, Perez-Padilla J and Waterman SH. Margolis HS. Dengue. Chapter 3 In. Health Information for International Travel May 2017. Centers for Disease Control and Prevention. [Accessed 25 October 2023]
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Yacoub S, Farrar J. Arboviral Infections in Farrar et al (eds) Manson's Tropical Diseases. 24th Edition. Edinburgh; WB Saunders: 2014.
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Public Health England. Dengue fever: guidance, data and analysis. November 2015. [Accessed 25 October 2023]
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Neumayr A, Muñoz J, Schunk M et al. Sentinel surveillance of imported dengue via travellers to Europe 2012 to 2014: TropNet data from the DengueTools Research Initiative. Eurosurveillance 22:1. January 2017. [Accessed 25 October 2023]
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