Update on dengue fever cases in Madeira, Portugal

26 November 2012

The outbreak of dengue fever in Madeira was first reported on 3 October 2012 is continuing. As of 18 November, the Portuguese Ministry of Health has reported a total of 1672 cases.

Since the beginning of the outbreak, 100 patients have been hospitalised and five currently remain in hospital. So far, 33 cases of dengue fever have been reported in other European travellers after returning from the island: cases have been reported from the UK (12), mainland Portugal (10), Germany (seven), France (two), Sweden (one) and Finland (one).

The latest risk assessment from the European Centre for Disease Prevention and Control (ECDC) suggests that the outbreak is still on-going and its exact development cannot be anticipated at this point of time. It is expected that cases in residents and travellers to Madeira will continue to be reported until the mosquito population is decreased and transmission interrupted.

Madeira is a popular winter sun destination for UK travellers and the HPA continues to advise people going on holiday to Madeira to take precautions like using repellents throughout the whole day to avoid mosquito bites. If you develop ‘flu like’ symptoms within 21 days of returning from Madeira you should seek medical advice either from NHS Direct or your GP.

This is the final statement the HPA will issue on this incident, unless there is a development with UK public health significance.

Notes to editors:

Dengue is transmitted by a daytime mosquito (Aedes aegypti). Protective measures should be applied throughout the whole day.
More information about Dengue fever is available from the HPA website from the Background information on dengue fever page
Advice for travellers and health professionals is available from the National Travel Health Network and Centre (NaTHNaC) [external link].
An update from the ECDC (20 November) is available from the European Centre for Disease Prevention and Control website [external link].

8 November 2012

The outbreak of dengue fever in Madeira has evolved rapidly since its onset on 3 October 2012. The Portuguese Ministry of Public Health has reported 1,148 cases of dengue infection, 517 of which have been laboratory confirmed. During the outbreak, 57 people have been hospitalised for observation but there have been no deaths or severe cases of dengue fever.

Almost all reported cases have been from the resident population but a small number of visiting tourists have been diagnosed with dengue infection after developing symptoms in their home countries. Six cases have now been reported in the UK, France and Germany have two cases each and Sweden one case. In addition, eight cases were diagnosed in those returning to mainland Portugal. None of the cases have had serious disease.

Dengue fever is a mosquito-borne infection that can cause a severe flu-like illness. Infection occurs following a bite from an infected Aedes mosquito carrying the virus – it cannot be passed from person to person. The clinical features of dengue fever range from non-existent or mild to severe and vary according to the age of the patient.

Dr Dipti Patel, joint director of the National Travel Health Network and Centre (NaTHNaC), said: “There is no specific preventive medicine or vaccination against dengue fever and prevention relies on avoiding mosquito bites particularly around dusk and dawn when the day biting mosquitoes are most active.

“To minimise the risk of being bitten, it is advisable to wear appropriate clothing to cover up - such as long sleeve tops and trousers, and to use insect repellents.”

Dr Jane Jones, a travel-associated infection expert at the HPA, said: “This is the first time that dengue fever has been reported in Madeira so UK residents planning a trip to the Island should take steps to avoid infection.

“Anyone who develops a fever or flu-like symptoms within two weeks of returning from a trip to Madeira should seek medical advice from NHS Direct or their GP.”

Notes to editors:

The World Health Organization has estimated that 2.5 billion people are at risk of acquiring dengue fever and that approximately 50 million infections occur each year. It occurs in tropical and sub-tropical regions of the world affecting approximately 100 countries in Africa, South and Central America, Asia, eastern Mediterranean, and western Pacific. Dengue fever does not occur in the UK but is reported in a number of UK travellers returning from endemic areas. In 2010, 406 cases of dengue fever were reported in England, Wales and Northern Ireland, a high proportion of whom had acquired their infections in India and Thailand.
For previous HPA updates on this outbreak, see:
http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2012PressReleases/121025denguefeverin
madeiraupdate/
An update from the European Centre for Disease Control (ECDC) is available from:
http://www.ecdc.europa.eu/en/press/news/Lists/News/ECDC_DispForm.aspx?List=32e43ee8%2De230%2D4424%2Da783%2D85742124029a&ID=776&RootFolder=%2Fen%2Fpress%2Fnews%2FLists%2FNews
More information about dengue fever is available from the HPA website: http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/DengueFever/GeneralInformation/DengBackground
informationondengue/ or NHS Choices http://www.nhs.uk/conditions/dengue/pages/introduction.aspx
Advice for travellers and health professionals is available from NaTHNaC www.nathnac.org
National Travel Health Network and Centre (NaTHNaC) is commissioned by the Health Protection Agency and hosted by University College London Hospitals NHS Foundation Trust. It works in partnership with the London School of Hygiene and Tropical Medicine, the Liverpool School of Tropical Medicine, the Hospital for Tropical Diseases, the Department of Health and the Health Protection Agency to achieve its objective of improving standards in travel medicine.
The Health Protection Agency is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards. In April 2013 the Health Protection Agency will become part of a new organisation called Public Health England, an executive agency of the Department of Health. To find out more, visit our website: www.hpa.org.uk or follow us on Twitter @HPAuk.
For more information please contact the national HPA press office at Colindale on 0208 327 7901 or email colindale-pressoffice@hpa.org.uk. Out of hours the duty press officer can be contacted on 0208 200 4400

25 October 2012

The Portuguese Ministry of Public Health has updated the number of Dengue fever cases reported in Madeira, Portugal to 52 confirmed cases and 404 probable cases.

In addition, cases of Dengue fever associated with travel to Madeira have been reported in other European countries; England (1), France (2) and Sweden (1). The person affected in England is recovering well.

The European Centre for Disease Prevention and Control (ECDC) does not recommend any restrictions on travel to Madeira, but travellers are advised to protect themselves from mosquito bites by taking necessary precautions.

Notes to editors:

More information about Dengue fever is available from the HPA website: http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/DengueFever/GeneralInformation/DengBackgroundinformationondengue/

An update from the ECDC website is available:
http://www.ecdc.europa.eu/en/press/news/Lists/News/ECDC_DispForm.aspx?List=32e43ee8%2De230%2D4424%2Da783%2D85742124029a&ID=768

19 October 2012

The Portuguese Ministry of Public Health has updated the number of Dengue fever cases reported in Madeira, Portugal to 37 confirmed cases and 262 probable cases. The European Centre for Disease Prevention and Control (ECDC) has confirmed that there are currently no travel restrictions to Madeira, although travellers are advised to protect themselves from insect bites by taking the necessary precautions.

The HPA is reminding travellers to minimise the risk of being bitten by wearing appropriate clothing to cover up and using insect repellents. Also anyone who develops a fever or flu-like symptoms within two weeks of returning from a trip to Madeira should seek medical advice as soon as possible.

Notes to editors

For a copy of the ECDC Rapid risk assessment: Autochthonous dengue cases in Madeira, Portugal [external link] visit their website.

Advice for travellers and health professionals is available from the National Travel Health Network and Centre (NaTHNaC) [external link]

12 October 2012

The Health Protection Agency (HPA) is aware of 18 confirmed cases and 191 probable cases of dengue fever in Madeira, Portugal since early October 2012.

This is the first time that dengue fever has been reported in Madeira. Dengue is a mosquito-borne viral infection and it is important that all travellers should avoid mosquito bites when visiting the region. It can cause a range of clinical symptoms from a mild flu-like illness to a more serious illness including rash and bone pain and can sometimes lead to severe complications.

There have not been any cases of dengue fever in UK travellers associated with travel to Madeira to date and the risk for travellers and residents will depend on the course of the outbreak in the coming weeks. The health authorities in Madeira are investigating and implementing control and prevention measures, alongside a public awareness campaign.

Dr Jane Jones, a travel-associated infection expert at the HPA, said: “Dengue fever cannot be passed from person to person and infection occurs after being bitten by the Aedes mosquito carrying the virus.

“To minimise the risk of being bitten it is advisable to wear appropriate clothing to cover up - such as long sleeve tops and trousers, and to use insect repellents.”

“Anyone who develops a fever or flu-like symptoms within two weeks of returning from a trip to Madeira should seek medical advice from NHS Direct or their GP.”

ENDS

Notes to editors:

The World Health Organization has estimated that 2.5 billion people are at risk of acquiring dengue fever and that approximately 50 million infections occur each year. It occurs in tropical and sub-tropical regions of the world affecting approximately 100 countries in Africa, South and Central America, Asia, eastern Mediterranean, and western Pacific. Dengue fever does not occur in the UK but is reported in a number of UK travellers returning from endemic areas. In 2010, 406 cases of dengue fever were reported in England, Wales and Northern Ireland, a high proportion of whom had acquired their infections in India and Thailand.
More information on dengue fever is available from the HPA website or NHS Choices [external link].
More information on dengue fever for health professionals and travellers is also available from the NaTHNaC website www.nathnac.org [external link] including specific advice on insect bite avoidance [external link].
National Travel Health Network and Centre (NaTHNaC) is commissioned by the Health Protection Agency and hosted by University College London Hospitals NHS Foundation Trust. It works in partnership with the London School of Hygiene and Tropical Medicine, the Liverpool School of Tropical Medicine, the Hospital for Tropical Diseases, the Department of Health and the Health Protection Agency to achieve its objective of improving standards in travel medicine.
The Health Protection Agency is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards. In April 2013 the Health Protection Agency will become part of a new organisation called Public Health England, an executive agency of the Department of Health. To find out more, visit our website: www.hpa.org.uk or follow us on Twitter @HPAuk.
For more information please contact the national HPA press office at Colindale on 0208 327 7901 or email colindale-pressoffice@hpa.org.uk Out of hours the duty press officer can be contacted on 0208 200 4400.

Last reviewed: 26 November 2012