Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan 5;22(1):30433.
doi: 10.2807/1560-7917.ES.2017.22.1.30433.

Sentinel surveillance of imported dengue via travellers to Europe 2012 to 2014: TropNet data from the DengueTools Research Initiative

Andreas Neumayr  1   2 , Jose Muñoz  3 , Mirjam Schunk  4 , Emmanuel Bottieau  5 , Jakob Cramer  6 , Guido Calleri  7 , Rogelio López-Vélez  8 , Andrea Angheben  9 , Thomas Zoller  2   10   11 , Leo Visser  12 , Núria Serre-Delcor  13 , Blaise Genton  14 , Francesco Castelli  15 , Marjan Van Esbroeck  5 , Alberto Matteelli  15 , Laurence Rochat  16 , Elena Sulleiro  17 , Florian Kurth  11 , Federico Gobbi  9 , Francesca Norman  8 , Ilaria Torta  7 , Jan Clerinx  5 , David Poluda  4 , Miguel Martinez  3 , Antonia Calvo-Cano  3 , Maria Paz Sanchez-Seco  18 , Annelies Wilder-Smith  19   20 , Christoph Hatz  1   2 , Leticia Franco  18   21 ; for TropNet  22
Affiliations

Sentinel surveillance of imported dengue via travellers to Europe 2012 to 2014: TropNet data from the DengueTools Research Initiative

Andreas Neumayr et al. Euro Surveill. .

Abstract

We describe the epidemiological pattern and genetic characteristics of 242 acute dengue infections imported to Europe by returning travellers from 2012 to 2014. The overall geographical pattern of imported dengue (South-east Asia > Americas > western Pacific region > Africa) remained stable compared with 1999 to 2010. We isolated the majority of dengue virus genotypes and epidemic lineages causing outbreaks and epidemics in Asia, America and Africa during the study period. Travellers acted as sentinels for four unusual dengue outbreaks (Madeira, 2012-13; Luanda, 2013; Dar es Salaam, 2014; Tokyo, 2014). We were able to characterise dengue viruses imported from regions where currently no virological surveillance data are available. Up to 36% of travellers infected with dengue while travelling returned during the acute phase of the infection (up to 7 days after symptom onset) or became symptomatic after returning to Europe, and 58% of the patients with acute dengue infection were viraemic when seeking medical care. Epidemiological and virological data from dengue-infected international travellers can add an important layer to global surveillance efforts. A considerable number of dengue-infected travellers are viraemic after arrival back home, which poses a risk for dengue introduction and autochthonous transmission in European regions where suitable mosquito vectors are prevalent.

Keywords: Dengue; Europe; Surveillance; importation; travel; travellers.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Geographical distribution of imported dengue cases, by WHO region, 2012–14 (n = 242)
Figure 2
Figure 2
Geographical pattern of imported dengue cases, by WHO region, 2012–14 (n = 242)
Figure 3
Figure 3
Time between onset of symptoms and returning back home in returning travellers developing dengue fever, 2012–14 (data available from 143 travellers)
Figure 4
Figure 4
Distribution of imported dengue virus serotypes, by WHO region, 2012–14 (n = 141)
See this image and copyright information in PMC

References

    1. World Health Organization (WHO). Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control: New Edition. Geneva: WHO; 2009. ISBN 978 92 4 154787 1. Available from: http://www.who.int/tdr/publications/documents/dengue-diagnosis.pdf?ua=1 - PubMed
    1. Frank C, Schöneberg I, Krause G, Claus H, Ammon A, Stark K. Increase in imported dengue, Germany, 2001-2002. Emerg Infect Dis. 2004;10(5):903-6. 10.3201/eid1005.030495 - DOI - PMC - PubMed
    1. Allwinn R. Significant increase in travel-associated dengue fever in Germany. Med Microbiol Immunol (Berl). 2011;200(3):155-9. 10.1007/s00430-011-0185-2 - DOI - PubMed
    1. Miquel M, del Río R, Borràs D, Barceló C, Esquivel CP, Lucientes J, et al. First detection of Aedes albopictus (Diptera: Culicidae) in the Balearic Islands (Spain) and assessment of its establishment according to the ECDC guidelines. Journal of the European Mosquito Control Association. 2013;31:8-11.
    1. Akiner MM, Demirci B, Babuadze G, Robert V, Schaffner F. Spread of the Invasive Mosquitoes Aedes aegypti and Aedes albopictus in the Black Sea Region Increases Risk of Chikungunya, Dengue, and Zika Outbreaks in Europe. PLoS Negl Trop Dis. 2016;10(4):e0004664. 10.1371/journal.pntd.0004664 - DOI - PMC - PubMed