Significant increase in travel-associated dengue fever in Germany
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Increasing numbers of dengue fever (DF) cases reflect the increasing travel mobility together with the expanding geographical distribution of the vector Aedes aegypti. Compared with earlier surveys in Germany, higher incidences occur and correlate well with ongoing outbreaks. Therefore, we investigated 767 serum samples from 594 returning travellers with suspected DF between 2005 and 2010, which where sent from different hospitals in the drainage area Frankfurt/Main. Established diagnostic assays were ELISA, immunofluorescence and chromatographic tests. We obtained 112 dengue-seropositive serum samples from totally 60 patients: the detection rate was 10.1% (60 out of 594). A significant increase was found in 2010. Most patients were aged between 40 and 49, and indirect immunofluorescence technique indicated mainly DF serotype 2. Actual data reveal a significant rise in imported DF cases in 2010 according to an increasing risk to acquire DF virus infection. Nevertheless, dengue haemorrhagic fever and dengue shock syndrome are still rare in travellers, but those with a history of dengue should be tested for DF serotypes and advised to protect themselves well from mosquitoes when travelling to endemic areas.
KeywordsTravel medicine Increasing dengue fever Dengue fever diagnostics
I would like to thank H. W. Doerr for his great support and all MTAs at the serological laboratory for their excellent technical assistance.
Conflict of interest
The author declares no conflict of interest.
- 2.Robert-Koch-Institut (RKI) (2010) Epidemiologisches Bulletin No 45, Berlin, Germany, p 452Google Scholar
- 6.Doerr HW, Allwinn R, Preiser W (2000) Dengue fever. In:Licker MD (ed) Year book of science and technology. Professional Book Group. McGraw Hill, Inc., NY, pp 109–112Google Scholar
- 8.Monath TP, Heinz FX (1996) Flaviviruses. In: Fields BN 3rd, Knipe DM, Howley PM (eds) Fields virology. Lippincott-Raven Publ, Philadelphia, pp 961–1034Google Scholar
- 10.Dejnirattisai W, Jumnainsong A, Onsirisakul N, Fitton P, Vasanawathana S, Limpitikul W, Puttikhunt C, Edwards C, Duangchinda T, Supasa S, Chawansuntati K, Malasit P, Mongkolsapaya J, Screaton G (2010) Cross-reacting antibodies enhance dengue virus infection in humans. Science 328:745–748PubMedCrossRefGoogle Scholar
- 18.Schmidt-Chanasit J, Haditsch M, Schoneberg I, Gunther S, Stark K, Frank C (2010) Dengue virus infection in a traveller returning from Croatia to Germany. Euro Surveill 15(40):19677Google Scholar
- 19.Rovida F, Percivalle E, Campanini G, Piralla A, Novati S, Muscatello A, Baldanti F (2011) Viremic Dengue virus infections in travellers: potential for local outbreak in Northern Italy. J Clin Virol 50:76–79Google Scholar
- 20.La Ruche G, Souares Y, Armengaud A, Peloux-Petiot F, Delaunay P, Despres P, Lenglet A, Jourdain F, Leparc-Goffart I, Charlet F, Ollier L, Mantey K, Mollet T, Fournier J, Torrents R, Leitmeyer K, Hilairet P, Zeller H, Van Bortel W, Dejour-Salamanca D, Grandadam M, Gastellu-Etchegorry M (2010) First two autochthonous dengue virus infections in metropolitan France, September 2010. Euro Surveill Sep 30:15(39)Google Scholar
- 24.Dobler G, Jelinek T, Frosner G, Nothdurft HD, Löscher T (1997) Cross reactions of patients with acute dengue fever to tick-borne encephalitis. Wiener Med Wochenschr 147(19–20):463–464Google Scholar
- 29.Guzman MG, Jaenisch T, Gaczkowski R, Ty Hang VT, Sekaran SD, Kroeger A, Vazquez S, Ruiz D, Martinez E, Mercado JC, Balmaseda A, Harris E, Dimano E, Leano PS, Yoksan S, Villegas E, Benduzu H, Villalobos I, Farrar J, Simmons CP (2010) Multi-country evaluation of the sensitivity and specificity of two commercially-available NS1 ELISA assays for dengue diagnosis. PLoS Negl Trop Dis 31:4(8): e811Google Scholar
- 34.Trent D, Shin J, Hombach J, Knezevic I, Minor P et al (2010) WHO Working Group on technical specifications for manufacture and evaluation of dengue vaccines, Geneva, Switzerland, 11–12 May 2009. Vaccine 28:8246–8255Google Scholar
- 35.Block OK, Rodrigo WW, Quinn M, Jin X, Rose RC, Schlesinger JJ (2010) A tetravalent recombinant dengue domain III protein vaccine stimulates neutralizing and enhancing antibodies in mice. Vaccine 28:8085–8094Google Scholar
- 36.Poo J, Galan F, Forrat R, Zambrano B, Lang J, Dayan GH (2010) Live-attenuated Tetravalent Dengue Vaccine in Dengue-naïve Children, Adolescents, and Adults in Mexico City: randomized Controlled Phase 1 Trial of Safety and Immunogenicity. Pediatr Infect Dis J Oct 28. [Epub ahead of print] PMID:21042231Google Scholar