Dengue Fever
Learn More about Dengue Fever and how Peak Pharmacy travel clinics can help protect you with our range of travel vaccinations.
In early 2023 a new travel vaccine arrived in the UK. It's not every day that you get to see a new vaccine, and it's ever rarer to see a new vaccine for a new disease. So without further ado let's take a deep dive into Dengue Fever and the Dengue Fever vaccine.
What is Dengue Fever and how do you get it?
Dengue Fever is a viral illness spread by mosquitoes. You can find Dengue Fever throughout the tropics and subtropics of Asia, Oceania, Central and South America and to a lesser extent Africa. The disease can even be found in temperate climates in Southern Europe, and in fact, can establish itself in any location where the Aedes mosquito lives.
In a rather bleak prediction, it is anticipated that by 2080 60% of the world's population could be at risk of this disease.
Every year 400 million people are infected by the Dengue virus, with around 100 million people becoming sick.
There are 4 strains of the Dengue Virus, which we refer to as DENV1, DENV2, DENV3, DENV4.
DENV1 and DENV2 are the most common strains.
How do I know if I've got Dengue Fever?
Symptoms of Dengue Fever are very similar to those of other viral/tropical diseases in the early days of an infection. Common tropical illnesses that Dengue can be mistaken for include malaria, enteric fever, zika, yellow fever, and chikungunya to name just a few.
Early Symptoms:
- High Temperature
- Severe Headache
- Pain behind the eyes
- Muscle, Joint and Bone Pain
- Rashes
The disease can develop, into what is known as Dengue Haemorrhagic Fever and the most severe form Dengue Haemorrhagic Shock with symptoms that include persistent vomiting, severe abdominal pain, liver enlargement, difficulty breathing, fluid accumulation and bleeding of mucous membranes eg gums. Whilst most patients recover with hospital treatment these forms of dengue can ultimately prove to be fatal.
Individuals who contract Dengue Fever will develop lifelong immunity to that particular strain but are not immune to reinfection and so can contract Dengue Fever on multiple occasions. Second infections are a risk factor for the severe forms of dengue.
Who is at greatest risk of complications?
It is worth noting that most cases of dengue Fever go unnoticed with symptoms that are mild, only 1 in 4 cases are typically symptomatic and of those who are symptomatic only 1 in 20 will likely suffer from severe dengue. That's around 1.25% of all Dengue Infections. Prompt intensive care treatment can reduce the risk of death in those with severe dengue to less than 0.5%
Risk factors for poor outcomes and hospitalisation with dengue fever:
- Second infections
- Very young and elderly patients
- Pregnancy
- Malnourishment or Obesity
- Ongoing health issues like Rheumatoid arthritis, Asthma, Diabetes, Heart problems, Kideny and Liver Disease, COPD
How to treat a Dengue infection?
Unfortunately, there are no specific treatments for Dengue Fever other than supportive care to minimise the risk of death if you suffer from a severe infection. So the best treatment is prevention, and this can be done by strict bite avoidance with insect repellents and vaccination.
The Dengue Vaccine
The Dengue Fever Vaccine QDENGA is now available for use in the UK and can be recommended for suitable patients travelling to areas of the world where Dengue Fever is found.
You can check your risk at Travel Health Pro by navigating to your destination country. If you check out the "Other Risks" tab Dengue Fever will be listed if it is present in that country.
At a Glance
Dose: 2 doses separated by 3 months
Protection: All 4 strains of Dengue. DENV1-4 (limited evidence for effectiveness against strains 3-4)
Age: 4 years upwards.
Suitability: Patient must have had a clinically confirmed case of Dengue Fever for vaccination to be considered. (updated 26/3/2024)
Booster: The need for a booster has yet to be established
Type: Live vaccine, ba/sed on DENV2
Price: £100 per dose
As with all vaccinations, not all individuals will develop a protective response against all the strains of dengue, and protection may decline over time. Vaccination against dengue fever is not a substitute for avoiding mosquito bites, bite avoidance is still very important! Please seek prompt medical attention should you experience dengue fever or dengue warning signs.
Why get vaccinated?
Reliable figures for the impact of Dengue Fever on UK travellers are limited, this is because reporting of travellers with dengue is not required under UK law. In a best-case scenario, you may contract dengue on your trip and suffer no symptoms. Those who contract dengue and are symptomatic will more than likely have their holiday ruined, and will be off work when they return. the recovery period can be several weeks.
The most important reason though is the risk of severe dengue fever, also known as Dengue Haemorrhagic Fever which can occur if you contract dengue fever again.
Who cannot be vaccinated?
Qdenga is licenced for those over 4 years, but a recent announcement from JCVI no longer supports the licenced indication due to insufficient data to rule out the risk of severe dengue fever in those who have not previously experienced dengue fever. This means Qdenga is at present time unsuitable for patients who have not had dengue fever previously.
Qdenga is unsuitable for patients who have had an allergic reaction to any of the ingredients in the vaccine as well as individuals who are immunosuppressed (have a weakened immune system), suffer from HIV, or are currently pregnant or breastfeeding.
Individuals planning a pregnancy should wait until at least 1 month after the last dose of the vaccine.
Can I get this vaccine free on the NHS?
No. Dengue Fever vaccines are not provided free of charge on the NHS for travellers, they are a private service.
The pharmacists who manage our Peak Pharmacy travel clinics will always tell you what vaccines you can obtain free of charge on the NHS, but for your information, these are usually Typhoid, Tetanus / Diphtheria / Polio, Hepatitis A and Cholera.
Want to get vaccinated at a Peak Pharmacy Travel Clinic?
Please speak to your specialist Peak Pharmacy travel pharmacist for more information. This service is by appointment only.
References
JCVI minutes March 2024: https://app.box.com/s/iddfb4ppwkmtjusir2tc/file/1477553418407
Electronic Medicines Compendium: https://www.medicines.org.uk/emc/product/14663/smpc#gref
