CDC Issues Crucial Guidance for Travelers to Dengue-Endemic Regions

The Centers for Disease Control and Prevention (CDC) encourages practicing usual precautions against Dengue virus (DENV) for travelers. They suggest travelers should take preventive measures such as applying an Environmental Protection Agency-approved insect repellent, wearing long-sleeved shirts and pants outdoors, and ensuring accommodations are either air-conditioned or equipped with window screens, or sleeping under a bed net treated with insecticide.¹

The dengue virus vaccine, Dengvaxia, is not approved for use in US travelers who are visiting but not living in areas where dengue is endemic. Annually, as many as 400 million individuals contract the dengue virus. Around 100 million cases result in illness, with severe dengue leading to approximately 40,000 deaths. Dengvaxia is authorized for children between the ages of 9 and 16 who have previously had a laboratory-confirmed dengue infection and reside in regions where dengue is prevalent, including certain US territories and associated states.¹

“In people who have not already been infected with DENV, Dengvaxia can increase the risk for severe illness and hospitalization if the person gets dengue after vaccination. Serodiagnostic tests with acceptable performance (≥75% sensitivity and ≥98% specificity) recommended by health authorities are available to test people for evidence of previous dengue,” according to the CDC. “Only people who test positive for previous DENV infection or who have other laboratory-confirmed evidence of a previous DENV infection are eligible for vaccination with Dengvaxia. Two other dengue vaccines are currently undergoing phase 3 clinical trials.”¹

Dengue fever is the world’s most prevalent mosquito-borne disease, actively threatening half of the global population. Dengue is endemic in more than 125 countries, and infection rates are 8 times higher now than 20 years ago. Climate change is a major factor, growing the mosquito population and making vector-borne diseases possible in new regions worldwide. Dengue is transmitted by Aedes mosquitoes, and changing climates mean areas outside of the tropics and subtropics have become breeding grounds for the vector.²

According to the CDC, “health effects from dengue include fever, headache, nausea, vomiting, rash, muscle and joint pain, and minor bleeding. Dengue can become severe within a few hours. Severe dengue is a medical emergency, usually requiring hospitalization. In severe cases, health effects can include hemorrhage (uncontrolled bleeding), shock (seriously low blood pressure), organ failure, and death.”¹

Countries at Risk

• Colombia
• Costa Rica
• French Guiana
• Guadeloupe
• Guatemala
• Haiti
• Jamaica
• Martinique
• Mexico
• Nicaragua
• Panama
• Saint Barthelemy
• Saint Martin
• Turks and Caicos Islands

The likelihood of contracting the dengue virus escalates with the length of stay and the prevalence of the disease in the destination, particularly during local outbreaks or the rainy season. Regardless of their duration of stay, travelers visiting tropical regions should remain conscious to prevent mosquito bites by employing various protective measures.

References

1. Dengue in the Americas. CDC. Published January 22, 2024. Accessed January 24, 2024. https://wwwnc.cdc.gov/travel/notices/level1/dengue-americas
2. N. Cosdon. Takeda redacts dengue vaccine application after FDA requests more data. Contagion. Published July 12, 2023. Accessed January 29, 2024. https://www.contagionlive.com/view/takeda-redacts-dengue-vaccine-application-after-fda-requests-more-data