By John Ely Deputy Health Editor For Mailonline
15:35 12 Jun 2024, updated 15:44 12 Jun 2024
As cases of potentially deadly dengue sweeps across Europe, sparking fears of a rise in cases in Brits, experts say holidaymakers need to be aware of the signs of the disease both on holiday and when home.
A total of 130 cases of the disease, once confined to the tropics, were recorded in the EU and EEA last year, almost double the number compared the previous year.
And health officials fear this is part of a growing trend. Case totals for 2023 and 2022s are a huge spike compared to the 73 cases recorded on the continent between 2010 and 2021.
Dengue is a potentially deadly virus passed to people by infected mosquitoes and was historically known as ‘breakbone fever’ in the 1700s because of the severe pain it can cause in the muscles and the joints, one of its symptoms.
While normally endemic to Central and South America, the Caribbean and Southeast Asia, experts have warned that climate change is making the Mediterranean more hospitable for the mosquito species that carry the disease.
Symptoms typically strike between four to 10 days after being bitten, which means holidaymakers may still need to keep an eye out for dengue signs upon their return to Britain.
Common signs of a dengue infection typically manifest as flu like symptoms.
Typically, patients suffer a fever that lasts for between two and seven days — this may peak, reduce and then peak again during this time.
During the first days, this may be accompanied by facial redness.
Other common symptoms at this stage include a severe headache, pain behind the eyes, muscle and joint pain — giving the disease its bone-breaker’ moniker — nausea and vomiting and swollen glands.
A flat, red rash may appear over most of the body within three to seven days after the fever starts — thought to be caused by an immune system reaction to the virus. This is itchy is around a quarter of patients.
Although less common, bleeding gums may also be seen.
Brits with dengue symptoms who have been in an area where the disease is prevalent are advised to contact their GP or NHS 111 for an urgent appointment.
This is due to a risk of a potentially life-threatening complication that typically strikes just as people start to feel better.
While people infected with dengue recover after one to two weeks, there is a chance some can develop a far more serious form of the infection.
Called ‘severe dengue’ this is a life-threatening condition that develops in about one to 20 cases (five per cent) of people being infected with the virus.
Experts estimate this version of dengue kills half of people who suffer it.
Symptoms of severe dengue include severe stomach pain, repeatedly being sick, fast breathing, bleeding gums, nose bleeds, extreme tiredness, restlessness and blood in your vomit or faeces.
These typically strike after between 24 to 48 hours after the initial wave of dengue symptoms has passed and people start to feel better.
It is a serious medical emergency and people with symptoms are advised to call 999 or head to A&E as soon as possible.
People who have had dengue previously are known to be more at risk of suffering a severe version of disease in the future from subsequent infections.
The NHS now warns people that dengue is a risk on European holiday-destinations like Croatia, France, Italy, Spain, and Portugal and Madeira between Spring and November.
It also advises that people who are more vulnerable to dengue, such as young children, the elderly, pregnant women and those with a weakened immune system should avoid traveling to areas where the virus is present.
Dr Simon Clarke, an infectious disease expert University of Reading, told MailOnline that Brits heading to the continent needed to be aware of potential dengue symptoms even after they returned home.
‘Dengue fever is something that has traditionally been associated with more unusual and exotic destinations, but more recently France, Italy and Spain have recorded multiple infections, so travellers from the UK should be more aware of this potentially fatal infection,’ he said.
‘Travellers need to be made aware not only of the increasing risk, but also of the symptoms, the 4fourto 10 days it can take for them to appear after someone has been bitten by an infected mosquito, and the importance of getting medical advice if they think they’ve contracted dengue.’
He added that as climate change is predicted to make the mosquitos that carry dengue more common in Europe controlling the insects would be an increasing important consideration for holiday destinations.
Professor Ian Jones, a virologist at Reading, also told this website that while there was no need re-think holiday plans yet, dengue in Europe is likely going to get worse.
The risk of contracting dengue in Europe remains low, far more cases are imported from countries where the infection is common, but the numbers are increasing, and we should expect this trend to continue in the near-term,’ he said.
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‘A number of virus infections, including dengue, are transmitted by insects and as climate change expands their range, the incidence of virus infection also increases.’
He urged holidaymakers to take sensible precautions to reduce their risk of catching the virus when travelling in known dengue areas.
Prevention is considered the best way to avoid getting dengue and people visiting areas where the disease is prevalent are take steps to reduce their risk of mosquito bites.
These include wearing long sleeved clothing and trousers, using insect repellent, keeping unscreened windows closed in their accommodation, and sleeping under a mosquito net.
People should be especially cautious during the early morning and early evening as these are when mosquitoes are most active.
Dengue transmission is currently not considered a risk in the UK, though mosquitoes capable of carrying the virus have been found in the wild in Britain previously.
Normally, people with dengue cannot pass the virus to others directly, though mosquitoes can bite them and then go on to infect other people.
However, very rare cases of dengue being passed on through contact with infected blood via transfusions or organ donation have been recorded.
A total of 634 dengue cases were recorded by The UK Health Security Agency (UKHSA) in 2023.
These were all imported cases, where someone was infected while overseas and then fell ill upon returning.
UKHSA officials warned the figure was now approaching pre-Covid levels after cases naturally dived during the pandemic due to travel restrictions and urged travellers to be vigilant.
Experts have previously warned dengue is among a number of diseases that could become established the UK due to a ‘slow march north’ of insects due to climate change.
Globally, there were a reported 6.5million cases of dengue of which 7,300 resulted in death in 2023, according to the World Health Organization (WHO).
However, the WHO says modelling suggests there are 390million actual infections per year.