Europe - Autochthonous transmission of dengue since 2010

[Gert van der Hoek]

last updated 9 Aug 2019

Dengue is a disease that is borne by Aedes mosquitoes and that is widely spread in tropical and subtropical regions. Globally, the virus is predominantly transmitted by Ae. aegypti and Ae. albopictus mosquitoes. While Ae. aegypti is so far not established in continental EU, Ae. albopictus is established in the southern and central parts of the EU and is spreading.

Dengue is not endemic in the EU/EEA and the vast majority of the cases are travellers infected outside of the EU/EEA. When the environmental conditions are favourable, in areas where Ae. albopictus is established, viraemic travel-related cases may generate a local transmission of the virus, as demonstrated by the sporadic events of dengue virus transmission since 2010.

2010	Croatia, Korčula Island and the Pelje?ac peninsula	One case among a German traveller. Two Croatian cases (and seven probable cases in same area with IgG and IgM positive)	August?October	Unknown	DEN-1	[1-3]
2010	France, Alpes-Maritimes department, Nice	Two	End August?September	Martinique	DEN-1	[4-6]
2013	France, Bouches?du-Rh?ne department, in the vicinity of Aix-en-Provence	One	October	Guadeloupe	DEN-2*	[6,7]
2014	France, Var department, Toulon	One	Early August	Unknown	DEN-1 (central America)	[6,8]
2014	France, Var department, Toulon	One	Early September	Unknown	DEN-2 (Asia)	[6,8]
2014	France, Bouches-du-Rh?ne department, Aubagne	Two	Late August?September	Unknown	DEN-2 (Asia)	[6,8]
2015	France, Gard department, N?mes	Eight	July?September	French Polynesia	DEN-1	[9,10]
2018	France, Alpes Maritimes department, Saint Laurent du Var	Five	September?October	Unknown	DEN-2 (Asia)	[6,11]
2018	France, H?rault department, Montpellier	Two	September?August	Unknown	DEN-1 (central America)	[6,11]
2018	France, Gard department, N?mes	One	October	French Polynesia	DEN-1 (Pacific)	[6]
2018	Spain, Murcia Region and possibly Province of C?diz	Five	August?September	Unknown	DEN-1	[11]

[Gert van der Hoek]

The Public Health Agency confirms another case of native dengue in Catalonia

09/17/2019

The Epidemiological Surveillance Urgency Service (SUVEC) of the Epidemiological Surveillance Network of Catalonia (XVEC) has received the notification of a case of autochthonous dengue confirmed by laboratory. The patient, resident in the Barcelon?s, discards any history of travel to areas where the transmission of the virus is endemic: most of the tropical and subtropical countries of Central America, the Caribbean, South America, Southeast Asia, South Pacific and in several countries in Africa.

The Monitoring and Control Protocol for mosquito-borne arboviruses in Catalonia was activated from the outset , and vector control measures - the tiger mosquito - are being implemented to prevent proliferation, as well as a Monitoring of mosquito viruses in order to prevent the appearance of new cases.

In Catalonia, every year there are reported cases of dengue cases in people affected by endemic areas in the XVEC, which makes possible the appearance of new autochthonous cases, mainly during the period of proliferation and maximum activity of mosquitoes (spring, summer and beginning of autumn). Since the year 2014, when the Protocol was launched, a total of 507 cases of dengue were detected in Catalonia, two of which are autochthonous; the first was last November and the second is the current case.

Although the risk of transmission to people is very low, given the beginning of the decrease in temperatures, it is necessary to think about the diagnosis of dengue in patients with a sudden picture of general malaise, high fever, headache and an eruption on the face that is spreading to the body, thorax and limbs. The patient in this native case required hospital admission and received the discharge two days later.

[Gert van der Hoek]

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France - Seven indigenous dengue cases in the Alpes-Maritimes

23 10 2019

In addition, seven indigenous cases of dengue fever have been identified in the Alpes-Maritimes and two others in the Rh?ne since 1 August 2019. According to the Directorate General of Health in a warning bulletin: " These are the first confirmed autochthonous dengue cases in the Auvergne-Rh?ne-Alpes region since the implementation of enhanced surveillance of arboviruses in this region 7 years ago ".

[Gert van der Hoek]

From Min of Health, France



Chikungunya, dengue and zika - Data on enhanced surveillance in metropolitan France in 2019

Updated on October 21, 2019


From May 1st to November 30th of each year, Public Health France coordinates the reinforced seasonal surveillance of chikungunya, dengue and Zika in the metropolitan departments colonized by the mosquito vector, Aedes albopictus, in connection with the ARS concerned (see monitoring and partners).

From May 1 to October 18, 2019:

529 imported cases of dengue fever, of which 16% had stayed on Reunion Island;
49 imported cases of chikungunya;
6 cases imported from zika;
9 indigenous cases of dengue fever;
2 indigenous cases of zika.
Two autochthonous dengue cases currently being confirmed have been reported in the Rhone department.

A focus of 7 indigenous dengue cases has been identified in the Maritime Alps.

Two indigenous cases of Zika virus infection have been identified in the department of Var.

For these two outbreaks of dengue fever in the Rhone and Alpes-Maritimes and the two cases infected with the Zika virus of the Var, epidemiological investigations were set up to identify other possible cases and to reinforce the preventive and protective measures. monitoring.
Health professionals in the sectors concerned were also made aware of the identification and reporting of possible other cases.
Mosquito control operators immediately carried out entomological investigations and carried out targeted mosquito control activities. These actions are systematically accompanied by a prior information campaign for local residents.

[Gert van der Hoek]

Autochthonous Dengue case - Spain - 2019

Opening date: 7 November 2019
Latest update: 8 November 2019

Epidemiological summary On 7 November, according to media quoting health authorities, Spain reported two confirmed cases of dengue in men who have sex with men (MSM) residing in the municipality of Madrid in September. The most recent detected case is a man who did not travel outside of Spain recently. He developed symptoms mid September and he was laboratory confirmed for dengue. This case is classified as autochthonous.

After confirmation of this case, his partner, a male who presented similar symptoms starting beginning of September, was tested and confirmed positive for dengue. This case had a recent travel history to Cuba and to the Dominican Republic at the end of August and beginning of September, this case is classified as imported. Entomological investigations at the place of residence of the men and surroundings were negative; no adult forms of Aedes albopictus were detected. The genetic sequencing confirmed that the virus strain of both cases is identical. Further investigations showed that the virus is also similar to dengue viruses circulating in Cuba.

ECDC assessment Spain assessment: In the absence of data supporting vectorial transmission or other known routes of exposure to dengue infection, we consider that the autochthonous case was most likely infected through sexual transmission. The experts in Spain could not identify any case of sexual dengue transmission among MSM in literature and only found a reported case of sexual transmission from a woman to a man in South Korea.

ECDC assessment: ECDC is not aware of any previous report of confirmed sexual dengue transmission among MSM. However, one scientific article describes a probable female-to-male sexual transmission of DENV. In an article published in Eurosurveillance, semen was found to be positive for dengue for 37 days post symptom onset. This mode of transmission for dengue is unusual and unexpected.