Dengue Fever (cont.)
How Can People Prevent Dengue Fever?
Dengue fever can be prevented by stopping mosquitoes from biting because they are the vectors the dengue viruses require for transfer to humans. The CDC has supplied these general rules to prevent transfer of viruses and other pathogens by mosquitoes and other biting vectors:
- Avoid outbreaks: To the extent possible, travelers should avoid known foci of epidemic disease transmission. The CDC Travelers' Health web page provides alerts and information on regional disease transmission patterns and outbreak alerts (http://www.cdc.gov/travel) or contact a travel medicine doctor (often an infectious-disease specialist).
- Be aware of peak exposure times and places: Exposure to arthropod bites may be reduced if travelers modify their patterns of activity or behavior. Although mosquitoes may bite at any time of day, peak biting activity for vectors of some diseases (for example, dengue, chikungunya) is during daylight hours. Vectors of other diseases (for example, malaria) are most active in twilight periods (for example, dawn and dusk) or in the evening after dark. Avoiding the outdoors or focusing preventive actions during peak hours may reduce risk. Place also matters; ticks are often found in grasses and other vegetated areas. Local health officials or guides may be able to point out areas with greater arthropod activity.
- Wear appropriate clothing: Travelers can minimize areas of exposed skin by wearing long-sleeved shirts, long pants, boots, and hats. Tucking in shirts and wearing socks and closed shoes instead of sandals may reduce risk. Repellents or insecticides such as permethrin (Elimite) can be applied to clothing and gear for added protection; this measure is discussed in detail below.
- Bed nets: When accommodations are not adequately screened or air conditioned, bed nets are essential to provide protection and to reduce discomfort caused by biting insects. If bed nets do not reach the floor, they should be tucked under mattresses. Bed nets are most effective when they are treated with an insecticide or repellent such as permethrin. Pretreated, long-lasting bed nets can be purchased prior to traveling, or nets can be treated after purchase. The permethrin will be effective for several months if the bed net is not washed. (Long-lasting pretreated nets may be effective for much longer.)
- Insecticides: Aerosol insecticides, vaporizing mats, and mosquito coils can help to clear rooms or areas of mosquitoes; however, some products available internationally may contain pesticides that are not registered in the U.S. Insecticides should always be used with caution, avoiding direct inhalation of spray or smoke.
- Optimum protection can be provided by applying repellents.
The CDC recommends insect repellent should contain up to 50% DEET (N,N-diethyl-m-toluamide), which is the most effective mosquito repellent for adults and children over 2 months of age.
There are no vaccines currently available commercially for dengue virus available in the U.S. However, Sanofi Pasteur has produced a dengue vaccine, Dengvaxia, designed to work against all four types of the virus. Unfortunately, it is only about 60% effective and approved for use in those 9-45 years of age who live in dengue-endemic areas. In addition, the CDC suggests that the vaccine is less effective against dengue virus types 1 and 2. Three countries have approved the vaccine for use: Mexico, Philippines, and Brazil. The vaccine has not been approved by the FDA for use in the U.S. to date (Jan. 5, 2016).
Medically Reviewed by a Doctor on 1/7/2016
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