Abstract
BackgroundDengue is a disease with major impacts on public health in tropical and subtropical countries. In Europe, in the past decade, few autochthonous outbreaks were described.AimWe aimed to identify factors associated with frequency of dengue virus infection among European travellers and at assessing how surveillance data could support preparedness against autochthonous outbreaks within Europe.MethodsWe performed a descriptive analysis of travel-related dengue cases reported by European countries from 2015 through 2019. Using flight passenger data, we calculated travellers’ infection rates (TIR). We investigated the following associations: (i) between TIR and incidence rate in selected countries of infection and (ii) between number of travel-related cases and occurrence of autochthonous outbreaks within Europe.ResultsThere were 11,478 travel-related dengue cases and the TIR was 2.8 cases per 100,000 travellers. Most cases were infected in Asia (71%), predominantly in south-eastern Asia. The TIR was highest among travellers returning from Asia (6.1/100,000). There was an association between the incidence rate in the country of infection and the TIR but no association between the number of travel-related cases and occurrence of autochthonous outbreaks in Europe.ConclusionsThe likelihood of infection in travellers is a function of the ongoing epidemiological situation in the country of exposure. The number of travel-related cases alone is not sufficient to estimate the likelihood of autochthonous outbreaks where vectors are present in Europe. Additional contributing factors such as adequate vectorial capacity and suitable environmental conditions are required.
Highlights
Dengue is an Aedes-borne disease affecting primarily people in the tropics and subtropics
We used travel-related cases reported through The European Surveillance System (TESSy) of European Centre for Disease Prevention and Control (ECDC) [10]; data were extracted on 6 October 2020
A travel-related case was defined as an individual with a dengue virus infection acquired in a country other than the country of diagnosis
Summary
Dengue is an Aedes-borne disease affecting primarily people in the tropics and subtropics. We investigated the following associations: (i) between TIR and incidence rate in selected countries of infection and (ii) between number of travel-related cases and occurrence of autochthonous outbreaks within Europe. There was an association between the incidence rate in the country of infection and the TIR but no association between the number of travelrelated cases and occurrence of autochthonous outbreaks in Europe. The number of travel-related cases alone is not sufficient to estimate the likelihood of autochthonous outbreaks where vectors are present in Europe. Additional contributing factors such as adequate vectorial capacity and suitable environmental conditions are required
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