Abstract
In October 2013, a locally-acquired case of dengue virus (DENV) infection was reported in Western Australia (WA) where local dengue transmission has not occurred for over 70 years. Laboratory testing confirmed recent DENV infection and the case demonstrated a clinically compatible illness. The infection was most likely acquired in the Pilbara region in the northwest of WA. Follow up investigations did not detect any other locally-acquired dengue cases or any known dengue vector species in the local region, despite intensive adult and larval mosquito surveillance, both immediately after the case was notified in October 2013 and after the start of the wet season in January 2014. The mechanism of infection with DENV in this case cannot be confirmed. However, it most likely followed a bite from a single infected mosquito vector that was transiently introduced into the Pilbara region but failed to establish a local breeding population. This case highlights the public health importance of maintaining surveillance efforts to ensure that any incursions of dengue vectors into WA are promptly identified and do not become established, particularly given the large numbers of viraemic dengue fever cases imported into WA by travellers returning from dengue-endemic regions.
Highlights
Dengue fever is caused by a mosquito-borne flavivirus, dengue virus (DENV), and is responsible for a significant disease burden globally with an estimated 390 million cases of dengue fever per annum, of which 96 million result in symptomatic disease [1]
Dengue fever transmission in Western Australia ceased in the 1940s and there are currently no known dengue vector species present
A comprehensive follow-up investigation was undertaken and while the dengue case was confirmed, no other cases were identified and not exotic dengue vector mosquitoes were detected around the location of exposure
Summary
Dengue fever is caused by a mosquito-borne flavivirus, dengue virus (DENV), and is responsible for a significant disease burden globally with an estimated 390 million cases of dengue fever per annum, of which 96 million result in symptomatic disease [1]. In recent decades there has been a resurgence of dengue fever in many tropical and sub-tropical regions following the re-introduction of the primary mosquito vector species Aedes (Stegomyia) aegypti (L.) [4]. Transmission of DENV in Australia is currently restricted to urban areas of north Queensland and the Torres Strait where Ae. aegypti remains well established and outbreaks regularly occur following importations of dengue viruses by returning travellers infected overseas [5,6,7]. Recent incursions of Ae. aegypti into towns in the Northern Territory have occurred, but the vectors were eliminated without any dengue activity being detected [8,9,10]. Other potential vectors of dengue, such as Aedes (Stegomyia) albopictus (Skuse), are not present in WA and no native mosquito species are known to have the potential to transmit DENV
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