Free Content Incidence and risk factors of probable dengue virus infection among Dutch travellers to Asia

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We studied the incidence of dengue virus (DEN) infections in a cohort of Dutch short-term travellers to endemic areas in Asia during 1991–92. Sera were collected before and after travel. All post-travel sera were tested for DEN immunoglobulin M (IgM) [IgM capture (MAC)-enzyme-linked immunosorbent assay (ELISA)] and IgG (indirect ELISA). Probable DEN infection was defined as IgM seroconversion or a fourfold rise in IgG ratio in the absence of cross-reaction with antibody to Japanese encephalitis virus (JEV). Infections were considered clinically apparent in case of febrile illness (> 24 H) with headache, myalgia, arthralgia or rash. Probable DEN infection was found in 13 of 447 travellers (incidence rate 30/1000 person-months, 95% CI 17.4–51.6). One infection was considered secondary; no haemorrhagic fever occurred. The clinical-to-subclinical infection rate was 1 : 3.3. The risk of infection showed marked seasonal variation. DEN infections are frequent in travellers to endemic areas in Asia; most remain subclinical.

Keywords: dengue; epidemiology; travel

Document Type: Original Article


Affiliations: 1: Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, Amsterdam, The Netherlands, 2: Laboratory of Exotic Viral Infections, Institute of Virology, Erasmus Medical Center, Rotterdam, The Netherlands, 3: Department of Infectious Diseases, Section of Public Health and Environment, Municipal Health Service, Amsterdam, The Netherlands, 4: Department of Clinical Virology, Academic Medical Center, Amsterdam, The Netherlands

Publication date: April 1, 2002



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