Vaccination against dengue fever in
of our practice in Munich.

Appointment travel medical consultation

We inform and vaccinate against dengue fever in Munich.

Below, we provide information on the protective measures you can take against infection/illness.

On the one hand, avoiding stings is a very effective protection.
However, the safest way is vaccination.

We will be happy to advise you on this in our practice in Munich.

In our practice in Munich, we usually have all travel medicine vaccines in stock.

Protection against dengue mosquitoes

Aedes mosquitoes are mainly diurnal. Avoiding stings is effective protection. No sting, no dengue fever.

As basic measures …

Wearing long, light-coloured, lightweight clothing and staying in mosquito-proof rooms is recommended. Air conditioning, closed windows or fly screens offer good protection. In addition, mosquito nets are particularly useful at night, especially in simple conditions. Nets made of synthetic materials (e.g. nylon) are much lighter and more space-saving than cotton nets, do not tend to mat and take on almost no foreign odours. A narrow mesh size of maximum 2mm, ideally 1.2mm, is important. It makes sense to use impregnated mosquito nets (e.g. with permethrin) or to impregnate them afterwards.

Repellents/skin protection:

Chemical mosquito protection in the form of creams, sprays or gels (repellents) has an excellent effect with very good tolerability, but should always be applied in sufficient quantity according to the manufacturer’s instructions and in good time. Depending on the active ingredient, the protection lasts a maximum of 6 to 8 hours, whereby the duration of action can be significantly reduced, especially in high humidity, heavy sweating or stays in water. If repellents are used together with sunscreen or skin care products, the repellent should always be applied last.

Clothing:

Waterproofing clothes is a useful additional protection. Many products can also be used on pregnant women and young children. With a single impregnation, a protection duration of up to 4 weeks can be achieved against insects and also lasts after washing.

Protection by vaccination

A vaccination against dengue fever will be licensed and available in Germany from February 2023. Besides mosquito protection, vaccination is the safest way to prevent infection and its consequences.

Vaccine:

It is a recombinant, live attenuated vaccine directed against all four serotypes of the dengue virus.

Vaccination schedule:

Vaccination is given 2 times at an interval of 3 months. Data indicate that even the first dose has some effect.

Effectiveness:

Overall efficacy against dengue infection in the pivotal studies, regardless of prior infection, was 80%, and efficacy against hospitalization was 90%. Efficacy also depends on the circulating serotype and is predominantly based on serotypes 1 and 2.

We will gladly advise you

For this purpose, make an appointment for a travel medicine consultation in our practice in Munich.

Appointment travel medical consultation

Dengue fever

The disease

Dengue fever has been ranked by WHO as one of the top 10 threats to global health.
Here you will find common questions and answers about the disease.

Dengue fever is transmitted by female Aedes aegypti (main vector) & Aedes albopictus mosquitoes. Since Aedes mosquitoes are predominantly diurnal but can also bite at dusk and dawn, and unlike malaria mosquitoes also live in urban areas, there is a risk almost always and everywhere in endemic areas. Any object in which water, including brackish water, can accumulate can become a breeding ground for the vectors.

Once infected, a mosquito can transmit the virus to humans for the rest of its life (up to four weeks) during its next blood meal and also vertically when laying eggs to your eggs and thus offspring.

Responsible for dengue fever is the dengue fever virus (DENV), which, like TBE, Japanese encephalitis or West Nile virus, belongs to the flaviviruses. It is a single-stranded RNA virus that isclassified into four closely related serotypes (DENV-1 through DENV-4).

The disease is transmitted in at least 128 countries and the number of cases has increased dramatically in the last 50 years.

Nearly 4 billion people are now at risk of dengue. Climate change, urbanization, and increasing mobility are expected to ensure rapid further spread of the pathogen via greater vector dispersal. It is estimated that 60% of the world’s population will be at risk of infection in 2080.

Over the past 20 years, the number of dengue fever cases reported in Germany under the Infection Protection Act has continued to rise. Nearly 1,200 illnesses were reported among travelers in 2019. Since only infections diagnosed in Germany are counted and not those in the country of travel, the number of unreported cases is probably much higher. Diseases without symptoms also occur and are not considered here.

In recent years, travelers from Southeast Asia, India and Central America have been the most affected. However, the risk changes from year to year in the individual countries.

In recent years, dengue infections have already occurred in previously unaffected European countries such as France, Portugal, Italy and Croatia.

No people have been infected in Germany so far. In principle, however, at least the vector would be available by now. Aedes albopictus has become widespread in some areas, especially along the A%5. An exciting overview of the presence of mosquitoes in Germany is provided here by the Mosquito Atlas: https: //mueckenatlas.com/

The main factors that determine the risk of infection are:

  • the prevalence and activity of dengue fever in the destination country
  • the duration of travel, i.e. the time spent in the risk area
  • the travel season, as e.g. mosquito activity is particularly high during the rainy season
  • The implementation of mosquito protection measures such as repellents, clothing, etc.

In principle, a secondary infection, i.e. a second illness with dengue fever, carries a higher risk of a severe course. This is where so-called antibody-dependent enhancement plays a role. In this case, antibodies are formed during the initial infection that do not optimally match the serotypes of the secondary infection and can even promote an excessive immune reaction here.

No. Even if the risk for a severe course is increased, one can still travel to risk areas. More details can be found in the statement of the German Tropical Medicine Society (DTG) Please click here.

After an incubation period of 4-6 days, fever and aching limbs usually set in This febrile phase lasts up to a week and turns into a critical phase. A skin rash is also common. Dengue fever should always be considered with a suitable travel history if the following symptoms are present:

High fever >40° and at least 2 of the following symptoms:

  • Severe headache
  • Pain behind the eyes
  • Muscle and joint pain
  • Nausea
  • Vomiting
  • Swollen lymph nodes
  • Skin rash

The critical phase is characterized by a decrease in fever and a possible transition to a severe course. The main focus here is on the loss of fluid from the vessels into the body (capillary leak) and a sometimes drastic reduction in blood platelets with a corresponding risk of bleeding. Warning signs of a severe course are:

  • Severe abdominal pain
  • Persistent vomiting
  • Fast breathing
  • Gum bleeding
  • Fatigue
  • Unrest
  • Hematemesis

The simplest diagnostic method is a rapid test for the NS! antigen, which becomes positive in the first days after infection. Antibodies are only detectable later in the course of the disease and thus often too late. PCR also plays a role in the early phase, but is usually not available.

There is no causative therapy available. The focus is on monitoring and, if necessary, the administration of fluids up to and including blood transfusions.

In particular, chronically ill people, people who are going through another infection at the same time, and women, especially those who are pregnant, are at increased risk.


<h2>Warning sign</h2>
<h3>for a severe dengue course are ...</h3>

Touch with the mouse pointer for more information.
Severe abdominal pain
Persistent vomiting
Fast breathing
Gum bleeding
Fatigue
Unrest
Hematemesis


<h2>To a dengue fever</h2>
<h3>should always be thought of ...</h3>

Touch with the mouse pointer for more information.

High fever >40° and at least 2 of the following symptoms:

Severe headache
Pain behind the eyes
Muscle and joint pain
Nausea
Vomiting
Swollen lymph nodes
Skin rash

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