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What is dengue: protect yourself from dangerous Aedes albopictus mosquito bites

Dengue, a tropical disease transmitted by mosquitoes, is making its appearance in the Italian tabloids, raising concerns about possible outbreaks in the country.

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Dengue is a viral disease transmitted to humans through the bite of infected mosquitoes, mainly of the Aedes aegypti species and, to a lesser extent, Aedes albopictus. The disease is particularly widespread in tropical and subtropical regions, but recent climate change and globalisation have led to its appearance in temperate areas too, raising concern about possible cases in Italy.

The dengue virus belongs to the Flaviviridae family and comes in four different serotypes, which can cause anything from classic dengue fever to haemorrhagic fever, a more severe form of the disease. Dengue is endemic in more than 100 countries in Africa, the Americas, the Eastern Mediterranean, South-East Asia and the Western Pacific. It was originally thought to be confined to tropical and subtropical areas because of the preferred habitat of the vector mosquitoes. In recent years, however, cases of dengue have also been reported in Europe, including Italy, mainly following travel to endemic areas.

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Dengue cases in Italy

In Italy, dengue cases are mainly imported, that is, they involve people who contracted the virus while travelling in countries where the disease is endemic. However, the presence of the Aedes albopictus mosquito, commonly known as the tiger mosquito, which is able to transmit the virus, raises concerns about possible local outbreaks. In Italy, 347 cases were recorded in 2023, of which 82 were locally transmitted (Source: ISS).

Transmission

Dengue is transmitted through the bite of an infected mosquito that has previously fed on the blood of a person infected with the virus. After an incubation period in the vector, the virus is able to infect a new human host. It is not transmitted directly from person to person.

Symptoms of dengue

Symptoms of dengue appear between 3 and 15 days after the bite and include:

  • Sudden onset of high fever (up to 40°) and chills, headache, retro-orbital pain (behind the eyes), back pain and joint pain
  • Leg and joint pain, sometimes so intense that the disease is called “breakbone fever”
  • Redness of the conjunctiva and eyelids
  • Light pink maculopapular rash, especially on the face
  • Enlarged lymph nodes
  • Rare neurological symptoms such as encephalopathy, seizures and, occasionally, Guillain-Barré syndrome

The more severe form, haemorrhagic fever, can also develop, especially in children under 10. It presents with bleeding such as bruising, petechiae (skin manifestations), epistaxis (nosebleeds), haematemesis (bloody vomit) and melaena (dark stools).

Dengue is rarely fatal. Mild cases recover in less than 72 hours. The fever usually drops suddenly after 48-96 hours, and it may return after another 24 hours of feeling well.

Immunity is lasting against the specific strain contracted, while broad-spectrum immunity against other strains lasts only 2-12 months.

Diagnosis is generally made through serological tests.

Treatment

There is no specific treatment for dengue. Managing the symptoms mainly involves rest, drinking plenty of fluids and using antipyretics to control fever and pain. It is important to avoid aspirin, which can increase the risk of bleeding. In more serious cases, hospitalisation may be necessary to manage the symptoms and prevent complications.

Prevention is based mainly on controlling mosquito populations and on personal protection from bites.

In short, although dengue is mainly associated with warmer climates, it is showing signs of potentially spreading in Italy too. Prevention through mosquito surveillance and protection from bites remains the most effective strategy against this emerging health threat.

Warning! This article does not claim to be a medical text and is for information purposes only. If you have worrying symptoms or are concerned about your health, always consult your doctor or the healthcare facilities in your area. Do not improvise and do not self-diagnose.

sources: ISS , MSD manuals

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