Dengue 'green book' chapter published

A new dengue chapter in the 'green book' (Immunisation against infectious disease) has been published

UK Health Security Agency has published new guidance on dengue vaccination in the 'green book' (Immunisation against infectious disease: Dengue. Chapter 15a). NaTHNaC encourage health professionals providing travel health services to read this new chapter in full.

In the UK, the Qdenga^® vaccine is currently recommended only for those with previous dengue infection. The objective is primarily to provide those who are at risk of dengue, and have already experienced dengue infection in the past, with protection from a secondary (and potentially more severe) infection.

Important points for clinical practice include:

• Qdenga^® is the only licensed dengue vaccine available in the UK; it is a live attenuated vaccine.
• Two doses of Qdenga^® should be given three months apart. Protection starts 14 days after the first dose.
• Currently in the UK, Qdenga^® vaccine can be considered for at risk individuals aged 4 years and over who have had dengue infection in the past.
• Qdenga^® vaccination is contraindicated for individuals who are under 4 years of age, pregnant, breastfeeding, immunocompromised (see chapter 6 of the 'Green Book') and those who have had a confirmed anaphylaxis reaction to a previous dose of the vaccine or any of the components of the vaccine.
• An algorithm at figure 1, and table 1 are available to help assess if a traveller is a suitable candidate for this vaccine.

Dengue is a viral infection spread by mosquitoes which mainly feed during daytime hours. There are four distinct serotypes of dengue virus: DENV 1, DENV 2, DENV 3 and DENV 4. Most people with dengue have mild or no symptoms and will get better in 1-2 weeks. Occasionally dengue infection develops into a more serious life-threatening illness. Severe dengue is rare in travellers. However, there is an increased risk of severe dengue with the second dengue infection.

Insect bite avoidance should be recommended for all travellers visiting risk areas, regardless of whether they have received a dengue vaccine.

NaTHNaC are in the process of reviewing other dengue resources. These will be posted on TravelHealthPro in due course.

For information on the dengue risk in individual countries please go to our Country Information pages.