What is dengue?

Dengue is a viral infection transmitted by mosquitoes. Symptoms of dengue include the abrupt onset of fever, shivering, severe headache (especially behind the eyes), and often characteristic muscle and joint pains. This is why it is also known as ‘breakbone fever’. People with dengue generally get better on their own within a few days, but in some cases, the infection develops into severe dengue. This is called dengue hemorrhagic fever and can become life-threatening if not treated.

How often can you contract dengue?

You can become infected with dengue fever more than once. In fact, there are four different types (strains) of dengue. Once you have been infected with one strain of the dengue virus, you will build up lifelong immunity to that strain, but not for the other strains. This means that you can contract dengue several times. A second infection increases the risk of serious complications. A third or forth infection decreases the risk.

How do you catch dengue fever?

The infection is transmitted through the bite of an infected Aedes mosquito, in particular the yellow fever mosquito (Aedes aegypti) and the Asian tiger mosquito (Aedes albopictus). These mosquitoes bite during daylight hours and can also transmit the chikungunya and Zika viruses. These mosquitoes are found in areas close to human habitation. They breed in water-filled containers such as old car tires, empty cans, barrels, buckets, flower vases, gutters, etc.

How serious can dengue be?

Most people (up to 80%) with dengue infections are asymptomatic. Those who do develop symptoms will usually experience something like flu, with a high fever, headache, muscle and joint pain, and red skin rashes. Nausea, vomiting, and diarrhea may also occur.

In some cases, the infection develops into severe dengue: dengue hemorrhagic fever. This is uncommon. In these cases, bruising, bleeding nose or gums, restlessness, and thirst will then also occur in addition to the symptoms already mentioned. Hemorrhage and shock can also occur. This can be fatal. Dengue hemorrhagic fever occurs almost exclusively in travelers who have previously had dengue.

How common is severe dengue among travelers?

It is estimated that 90 million people worldwide become ill every year, of whom 500,000 become seriously ill, particularly children. In the Netherlands, dengue only occurs among travelers returning from abroad. About 150 infections are reported in the Netherlands every year, of which a few cases will develop serious complications. 

How effective is the new dengue vaccine?

The new vaccine prevents infection in about 80% of cases and, most importantly, offers good protection against severe (hemorrhagic) dengue infection. It prevents 95% of hospital admissions due to dengue.  

How many vaccines are needed?

The vaccination consists of a series of two doses, with the second dose being given after three months. It is important to get both doses.

How long will the vaccine protect you?

The duration of protection is currently unknown.

When should you get vaccinated?

The vaccine is particularly important for people who have already had dengue and are traveling to regions where dengue is endemic. The risk of severe infection is higher for these people. People who have not had dengue may be advised to get vaccinated. This depends on your medical history, travel duration and whether you can complete the two-shot series before your trip.

The vaccine is not given to children under the age of four, pregnant women, breastfeeding women, or people with immune disorders. Moreover, it is important that you are able to complete the whole series, which means that you will need to get your first dose more than three months before departure.

What does the vaccine cost?

The dengue vaccination costs €124.95 per shot.

What else can you do to prevent infection?

The mosquitoes that transmit dengue bite during the day, between sunrise and sunset. Make sure you protect yourself from bites in the meantime:

• Wear as much covering clothing as possible.
• Use a mosquito repellent on uncovered skin that contains at least 30% DEET or a mosquito repellent with Icaridin.
• Keep your room free of mosquitoes and always use a mosquito net if available.
• Use a mosquito net during the afternoon rest and for babies. Are you in a malaria area? Then definitely use the mosquito net at night as well. 

Additional information on dengue

• Read the information on the page about dengue.
• See the vaccination advice for your destination on the Travel Advice by country page.