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.

*Travel, Adult, Aged, Antibodies, Viral/*isolation & purification, Asia, Dengue/*epidemiology/physiopathology, Enzyme-Linked Immunosorbent Assay, Female, Humans, Immunoglobulin M/immunology, Incidence, Male, Middle Aged, Netherlands/epidemiology, Questionnaires, Risk Factors, Seasons
dx.doi.org/10.1046/j.1365-3156.2002.00864.x, hdl.handle.net/1765/3855
Tropical Medicine & International Health
Erasmus MC: University Medical Center Rotterdam

Cobelens, F.G.J, Groen, J, Osterhaus, A.D.M.E, Leentvaar-Kuipers, A, Wertheim-van Dillen, P.E.M, & Kager, P.A. (2002). Incidence and risk factors of probable dengue virus infection among Dutch travelers to Asia. Tropical Medicine & International Health, 7(4), 331–338. doi:10.1046/j.1365-3156.2002.00864.x