British holidaymakers have been issued a fresh warning over the spread of 'bone-breaker fever' in Ibiza.
Two cases of dengue fever thought to be acquired locally have sparked concerns that the virus is spreading under the radar.
Experts fear dozens more could be sickened, warning that mosquitos carrying the illness become rife in April.
Dengue, given its nickname because of the agonising pain it inflicts on sufferers, is typically found in tropical parts of the world, such as parts of Africa, Asia and South America.
It infects an estimated 400million people per year, killing about 40,000.
The Balearic island, famed for its raucous parties and sun-kissed beaches, attracts millions of tourists every year. Neither of the two cases were proven to be locally-acquired, researchers wrote in the Euro Surveillance journal. But the evidence suggests both were, according to the team
The biting insect, which feeds through the day, has already spread across much of Europe in recent years — including in France , Spain and Italy — as warmer conditions have helped it travel alongside humans or through the transportation of goods
WHO chiefs say it poses a 'pandemic threat'.
Virologists say citizens need to be aware of the potential spread of dengue fever in Ibiza.
The Balearic island, famed for its raucous parties and sun-kissed beaches, attracts millions of tourists every year.
Neither of the two cases were proven to be locally-acquired, researchers wrote in the Euro Surveillance journal.
BUGGING OUT: THE THREAT OF DENGUE FEVER
Dengue is a viral infection spread by mosquitoes.
It is caught by people visiting or living in Asia, the Caribbean, and North, South or Central America.
Mosquitoes in the UK do not spread the virus.
In most cases, the infection is mild and passes in around a week.
Symptoms usually include:
- Fever
- Severe headache
- Pain behind the eyes
- Muscle and joint pain
- Nausea and vomiting
- Widespread rash
- Abdominal pain
- Loss of appetite
There is no cure or specific treatment.
Patients can relieve their symptoms via painkillers, staying hydrated and resting.
In rare cases, dengue symptoms can develop into severe dengue.
Elderly patients, or those with other medical conditions, are most at risk.
Severe dengue fever symptoms can include:
- Severe skin bleeding with spots of blood on and under the skin
- Blood in the urine and stools
- Respiratory distress - when the lungs cannot provide the vital organs with enough oxygen
- Organ failure
- Changes in mental state and unconsciousness
- Dangerously low blood pressure
Severe dengue is usually treated via a blood and platelet transfusion, IV fluids for rehydration and oxygen therapy if levels are low.
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But the evidence suggests both were, according to the team.
The two cases in German holidaymakers, who both travelled separately, occurred in 2022.
Positive laboratory tests confirmed the disease in 2023, which made headlines at the time.
Neither patient's name or age was recorded by the researchers. But local reports at the time said they were in their 20s and 30s.
Issuing the new alert, experts noted that the first — who visited the island for a week in August — developed symptoms synonymous with the infection — a fever, rash and joint pain —the day they returned to Germany.
The patient logged a positive denguetest result eight days later.
One of their travel companions also experienced a fever and runny nose.Another suffered with a sore throat, runny nose and joint pain.
Neither underwent tests as they didn't require any healthcare assistance.
The second case travelled from Germanyto the same town in Ibiza, in early October for just under three weeks.
They developed similar symptoms the day after returning home, with a positive test confirmed five days later.
Two family travel companions also reported signs of the infection days later.
Again, however, they did not undergo diagnostic tests.
But the family admitted they had suffered mosquito bites at their accommodation on the island.
The second case had also spent two weeks in a 'dengue-endemic country' before heading to Ibiza.
Writing in the journal, experts said evidence suggests 'the most likely transmission was through mosquito bites, but other possibilities cannot be totally excluded'.
They added: 'Although the source case assured that they had not been bitten by mosquitoes and that they had spent the entire symptomatic period at home, it is possible that the bites went unnoticed.
'The lack of detection of additional cases in Ibiza residents, especially during the temporal gap between the two German cases, suggests that some cases probably linked to this outbreak may have gone undetected.
'It is very important to increase the awareness of detection of dengue cases in Spain and other European countries.'
Dengue has caused outbreaks of illness throughout history, with the first known to have occurred in 1635 in the West Indies.
It hit Europe in 2010 and was firstdetected in Ibiza in 2014.
Latest data from the European Centre for Disease Prevention and Control (ECDC) shows 71 cases of locally-acquired dengue were reported in 2022, with 65 in France and six in Spain.
Experts fear dozens more could be sickened, warning that mosquitos carrying the illness become rife in April. Dengue, nicknamed 'bone-breaker fever' because of the agonising pain it inflicts on sufferers, is typically found in tropical parts of the world, such as parts of Africa, Asia and South America
The toll is equivalent to the total reported in the decade prior.
Some people who are infected with dengue won't develop symptoms. But for those who do, they usually start four to ten days after being bitten by an infected mosquito.
They include a fever, severe headache, pain behind the eyes, muscle and join pain, feeling and being sick and a blotchy rash that is made up of raised spots.
Most people recover without treatment within days.
However, some develop a severe form of the disease. This can trigger tummy pain, repeated vomiting, fast breathing, bleeding gums or nose and extreme tiredness.
While there is no treatment, sufferers are kept in hospital until they recover. Resting, drinking plenty of fluids and taking paracetamol are recommended.
Dengue is among a number of diseases experts have warned will eventually become established in Britain thanks to climate change making the UK more hospitable to their carriers.
Transmission of the virus, as opposed to imported cases, has become an increasing health concern in Europe as it marches north from the tropics.
