Autochthonous transmission of dengue virus in mainland EU/EEA, 2010-present

Dengue is an Aedes-borne disease widely distributed in tropical and subtropical regions. Globally, the virus is predominantly transmitted by the Ae. aegypti and Ae. albopictus mosquitoes. While Ae. aegypti is so far not established in mainland EU, Ae. albopictus is established in the southern and central parts of mainland EU and is spreading. 

Dengue is not endemic in mainland EU/EEA and the vast majority of the cases are travellers infected outside of mainland EU/EEA.  When the environmental conditions are favourable, in areas where Ae. albopictus is established, viraemic travel-related cases may generate a local transmission of the virus, as demonstrated by the sporadic events of dengue virus transmission since 2010.

Year

Country

Region, municipalities

Number of autochthonous cases

Probable period of virus circulation

Probable origin of the virus

Virus serotype

 

Mode of transmission

References

2010

Croatia

Korčula Island and the Pelješac peninsula

Two Croatian cases (and seven probable cases in same area with IgG and IgM positive)

One case among a German traveller. 

August–October

Unknown

DENV-1

Vector-borne transmission

[1-3]

2010

France

Alpes-Maritimes department, Nice

Two 

August–September

Martinique

DENV-1

Vector-borne transmission

[4-6]

2013

France

Bouches–du-Rhône department, Venelles

One 

September-October

Guadeloupe

DENV-2

Vector-borne transmission

[6,7]

2014

France

Var department, Toulon

One 

July-August

Unknown

DENV-1 (central America)

Vector-borne transmission

[6,8]

2014

France

Var department, Toulon

One 

August-September

Unknown

DENV-2 (Asia)

Vector-borne transmission

[6,8]

2014

France

Bouches-du-Rhône department, Aubagne

Two 

August–September

Thailand

DENV-2 (Asia)

Vector-borne transmission

[6,8]

2015

France

Gard department, Nîmes

Eight 

July–September 

French Polynesia

DENV-1

Vector-borne transmission

[6,9,10]

2018

France

Alpes Maritimes department, Saint-Laurent-du-Var

Five

September–October

Unknown

DENV-2 (Asia)

Vector-borne transmission

[6,11]

2018

France

Hérault department, Clapiers

Two

September–October 

Unknown

DENV-1 (central America)

Vector-borne transmission

[6,11]

2018

France

Gard department, Nîmes

One

September–October

French Polynesia

DENV-1 (Pacific)

Vector-borne transmission

[6]

2018

Spain

Murcia region or province of Cádiz

Five

August-September

Unknown

DENV-1

Vector-borne transmission

[11-13]

2018

Spain

Catalonia region

One

October

Unknown

DENV-1

Vector-borne transmission

[13]

2019

Spain

Catalonia region

One

September

Unknown

DENV-1

Vector-borne transmission

[14,15]

2019

France

Alpes-Maritimes department, Vallauris

Seven

August-September

Thailand

DENV-1

Vector-borne transmission

[15,16]

2019

France

Rhône department, Caluire-et-Cuire

Two

July

Cambodia

Unknown

Vector-borne transmission

[15,17]

2019

Germany

Not applicable

One

May

Not applicable

Unknown

Needle-related injury

[18]

2019

Spain

Municipality of Madrid

One

August-September

Cuba

DENV-1

Sexual transmission

[19]

2020

France

Hérault department, Cessenon-sur-Orb

One

July

Costa Rica

DENV-1

Vector-borne transmission

[20]

2020

France

Var department, la Croix Valmer

Three

July-August

Unknown

Unknown

Vector-borne transmission

[21-23]

2020

Italy

Veneto region, Montecchio Maggiore

Eleven

August

Indonesia

DENV-1

Vector-borne transmission

[24]

2020

France

Alpes-Maritime department, Nice

Five

August-September 

Réunion

DENV-2

Vector-borne transmission

[23,25,26]

2020

France

Gard department, Saint-Jean-de-Valériscle

One

August

Guadeloupe

Unknown

Vector-borne transmission

[23,27]

2020

France

Alpes-Maritime department, Saint-Laurent-du-Var

Two

September-October

Unknown

DENV-1

Vector-borne transmission

[23]

2020

France

Hérault department, Montpellier, or Gard department, Cabrières

One

August-September

Unknown

Unknown

Vector-borne transmission

[23,28]

2021

France

Var department, Toulon

One

July

 

Unknown

Unknown

Vector-borne transmission

[29]

DENV-1 and DENV-2: Dengue virus serotype 1 and 2, respectively.

The table combines information published in official reports and in the scientific literature plus information that was provided by the public health institutes and/or the ministries of health in the affected Member States.

References:

1.       Gjenero-Margan I, Aleraj B, Krajcar D, Lesnikar V, Klobucar A, Pem-Novosel I, et al. Autochthonous dengue fever in Croatia, August-September 2010. Euro Surveill. 2011 Mar 03;16(9).

2.       Kurolt IC, Betica-Radic L, Dakovic-Rode O, Franco L, Zelena H, Tenorio A, et al. Molecular characterization of dengue virus 1 from autochthonous dengue fever cases in Croatia. Clin Microbiol Infect. 2013 Mar;19(3):E163-5.

3.       Schmidt-Chanasit J, Haditsch M, Schoneberg I, Gunther S, Stark K, Frank C. Dengue virus infection in a traveller returning from Croatia to Germany. Euro Surveill. 2010 Oct 07;15(40).

4.       Vega-Rua A, Zouache K, Caro V, Diancourt L, Delaunay P, Grandadam M, et al. High efficiency of temperate Aedes albopictus to transmit chikungunya and dengue viruses in the Southeast of France. PLoS One. 2013;8(3):e59716.

5.       La Ruche G, Souares Y, Armengaud A, Peloux-Petiot F, Delaunay P, Despres P, et al. First two autochthonous dengue virus infections in metropolitan France, September 2010. Euro Surveill. 2010 Sep 30;15(39):19676.

6.       Franke F, Giron S, Cochet A, Jeannin C, Leparc-Goffart I, de Valk H, et al. Autochthonous chikungunya and dengue fever outbeak in mainland France, 2010-2018 [in French: Emergences de dengue et de chikungunya en France métropolitaine, 2010-2018]. Bull Epidémiol Hebd. 2019;19-20; 9 Jul 2019.

7.       Marchand E, Prat C, Jeannin C, Lafont E, Bergmann T, Flusin O, et al. Autochthonous case of dengue in France, October 2013. Euro Surveill. 2013 Dec 12;18(50):20661.

8.       Giron S, Rizzi J, Leparc-Goffart I, Septfons A, Tine R, Cadiou B, et al. New occurrence of autochthonous cases of dengue fever in southeast France, August-September 2014. Bull Epidémiol Hebd. 2014;13-14:217.

9.       Succo T, Leparc-Goffart I, Ferre JB, Roiz D, Broche B, Maquart M, et al. Autochthonous dengue outbreak in Nimes, South of France, July to September 2015. Euro Surveill. 2016 May 26;21(21).

10.     Succo T, Noel H, Nikolay B, Maquart M, Cochet A, Leparc-Goffart I, et al. Dengue serosurvey after a 2-month long outbreak in Nimes, France, 2015: was there more than met the eye? Euro Surveill. 2018 Jun;23(23).

11.     European Centre for Disease Prevention and Control (ECDC). Rapid Risk Assessment: Local transmission of dengue fever in France and Spain, 22 October 2018. Stockholm: ECDC, 2018.

12.     Monge S, Garcia-Ortuzar V, Lopez Hernandez B, Lopaz Perez MA, Delacour-Estrella S, Sanchez-Seco MP, et al. Characterization of the first autochthonous dengue outbreak in Spain (August-September 2018). Acta Trop. 2020 May;205:105402.

13.     Centro de Coordinación de Alertas y Emergencias Sanitarias. Primeros casos de dengue autóctono en España [in Spanish: First autochthonous cases of dengue in Spain}; November 2018 Madrid: Ministerio de Sanidad, Consumo y Bienestar Social.

14.     Agència de Salut Pública. L'Agència de Salut Pública confirma un altre cas de dengue autòcton a Catalunya [in Catalan: the public health agency confirms a new autochthonous case of dengue in Catalonia]; 18 September 2019 Barcelona: Agència de Salut Pública,;  [27 October 2020]. Available from: https://salutpublica.gencat.cat/ca/detalls/Article/Dengue-autocton.

15.     European Centre for Disease Prevention and Control (ECDC). Rapid risk assessment: Autochthonous cases of dengue in Spain and France, 1 October 2019. Stockholm: ECDC. Available from: https://www.ecdc.europa.eu/en/publications-data/rapid-risk-assessment-autochthonous-cases-dengue-spain-and-france.

16.     Santé publique France (SpF), Agence regionale de santé Provence-Alpes-Cote d'Azur (ARS PACA). Surveillance épidémiologique en PACA [in French: Epidemiological surveillance in PACA], 16 October 2019. Saint-Maurice: SpF. Available from: https://www.santepubliquefrance.fr/regions/provence-alpes-cote-d-azur-et-corse/documents/bulletin-regional/2019/surveillance-epidemiologique-en-paca.-point-au-16-octobre-2019.

17.     Santé publique France, Agence regionale de santé Auvergne-Rhone-Alpes. Surveillance épidémiologique en région Auvergne-Rhone-Alpes [in French: Epidemiological surveillance in the region Auvergne-Rhone-Alpes]; 14 October to 20 October 2019. Saint-Maurice: SpF. Available from: https://www.auvergne-rhone-alpes.ars.sante.fr/system/files/2019-10/PE_ARA_2019_23_bronchio_grippe.pdf.

18.     European Centre for Disease Prevention and Control. Dengue. In: Annual epidemiological report for 2019. Stockholm: ECDC, 2021.

19.     European Centre for Disease Prevention and Control (ECDC). Rapid Risk Assessment: Sexual transmission of dengue in Spain Stockholm: ECDC. Available from: https://www.ecdc.europa.eu/en/publications-data/rapid-risk-assessment-sexual-transmission-dengue-spain.

20.     Santé publique France, Agence régionale de santé Occitanie. Press release: Autochthonous case of dengue in the Hérault deparment [in French: un cas autochtone de dengue confirmé dans l’Hérault]; 31 July 2020. Montpellier: ARS Occitanie. Available from: https://www.herault.gouv.fr/content/download/34737/233309/file/2020_07_31_CP-Dengue-Cessenon-sur-Orb-34_V2-dm.pdf.

21.     Santé publique France, Agence régionale de santé Provence-Alpes-Côte d'Azur (ARS PACA). Press release: Un cas autochtone de dengue dans le Var [in French: Autochthonous case of dengue in Var]; 8 September 2020. Marseille: ARS PACA. Available from: https://www.paca.ars.sante.fr/un-cas-autochtone-de-dengue-dans-le-var.

22.     Vermeulen TD, Reimerink J, Reusken C, Giron S, de Vries PJ. Autochthonous dengue in two Dutch tourists visiting Departement Var, southern France, July 2020. Euro Surveill. 2020 Oct;25(39).

23.     Santé publique France. Chikungunya, dengue et zika - Données de la surveillance renforcée en France métropolitaine en 2020 [in French: Chikungunya, dengue and zika - Data from the enhanced surveillance in metropolitan France in 2020]; 26 October 2020 Saint-Maurice: SPF;  [Accessed on 27 October 2020]. Available from: https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-a-transmission-vectorielle/chikungunya/articles/donnees-en-france-metropolitaine/chikungunya-dengue-et-zika-donnees-de-la-surveillance-renforcee-en-france-metropolitaine-en-2020.

24.     Lazzarini L, Barzon L, Foglia F, Manfrin V, Pacenti M, Pavan G, et al. First autochthonous dengue outbreak in Italy, August 2020. Euro Surveill. 2020 Sep;25(36).

25.     Santé publique France, Agence régionale de santé Provence-Alpes-Côte d'Azur (ARS PACA). Press release: Cinq cas autochtones de dengue détectés à Nice [in French: Five autochthonous cases of dengue detected in Nice]; 18 September 2020. Marseille: ARS PACA. Available from: https://www.paca.ars.sante.fr/cinq-cas-autochtones-de-dengue-detectes-nice.

26.     Santé publique France, Agence régionale de santé Provence-Alpes-Côte d'Azur (ARS PACA). Press release: Cas de dengue dans les Alpes-Maritimes [in French: Case of dengue in Alpes-Maritimes]; 4 September 2020. Marseille: ARS PACA. Available from: https://www.paca.ars.sante.fr/cas-de-dengue-dans-les-alpes-maritimes.

27.     Santé publique France, Agence régionale de santé Occitanie. Press release: Un probable cas autochtone de dengue dans le Gard [in French: A probable case of dengue in Gard], 18 September 2020. Montpellier: ARS Occitanie; Available from: https://www.occitanie.ars.sante.fr/system/files/2020-09/2020_10_18_CP%20Dengue%20Gard.pdf.

28.     Santé publique France, Agence régional de santé Occitanie. Un cas autochtone fortement suspecté de dengue dans le Gard et l’Hérault [in French: a suspected autochthonous case of dengue in Gard and Hérault]; 14 October 2020. Montpellier: ARS Occitanie. Available from: https://www.occitanie.ars.sante.fr/system/files/2020-10/2020_10_14_CP%20Dengue%20Gard_Herault.pdf.

29.     Santé publique France, Agence régionale de santé Provence-Alpes-Côte d'Azur (ARS PACA). Press release: démoustication et surveillance renforcée après la détection d’un cas autochtone de dengue [in French: Var: Mosquito control and surveillance after detection of an autochthonous case of dengue]; 29 July 2021 Marseille: ARS PACA. Available from: https://www.paca.ars.sante.fr/var-demoustication-et-surveillance-renforcee-apres-la-detection-dun-cas-autochtone-de-dengue?fbclid=IwAR3Kh8aOHc6dvmNAyvCbBdQQafw1nSVjYlnHqb3p5DZXEBUMUy31kn_efrE