Damon Mcknight
Dengue fever is a viral disease spread by mosquitoes in tropical and subtropical regions. It is not endemic to Australia, but outbreaks have occurred due to the importation of the virus by tourists or returning residents. North Queensland is currently the only area with the potential for indigenous (epidemic) dengue fever in Australia, with outbreaks occurring in the 1980s, 1990s, and as recently as 2019. Aedes aegypti mosquitoes, which spread dengue fever, were once widely distributed in northern Australia but are now largely restricted to a small area of northern Queensland, thanks to interventions by the World Mosquito Program and local authorities.
| Characteristics | Values |
|---|---|
| Areas with potential for dengue fever in Australia | North Queensland |
| Areas with Aedes aegypti mosquitoes in Australia | Parts of Queensland, previously as far south as the Victorian border in eastern Australia and south of Perth in Western Australia |
| Areas with Aedes albopictus mosquitoes in Australia | Islands of the Torres Strait |
| Dengue fever in Australia | Not endemic, but among the most frequently imported infections |
| Dengue fever vaccine availability in Australia | Currently unavailable |
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What You'll Learn
Dengue fever in North Queensland
Dengue fever is a viral disease spread by mosquitoes in tropical and subtropical regions. The Aedes aegypti mosquito is the main vector for transmitting dengue fever and is found in many tropical countries, including north and central Queensland and some areas of southern Queensland. The Asian Tiger mosquito, or Aedes albopictus, is another type of mosquito that can spread dengue fever but is currently only found in the Torres Strait, although it may spread to the mainland.
In the past, Aedes aegypti mosquitoes were found across Queensland, in parts of the Northern Territory and northern New South Wales. By the 1970s, they were restricted to a small area of northern Queensland, and epidemic dengue returned to this region in 1981–82. Other outbreaks occurred in the 1990s, with the mosquitoes spreading westwards towards the Northern Territory border and the New South Wales border.
North Queensland is currently the only area in Australia with the potential for indigenous (epidemic) dengue fever. The World Mosquito Program's long-lasting Wolbachia method has successfully stopped dengue transmission in Cairns and surrounding locations in northern Queensland, with a 93% reduction in reported cases. However, dengue outbreaks can still occur annually in north and central Queensland, and it is important for residents and tourists to know how to protect themselves and prevent the spread of the disease.
Dengue fever typically presents as an acute febrile illness with a sudden onset and is extremely debilitating. The fever lasts 3–5 days and is accompanied by myalgia (especially backache), arthralgia, retro-orbital pain, anorexia, gastrointestinal disturbance, rash, and increased vascular permeability. Early diagnosis, within 5 days of illness onset, can be made through polymerase chain reaction (PCR) testing, while later diagnosis can be made through IgM detection and a second blood test for IgG seroconversion.
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Aedes aegypti mosquitoes in Australia
Aedes aegypti mosquitoes are not native to Australia but arrived from Africa over a century ago. They are currently found in central and northern Queensland, although they were previously present in New South Wales, the Northern Territory, Western Australia, and Victoria. The female Aedes aegypti mosquito is known to transmit dengue fever, as well as chikungunya and Zika viruses.
Historically, Aedes aegypti mosquitoes were widely distributed in northern Australia, reaching as far south as the Victorian border in the east and south of Perth in Western Australia. By the 1970s, their range had contracted to a small area of northern Queensland, the only region in Australia with the potential for indigenous (epidemic) dengue fever.
Outbreaks of dengue fever in Australia have typically been caused by the importation of the virus by infected tourists or returning residents. However, the Aedes aegypti mosquito's presence in Queensland poses a risk of local transmission. In 2011, health authorities in Gin Gin, Queensland, discovered Aedes aegypti larvae during routine surveillance. This discovery prompted larval habitat and adult control interventions to eliminate the mosquito population and prevent the spread of exotic diseases.
To prevent the establishment of Aedes aegypti mosquitoes and the associated risks of dengue fever and other arboviral diseases, Australian health authorities employ various strategies. These include community engagement, traditional mosquito control methods, population genetics analysis, and novel surveillance tools. Additionally, biosecurity officers play a crucial role in intercepting exotic mosquitoes at airports and other points of entry.
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Dengue as an imported infection
Dengue fever is not an endemic disease in Australia, and outbreaks that have occurred have been due to the virus being brought in by tourists or returning residents. The Aedes aegypti mosquito, the primary vector for dengue fever, was once found across Queensland, in parts of the Northern Territory, and in northern New South Wales. By the 1970s, its range had contracted to a small area of northern Queensland, the only area in Australia with the potential for indigenous (epidemic) dengue fever.
The Asian Tiger mosquito, or Aedes albopictus, is another vector for dengue fever. This species is currently only found in the Torres Strait, but there is a significant risk that it will spread to mainland Queensland.
Imported dengue trends reflect both Australian travel destinations and patterns and local epidemiology in endemic countries. Increased holiday and business travel to dengue-endemic countries has made it easier for the disease to spread from country to country, and the number of dengue cases worldwide is increasing annually.
Between 2012 and 2022, 13,343 dengue cases were reported in Australia, of which 12,568 (94.2%) were imported. To prevent the local spread of imported dengue cases, it is important to rapidly diagnose the disease in returning residents and tourists.
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Dengue prevention in Australia
Dengue fever is a viral disease spread by the bites of certain mosquitoes, most commonly the Aedes aegypti mosquito, also known as the "dengue mosquito". The disease has been found in northern Australia, particularly in North Queensland, which is currently the only area with the potential for indigenous (epidemic) dengue fever in the country. Other outbreaks have occurred due to the virus being imported by tourists or returning residents.
To prevent the spread of dengue fever in Australia, it is important to rapidly diagnose the disease in returning residents and tourists to prevent local spread in receptive areas. Early diagnosis (within 5 days of illness onset) can be done through polymerase chain reaction (PCR) testing, while later diagnosis can be conducted through IgM detection and a second blood test to check for IgG seroconversion.
In the event of a person being found to have acquired dengue fever in Australia, the following measures may be implemented:
- Search for and eliminate breeding sites of Aedes aegypti mosquitoes in urban areas.
- Educate the public via mass communication.
- Use mosquito repellents, mosquito nets, and other methods of personal protection.
- Control Aedes aegypti mosquitoes near airports to prevent their importation.
To protect yourself from dengue fever, it is important to prevent mosquito bites, especially in areas with a higher risk of mosquito-borne diseases, such as Central and Far North Queensland. Here are some ways to avoid mosquito bites:
- Wear loose, long-sleeved, light-coloured clothing, including socks and covered shoes. Mosquitoes can bite through tight clothing.
- Use mosquito repellent on exposed skin, containing DEET, picaridin, or oil of lemon eucalyptus.
- Regularly check and empty any containers of still water around your home, such as pot plant saucers, as mosquitoes breed in still water.
- Use window screens or air conditioning.
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Dengue symptoms and treatment
Dengue fever is a viral disease transmitted by mosquitoes in tropical and subtropical climates. The Aedes aegypti mosquito is the primary vector for the dengue virus, and the risk of mosquito infection is higher when a patient has a high fever and high viremia. Notably, the Aedes aegypti mosquito was once prevalent in northern Australia, reaching as far south as the Victorian border in the east and south of Perth in Western Australia. However, by the 1970s, its range had shrunk to a small area in northern Queensland, the only region in Australia with the potential for indigenous (epidemic) dengue fever today.
Dengue fever typically manifests as an acute febrile illness with a sudden onset. The fever lasts for about 3–5 days and is accompanied by myalgia (especially backache), arthralgia (break-bone), retro-orbital pain, anorexia, gastrointestinal issues, a rash, and increased vascular permeability. While most people infected with dengue do not exhibit symptoms, those who do usually experience high fever, headache, body aches, nausea, and a rash.
There is currently no specific treatment for dengue fever or severe dengue. The primary focus of management is pain control with medications such as acetaminophen (paracetamol). It is important to avoid non-steroidal anti-inflammatory drugs like ibuprofen and aspirin, as they can increase the risk of bleeding. Most cases of dengue fever can be managed at home with pain medication. However, severe dengue cases may require hospitalization.
Early detection and access to proper medical care are crucial in lowering fatality rates associated with severe dengue. While most people recover within 1–2 weeks, some may experience fatigue for several weeks after recovery. To prevent dengue, it is essential to avoid mosquito bites, especially during the day, as this is when mosquitoes are most active. Additionally, in areas where dengue fever is present, measures such as eliminating mosquito breeding sites, using mosquito repellents and nets, and controlling mosquito populations near airports are crucial to prevent the spread of the disease.
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Frequently asked questions
Dengue fever is not endemic to Australia, and outbreaks are usually due to the importation of the virus by tourists or returning residents. However, North Queensland is currently the only area with the potential for indigenous (epidemic) dengue fever in Australia.
Dengue fever is spread by the bite of a mosquito. Not all mosquitoes can spread the dengue virus, and the risk is limited in Australia due to the low prevalence of Aedes aegypti and Aedes albopictus mosquitoes.
Symptoms of dengue fever typically include rash, fever, chills, headache, muscle and joint pain, and fatigue. More severe symptoms may include the presence of blood in vomit, bleeding gums, and breathing difficulties.
There is currently no vaccine for dengue fever in Australia, so mosquito avoidance is crucial. Use mosquito repellents, mosquito nets, and other methods of personal protection.
Dengue infection must be confirmed via a blood test. Most people will recover on their own, but it is important to stay hydrated and manage pain. If more severe illness occurs, seek urgent medical care.
