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Dengue Fever: A Comprehensive Traveler’s Guide

Whether you’re traveling to the Kingdom of Thailand for vacation, or you live here full time, there’s no doubt that you want to avoid contracting any tropical diseases.

The one disease that springs to mind when people are planning a trip to Thailand is malaria. Some people take a course of tablets to prevent the disease, while others simply take care in  high risk areas.

But there is another mosquito-borne risk that many people aren't aware of – dengue fever.

Dengue fever is a mosquito-borne tropical disease caused by the dengue virus, and one that can seriously ruin your holiday. up

To help you avoid catching the virus, and to understand what to do if you are hit with a bout of dengue, I've created a comprehensive guide containing everything you need to know.

dengue-fever-thailand

1. What is Dengue Fever and what causes it?

Dengue (pronounced ‘den’-’gee’) Fever is a viral infection caused by four different strains of viruses (DENV-1, DENV-2, DENV-3, DENV-4) that all belong to the Flaviviridae grouping.

The strains are carried by infected Aedes aegypti and Aedes albopictus female mosquitoes and are passed to humans during routine mosquito bites.

It’s important to note that these species of mosquito are present both in and out-of-doors, thrive particularly in shallow, stagnant water (like puddles, ponds, containers, and water tanks), and often bite between the hours of dawn and dusk.

Dengue is present in over 100 countries and is most present in tropical and subtropical climates, accounting for over 100 million clinical cases per year.

Outbreaks tend to occur seasonally (following the life-cycle patterns of breeding mosquitoes) and are often the second-most common ailment in travelers to warm, humid climates.

2. Where is Dengue Fever found?

Dengue is not found in most European and North American countries; it is commonly relegated to more tropical climes, and can occur in places like: Southeast Asia, the Caribbean, the Indian subcontinent, South and Central America, Africa, the Pacific Islands, and even Australia, New Zealand, and Fiji.

Because Thailand is home to both tropical climates and an abundance of still water sites, infected mosquitoes remain an issue in the Kingdom, so exercise caution when visiting during peak periods.

3. Where is dengue most common in Thailand?

The virus is endemic in the country, and risk exists in both urban and rural districts of the Kingdom, with an increased risk warning for the northeastern area of Thailand, though areas of the country’s southernmost coast have been hit hard this year.

In 2018, the province of Phuket recorded the highest per-capita infection rate in Thailand with 93.34 cases for every 100,000 people. The island saw 357 hospital-confirmed cases.

In 2019 (thus far), there have been 28,785 cases, 43 of whom died.

4. What is the best time to travel to avoid Dengue?

Travelers to Thailand should take care to avoid the country’s rainy season, which lasts from April until December. Rainy season is also prime mosquito season.

5. What are the symptoms of Dengue Fever?

There are three different types of dengue fever that vary in severity: uncomplicated dengue fever, dengue hemorrhagic fever (DHS), and dengue shock syndrome (DSS).

Most who contract the disease from an infected bite suffer from uncomplicated dengue fever, and may notice symptoms four to 10 days after becoming infected.

These symptoms may include: high temperature/fever (which can reach 40C/104F or even higher), pain behind the eyes, extreme muscle and joint pain, bad headaches, stomach upset or nausea, loss of appetite, weight loss, fatigue, and a red skin rash.

If the virus is mild, symptoms typically pass in seven days time, though those afflicted may feel weak and tired for several days afterward. In severe (and rare) cases, the infection develops into a more serious form of dengue.

6. How long does it take to recover?

If the infection is a mild one, symptoms begin 4-10 days after infection, can last for up to 10, but generally start to clear up after about a week – though the after-effects of the disease may leave you feeling tired and unwell for up to two weeks.

There is no specific treatment for the disease; most doctors recommend resting and treating the symptoms until the infection runs its course. The NHS recommends taking paracetamol (avoid aspirin and ibuprofen) to alleviate pain and discomfort from fever, adequately hydrating to avoid feeling unwell, and resting.

7. Can you die of dengue fever?

In very rare cases (1-2%), a dengue infection can progress to ‘severe dengue,’ which is sometimes fatal.

8. Is there a Dengue Fever vaccine?

In 2016, scientists developed a fairly effective vaccine for dengue that became available in a few Southeast Asia countries, namely the Philippines, Indonesia, and Singapore, and in the Central and South American countries of Mexico, El Salvador, Costa Rica, Brazil, and Paraguay.

The issue, however, is that the three-installment dose costs roughly $207 USD.

Last year, the drug’s manufacturers cautioned that the vaccine should only be used in those who had previously contracted a dengue infection, as the vaccination may worsen the severity of subsequent infections.

Still, the formula — which is a combination of the yellow fever virus and the four strains of dengue — has been found around 60% effective in action. Researchers are still working on the ideal dengue vaccination — one that is cost effective and affordable, easily shipped, and safe.

9. Can you get Dengue Fever twice?

Contracting dengue only makes you immune to one variant of the virus — because dengue has four different strains, it’s quite possible to become infected again.

Health professionals warn that contracting dengue a second time may lead to a more severe infection with worse symptoms, and an increased risk of contracting DHF.

10. Is Dengue Fever contagious?

It’s widely believed that dengue cannot be spread from person to person — you can only contract it from an infected mosquito bite.

11. Can Dengue be spread through sex?

Contrary to popular belief, there is new evidence to suggest that dengue fever can be spread by sexual contact.

In a recent case, an Italian man was found to have the virus lingering in his semen a month after he contracted the infection in Thailand (the virus left his blood and urine after 23 days, but remained in his semen after 37).

This highlights a new possibility that dengue could be sexually transmitted, though the researchers acknowledged that further studies were needed to confirm this theory.

12. What is severe dengue?

In rare cases, dengue infections and symptoms worsen, becoming what health professionals call ‘severe dengue.’ T

hose who have already been infected are at a higher risk of contracting severe dengue (though it is quite rare for travelers to get it).

Signs of severe dengue include: severe abdominal pain, a swollen abdomen, frequent vomiting (and vomiting blood), bleeding gums, cold and damp skin, a shallow and fast pulse, difficulty breathing, and drowsiness or unconsciousness due to inflammation of the brain.

It is uncommon for travelers to contract severe dengue, and is most often seen in babies and young children; the virus favors females with a higher body mass index and can be life threatening to those with chronic diseases (diabetes or asthma).

13. What is dengue hemorrhagic fever (DHF) & can it be treated?

In very rare cases, dengue can develop into DHF, which results in bleeding, blood plasma leakage, low levels of blood platelets, and an extremely low blood pressure.

Like lesser strains of dengue, there’s no specific and widely available medication — though, if caught early, DHF can be treated in a hospital with fluid replacement therapy.

14. How common is dengue in Thailand?

Dengue is growing more and more common, though travelers to the Kingdom are unlikely to be infected if they heed health officials’ warnings and travel responsibly.

5 Tips for Reducing Risk of Dengue

1. Always wear a good insect repellent (look for one that contains Picaridin or Lemon-Eucalyptus oil).

2. Wear (neutral coloured) loose clothing that covers your limbs and neck; you can even douse clothing in insect spray.

3. Secure windows and doors and check for holes in screens.

4. Clear away stagnant water sources, such as vases, animal watering containers, or water storage barrels.

5. Consider sleeping under mosquito nets.

For more information on dengue outbreaks in Thailand, you can refer to these helpful sources: Center for Disease Control and Outbreak News Today.

Tips to Start Planning Your Trip Now:

Don’t Forget Travel Insurance!

Travel insurance protects you against illness like dengue fever, theft, cancellations, and more. I never travel without it. I’ve been using World Nomads for 15 years.

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Find a cheap flight to Thailand using Momondo. This is my go-to search engine.

Book Your Accommodation

Best hotel rates are found at Agoda, Booking.com, and Hotels.com. For hostels check out Hostelworld.

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Comments Sort by : newest | oldest

  2. Bruce Boyd says

    Thanks for all the great info. I just met an elderly gentleman from the UK here in NE Thailand, who said he's gotten dengue twice and got over it quite easily both times, but I don't want to risk it. Rainy season is just getting going now. Thanks again
    Reply

  3. Ana says

    Thank you for providing this very important information on Dengue. My daughter traveled to Thailand and spend 3 months there - about 3/4 of the way through her trip she developed Dengue Hemorrhagic Fever, and spent 7 days in hospital - 5 days in I.C.U. at Bumrungrad, where she had massive plasma leakage, and her organs became very compromised. It was one of the toughest times to go through as a parent. Thankfully, she recovered. I always tell people who are traveling this region to be mindful of Dengue, because it was the one thing the doctor here didn't mention when she got her vaccines before her trip, and it's so preventable. When we updated him of her condition, the Doctor here had never even heard of Dengue.
    Reply

    • TheThailandLife says

      Sorry to hear of your daughter's terrible ordeal. I'm happy to hear she made a full recovery. The problem with the dengue fever vaccine is that it only be given to people aged 9-45 who have had one previous laboratory-confirmed case of dengue.Additionally: while the vaccine offers protection for people who have already had at least one bout of dengue, it increases the risk of severe infection in children who were dengue-naïve — that is, never infected — when they were vaccinated. Quoted from: https://www.statnews.com/2019/05/01/fda-dengue-vaccine-restrictions/
      Reply

      • Ana says

        Yes, thank you for your response, we are thankful too :) I don't wish to scare people, because Thailand has so much to offer, and she had a wonderful time otherwise! I tell them, just be aware that Dengue requires certain precautions such as wearing Deet, head to toe and wear it even at night. We became informed via the CDC website, that a vaccine was approved but is not (and was not) available for many situations, and so the best prevention is bug spray. Too bad no one here gave that same advice beforehand. We also believe she may have had it earlier in her trip, as she caught what seemed to be a terrible flu after visiting Laos. It wasn't a few weeks later she was being transported from south Thailand to Bangkok. Again, not trying to scare people, just be mindful, have fun and wear your Deet! :)
        Reply

        • Ana says

          Something to add about travel insurance for medical emergencies that we didn't know - if you buy two one-way tickets, like she did, you are only covered on those two travel dates, not the time in-between while in country. Round trip ticket travel insurance includes the travel time in-between flights, one way tickets do not (they won't cover for an undetermined amount of time). Just wanted to add that in case it helps someone.
          Reply

    • Eileen says

      I got Dengue last December in Ko Samui but was not diagnosed until i came back to Ireland after a miserable journey home.My white cells and my platelets dropped and liver function elevated.Both legs covered in a haemorrhagic rash.Spent 9 days in hospital.
      One big side effect was my hands ankles and feet all peeled.Six weeks after my hair started to thin still thinning at the moment
      Reply

    • TheThailandLife says

      Drug resistance is scary but the same study showed that the disease is still highly treatable using different methods, and cases are falling.In Cambodia there were:262,000 cases of malaria in 2008 36,900 cases of malaria in 2018
      Reply

  7. anita sylvia west says

    I contacted dengue and skeeter syndrome in the uk last year allergic reaction to mosquito bites swollen leg and bad red bites. I am still not completely over it over nearly 8 months afterwards. The main symptoms have gone but the malaise is still with me. I hope I never get these infections again I have never felt so ill.
    Reply

    • carole heath says

      Hi Anita I can relate to your dilemma. I also got these infections in the UK. I am still struggling with the symptoms since October last year. I read in an article because of global warming more cases of dengue are being diagnosed in the UK unfortunately.
      Reply

  9. Insolpitek says

    Maybe a precision would be needed :

    "Last year, the drug’s manufacturers cautioned that the vaccine should only be used in those who had previously contracted a dengue infection, as the vaccination may worsen the severity of subsequent infections."

    My understanding is that in case of a second infection, the illness can be more severe, that is why the already infected people should consider vaccination.
    Does the article suggest that the vaccine may worsen the first infection?
    Reply

  10. Thomas says

    Great information. Thanks for sharing. I've tired to prepare best I could by going to the CDC Website and getting all the shots recommended for Thailand and SEA. I even inquired regarding Dengue Fever. Sadly, as you've stated. They said Sorry, nothing we can give you at this time. So, I'll just have to hope I get lucky. Again, you do a great job of providing important and useful information. Greatly appreciated by all I'm sure. Again, thanks for sharing.
    Reply

    • Pat says

      I got vaccinated in Bangkok - Samitivej Hospital - since I already suffered from that disease.

      It took a year and 3 shots - one every 6 month.

      Luckily my health insurance paid for it!

      But it‘s not 100% safe - they said it’s about 80% since there are 4 types of dengue...
      Reply

    • TheThailandLife says

      The vaccine isn't widely available and as someone else commented it took 3 shots over the course of a year. Just take extra precautions when outside in the evening and don't let the critters get into your room!
      Reply

  11. pat says

    hej,
    I suffered from dengue last year. it was the most painful disease I‘ve ever had.
    In the beginning I ignored all the symptoms... very strong pain in the back, vomiting, high fever... I ignord it all. blamed the high temperatures on Koh Lipe...
    After the terrible bumpy speedboat ride, 2h in a minivan and a flight back to bkk... I thought I would die.
    But I still didn‘t go to the hospital. i stayed in a hotel because I couldn‘t move in my apartment yet.
    when I got home in the evening I asked the woman at the reception to please call a taxi and bring me to a hospital.
    they dropped me off at Samitivej Sukhumvit hospital. I was so lucky.
    my body as freezing but my head was hot like fire.
    after testing my blood they told me that I suffer from dengue, „ you have Dengue - can‘t go home now“

    after 6 days of hospitalization i finally was allowed to go home.

    A very bad side effect are depressions. It took me 2 month untill I started felling good again!

    DON‘T UNDERESTIMATE THIS PARTICULAR SIDEEFFECT!
    Reply

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