Risk of Dengue in Travelers: Implications for Dengue Vaccination.

PURPOSE OF REVIEW: Dengue is found in tropics and subtropics that are considered to be popular travel destinations. We set out to review the burden of dengue on international travelers. RECENT FINDINGS: GeoSentinel, a global network of travel medicine providers, has seen an increasing trend of dengue in returning travelers over the past decades. In Southeast Asia, annual proportionate morbidity increased from 50 dengue cases per 1000 ill-returned travelers in non-epidemic years to an average of 159 cases per 1000 travelers during epidemic years. Dengue is the leading cause of fever in returning travelers, having overtaken malaria for travelers to Southeast Asia. Most dengue seroconversion studies in travelers report an attack rate of around 5% depending on duration of travel and destination. Dengue vaccination would be justified for travelers. The first licensed dengue vaccine CYD-TDV is only recommended in seropositive individuals. This review considers preventive measures including how best to use the first licensed dengue vaccine CYD-TDV.