Rapid risk assessment - Sexual transmission of dengue in Spain
Spanish authorities have reported the likely sexual transmission of dengue between two men. This is the first case of dengue described in an area without the presence of vector mosquitoes that has been attributed to sexual transmission, and the first sexual transmission described between men who have sex with men (MSM).
Spanish authorities have reported the likely sexual transmission of dengue between two men. One of the men travelled to Cuba and the Dominican Republic (both countries where dengue is endemic) and returned to Spain on 4 September 2019. He developed symptoms of dengue on 5 September. In the days following his return, the man had unprotected sex with his partner, who had not travelled outside of Spain in the previous 45 days. His partner developed dengue symptoms on 15 September. According to the Spanish authorities, the comorbidities of both patients were assessed by clinicians responsible for their follow-up and were not considered relevant for the risk assessment.
Semen samples from both cases tested positive for dengue virus (DENV). Molecular investigations identified identical viral sequences between the two cases. Entomological investigations around the residence of the cases in the municipality of Madrid, Spain did not find any Ae. albopictus . mosquitoes, a known vector for DENV.
In the absence of data supporting infection through other possible routes, it appears likely that the secondary case acquired DENV infection through sexual contact. This is the first case of dengue described in an area without the presence of vector mosquitoes that has been attributed to sexual transmission, and the first sexual transmission described between men who have sex with men (MSM). This mode of transmission is consistent with what has been observed for other flaviviruses such as Zika virus.
Despite the large numbers of imported cases, sexual transmission of DENV had not been previously reported in the EU/EEA.
Based on the current limited evidence, sexual transmission of dengue appears to be a rare route of transmission and the risk (both among MSM and heterosexuals), is considered extremely low. More research is needed to quantify the risk of sexual transmission and to identify risk factors. However, the risk of transmission by those returning from dengue-endemic areas with symptoms compatible with dengue infection, or with confirmed dengue infection, can be minimised by abstaining from sex or practicing safe sex using condoms until all symptoms are resolved.
Infectious disease clinicians should be informed that sexual transmission is a potential, but apparently rare mode of transmission for dengue and that they should: 1) consider it in patients with dengue in the absence of a compatible travel history; and 2) advise all patients with dengue on the potential risks of sexual transmission, and that those risks can be mitigated through abstinence from sexual contact, or practicing safe sex using condoms, during the course of their disease. This particularly applies if their partner is pregnant to prevent adverse pregnancy outcomes related to dengue infection during pregnancy.
Rapid risk assessment - Sexual transmission of dengue in Spain – EN – [PDF-290.57 KB]
Latest News from
Impact of the UK’s withdrawal from the EU – EUTMs and RCDs: updated information28/01/2020 15:25:00
Ahead of 1 February 2020, the day on which the UK will leave the EU in accordance with the Withdrawal Agreement concluded between the EU and the UK (read the latest news here), the EUIPO has updated the Brexit section on its website.
Sustainble urban mobility must come first: so how do you get people out of their cars?28/01/2020 14:33:00
As operators & designers of public transport services, local & regional authorities and policy makers have the opportunity to shape and structure urban spaces. The best way to make the most positive impact on people’s living conditions, and to influence their daily mobility choices, is to offer the very best options for movement.
In the EU Parliament this week: Brexit, better pay for women, Holocaust remembrance28/01/2020 12:25:00
Along with a vote on the UK withdrawal deal, this week MEPs will tackle the gender pay gap, call for a common charger for electronic devices and mark 75 years since the end of the Holocaust.
Verhofstadt on future EU-UK relations: “We should be ambitious”28/01/2020 10:33:00
Ahead of the vote on the EU-UK withdrawal agreement on 29 January, Parliament’s Brexit coordinator Guy Verhofstadt gave an interview.
EU and 16 WTO members agree to work together on an interim appeal arbitration arrangement27/01/2020 15:25:00
The EU and Ministers from 16 Members of the World Trade Organization (WTO) have agreed to develop a multi-party interim appeal arrangement that will allow the participating WTO members to preserve a functioning and two-step dispute settlement system at the WTO in disputes among them.
Q&As the United Kingdom's withdrawal from the European Union on 31 January 202027/01/2020 13:25:00
The UK is set to leave the European Union on 31 January 2020 at midnight (Brussels time). It will no longer be a Member State of the EU. This is a decision that the EU regrets but respects.
Christine Lagarde: How can a united Europe meet the challenges it faces today?24/01/2020 15:20:00
Opening remarks by Christine Lagarde, President of the ECB, during a dinner on "Uniting Europe" at the World Economic Forum
Artificial intelligence: EU must ensure a fair and safe use for consumers24/01/2020 14:20:00
MEPs want a strong set of rights to protect consumers in the context of artificial intelligence and automated decision-making.
Show us the money for new policy proposals, MEPs tell budget commissioner24/01/2020 13:20:00
During a debate with budget commissioner Johannes Hahn on 22 January, members of the Parliament’s negotiating team for the EU's next long-term budget expressed concern that the Commission’s budget proposal for how the EU should spend its money the next seven years no longer adds up.
The EESC bids farewell to its UK members with the promise of maintaining close ties with UK civil society24/01/2020 12:20:00
The European Economic and Social Committee (EESC) paid tribute to its British members on 22 January 2020 at the last plenary session they will attend before the UK leaves the EU on 31 January.