Lack of perception regarding risk of dengue and day-active mosquitoes in Finnish travellers

Abstract

Background: An increasing number of international travellers are at risk for dengue infection. We analysed the characteristics of Finnish travellers with recently acquired dengue infections.

Methods: Notified dengue infections from 2016 to 2019 were obtained from the Finnish National Infectious Disease Register. We developed a questionnaire and invited individuals diagnosed with dengue to provide information on countries and areas of infection, travel characteristics, risk perception and use of protective measures.

Results: Almost all infections (94%, 127/135) were acquired in Asian countries, most in Thailand (78/135, 58%). The Maldives had the highest crude risk after adjusting for the number of travellers (55.6/100,000). Most trips were pre-booked holidays (93/111, 84%) and 62% (69/111) had a duration of 14–21 days with time spent mostly on the beach (78/111, 70%). The majority of travellers were not aware of the risk of dengue infection before travelling (67/111, 60%) and had not sought pre-travel advice (72/111, 65%). The majority applied some protective measures (71/111, 64%) but mainly after sunset (64/111, 58%).

Conclusions: Most dengue infections in Finnish travellers were acquired at popular destinations in Southeast Asia, especially Thailand. Our study showed that there was low awareness regarding the risk of contracting the infection. In addition, many travellers reported inadequate use of protective measures. This calls for further public health actions, such as raising awareness of day-active mosquitoes, of risk at popular travelling destinations and the correct way of applying anti-vectorial measures.

Keywords:

• Dengue
• global travel
• Finnish travellers
• risk perception
• vector-borne disease
• imported infections

Acknowledgements

We would like to thank Harri Antikainen and Tiina Lankila from Geography Research Unit, Oulu University for their input as well as Timothée Dub from Finnish Institute for Health and Welfare for his assistance. We would also like to thank Lisa Hansen for her input and comments to the manuscript.

Ethical approval

Specific ethics approval was not needed for this study. The study was performed under the mandate of the Finnish Communicable Diseases Act and participation was voluntary.

Disclosure statement

The authors report no conflict of interest.