HOLIDAY makers heading to Spain have been warned of the spread of a virus that causes vomiting, bleeding gums and pain behind the eyes.
Two cases of dengue fever thought to have been acquired locally in the country's party capital, Ibiza, have sparked concerns that the virus is spreading secretly.
Scientists fear this means dozens more people on the Balearic island have been infected unknowingly.
The debilitating disease, dubbed ‘breakbone fever’ because of how painful it is, is spread by mosquitoes and is more common in tropical areas, such as Africa, Asia, and Central and South America.
However, the disease-ridden critters are becoming more common in Europe, with recorded cases in Italy, France and Spain.
Three locally acquired cases were reported in Spain in 2023 - all in Catalonia, in the Northeastern region of the country.
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Between 2015 and 2023, 44 cases of dengue were reported in the Balearic Islands, which is made of Majorca, Menorca, Ibiza, and Formentera.
Dengue infects up to 400 million people and kills 40,000 - and cases are rising.
For example, 2019 saw the greatest number of dengue fever cases ever recorded, at 5.2 million—almost twice as many as the previous year.
The World Health Organisation (WHO) chiefs have called it the world's fastest-spreading tropical disease and say it is a "pandemic threat".
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Virologists say Brits need to be aware of the potential spread of dengue fever in Spain and other European countries.
The two cases reported in Ibiza in 2022 were German tourists who both travelled separately.
Neither of the two cases was proven to be locally acquired, researchers wrote in the .
But the evidence suggests both were caught in the country, the authors said.
Other possible cases
Writing in the journal, experts said evidence suggests "the most likely transmission was through mosquito bites, but other possibilities cannot be totally excluded".
They added: "Although the source case assured that they had not been bitten by mosquitoes and that they had spent the entire symptomatic period at home, it is possible that the bites went unnoticed.
"The lack of detection of additional cases in Ibiza residents, especially during the temporal gap between the two German cases, suggests that some cases probably linked to this outbreak may have gone undetected.
"It is very important to increase the awareness of detecting dengue cases in Spain and other European countries."
In 2022, there were 71 cases of locally acquired dengue in Europe, the same number recorded over the previous 11 years - 65 of these were in France and six in Spain.
What is dengue fever?
Dengue fever is a member of the Flaviviridae family, transmitted by Aedes aegypti mosquitoes.
The earliest descriptions of an outbreak surfaced in the late 1700s.
Further outbreaks occurred in the 19th century before becoming more widespread in the last 150 years.
Today, this virus is responsible for more disease and deaths than any other illness spread to people by insects, according to Dengue Virus Disease.
About half of the world's population is now at risk, with 100 to 400 million infections occurring each year, the WHO estimates.
Dengue fever symptoms
Dengue won't always cause symptoms, according to NHS guidance.
But if you do experience some, they'll usually come on four to 10 days after an infected mosquito bites you.
The symptoms can be similar to the flu and include:
- A high temperature
- A severe headache
- pain behind your eyes
- Muscle and joint pain
- Feeling or being sick
- Swollen glands
- A blotchy rash made up of flat or slightly raised spots – this can affect large areas of your body
- Severe tummy pain
- Repeatedly being sick
- Fast breathing
- Bleeding gums or nose
- Extreme tiredness (fatigue)
- Being unable to relax (restlessness)
- Blood in your vomit or poo
The latter seven symptoms listed only tend to occur in severe cases of dengue - you should call 999 or go to A&E if you experience them.
Rabies in Vietnam
Brits planning on heading to Vietnam in the coming months have been warned the country is experiencing a surge in rabies, with a 160 per cent jump in human deaths recorded so far this year.
Since January, 29 people have died from the virus in the Southeast Asian country.
This is compared to 11 fatalities in the first three months of 2023, according to government figures.
Experts warn the number of deaths is likely to rise due to unvaccinated animals and the country’s prominent dog and cat meat trade.
"Unfortunately, we can expect an increasing number of people to die of rabies in 2024, in line with the dramatic, more than two-fold rise in animal rabies in 2023,” a spokesperson for the WHO's Vietnam office told the Telegraph.
There are two main forms of disease.
'Furious rabies' kills people within days after triggering hallucinations, hyperactivity, loss of coordination and fear of water or fresh air.
By contrast, “paralytic rabies,” which causes 20 per cent of cases, gradually stops a person’s muscles working until they fall into a deadly coma.
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Vaccines can be given before and after exposure, while treatments, including immunoglobulin and monoclonal antibodies, are prescribed in severe cases.
Yet, in Vietnam, access to these tools is limited in some regions.