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Urgent Warning As Mosquito-borne Infections Return To Pre-pandemic Levels - Full Symptoms List

Those planning to travel abroad have been issued a warning amid a rise in infections as medics list the key symptoms to look out for as data returns to pre-pandemic levels

A Mosquito warning has been issued to those travelling abroad (

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Travellers have been told to plan ahead amid a rise in mosquito-borne infections which have returned to pre-pandemic levels, experts say.

Cases of the diseases, such as dengue and malaria, are at a volume not seen since 2019, the UK Health Security Agency has warned. Symptoms of the infections include fever, severe headache, pain behind the eyes, in muscles, joints and abdomen, loss of appetite, nausea and vomiting.

Last year, 634 dengue cases were reported in returning travellers across England, Wales and Northern Ireland. That compares to 790 five years ago. During 2023, the most reported cases were in Southern Asia and South-Eastern Asia and particularly India but a growing number were also made in Central America and the Caribbean, government officials say.

From January to October 2023, 1,637 cases were also confirmed in England, close to to the 1,719 reported in the UK in the year before the Covid-19 pandemic. A total of 1,637 malaria cases were confirmed in England from January to October 2023. Cases returned to pre-pandemic levels, similar to the 1,719 cases reported in the UK in 2019 and matching closely with the average of 1,612 cases reported between 2010 and 2019.

Mosquito-borne infections such as dengue and malaria are rising again (

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Getty Images/iStockphoto)

Medics say it is vital to ensure your routine childhood vaccines are up to date, stock up on necessary medications and also secure valid travel insurance to cover your entire trip and planned activities. Travellers can protect themselves by using "insect repellent, covering exposed skin, and sleeping under a treated bed net where air conditioning is not available".

Dr Philip Veal, a consultant in public health at the UKHSA, outlined a number of steps travellers can take to reduce the risk of infection. That including using insect repellent, covering exposed skin and sleeping under a treated bed net. He said: "As travel has increased following the lifting of travel restrictions during the pandemic, so have serious mosquito borne infections. There are simple steps that people can take to reduce the risk of infections such as malaria, dengue and Zika.

"Prevent mosquito bites by using insect repellent, covering exposed skin and sleeping under a treated bed net. Plan ahead and visit the TravelHealthPro website to look up your destination and the latest health information and advice. Even if you have visited or lived in a country before, you will not have the same protection against infections as local people and are still at risk."

Dr Dipti Patel, Director of the National Travel Health Network and Centre, said planning ahead is crucial. She said: "If you are making plans to travel abroad this year, please take a moment to prioritise your health and plan ahead. Check the relevant country information pages on our website, TravelHealthPro, and ideally speak to your GP or a travel health clinic 4-6 weeks ahead of travelling to ensure you have had all the necessary vaccinations and advice you need to ensure your trip is a happy and healthy one."

  • Fever
  • Severe headache
  • Pain behind the eyes
  • Pain in muscles, joints and abdomen
  • Loss of appetite
  • Nausea
  • Vomiting

  • Insect Stings And Bites: How Deadly Are They And When To Seek Medical Attention

    As for people who have had an allergic reaction to insect stings, be prepared with an allergy action plan and have the necessary standby treatment on hand.

    "They should carry an EpiPen (containing adrenaline) that can be administered immediately if necessary. Such patients should also be reviewed by an allergy specialist," Dr Tang from NUH said.

    During their fieldwork, Mr Baptista and Mr Moo from Cuprina use insect repellent and are generally cautious around insect nests and habitats — something that they also ask the general public to do when outdoors.

    "My advice to readers is to be aware of your surroundings, especially in nature, and avoid disturbing insects and their nests.

    "Knowing how to react to a sting and when to seek medical help is also essential," Mr Baptista said. 

    What you can do:

    1. Move to a safe location to prevent further stings.

    2. Do not "suck the venom out" of a bite or sting site, be they from insects, snakes or spiders. This risks soft tissue injury. "Don't believe what you see on TV," Dr Tang said.

    3. Try removing the stinger to reduce the venom load — but do this by scraping it away with a sideways movement using a card or fingernail.

    "Avoid pinching or squeezing the stinger because this may force more venom to be injected into the wound," Dr Tang added.

    4. Wash the affected area with soap and water, and apply a cold pack to reduce swelling and pain, Mr Baptista advised. Take antihistamines for itching and swelling, if necessary.

    BODILY REACTIONS TO INSECT STINGS

    The human body's reactions to insect stings can vary widely.

    Dr Tang said that the majority of people usually have a mild local reaction that is self-limiting, including pain, swelling and redness over the affected site, which usually resolves within 24 hours.

    "Larger local reactions (swelling of more than 10cm) can take up to a week to fully subside."

    Dr Tan from TTSH said that most patients who suffer allergic reactions frequently have skin symptoms such as itch, flushing, wheals, eye or lip swelling.

    However, if there is toxic envenomation, it usually results in damage to the internal organs and requires blood investigations to diagnose and monitor.

    "It is difficult to predict if an insect sting will be uneventful (apart from pain and minor swelling at the sting site) or whether a reaction will develop.

    "Therefore, individuals who have been stung should be vigilant for any evolving signs or symptoms that might suggest a reaction.

    "It is advisable they stop what they are doing immediately and move to an area where help is readily available, should any reaction develop," Dr Tan added. 

    WHEN TO GET MEDICAL AID OR CALL FOR AN AMBULANCE
  • Seek medical attention early when one has been stung multiple times
  • Consult a general practitioner if there are signs of infection over the affected site, for example, increasing pain, swelling, redness and fever
  • People who have been stung should also be aware that serious symptoms might not show up straight away
  • Get medical attention when there are signs of anaphylaxis — swelling of the tongue or throat leading to hoarse voice or difficulty swallowing, difficulty breathing, vomiting, diarrhoea or abdominal pain, rapid heart rate, confusion or collapse
  • Anaphylaxis symptoms occur early within minutes to a few hours after being stung, while toxic envenomation can have a delayed onset after 24 to 48 hours
  • Dr Tang said that there is no antidote to reverse the effects of venom.

    People who get emergency help at hospitals will be assessed for how severe the reaction is and whether there is any immediate threat to life, the doctors said.

    Treatment ranges from removing stingers to getting patients to take anti-histamines and corticosteroids (anti-inflammatory medication).

    Patients will be observed for six hours and discharged if they have no symptoms, Dr Tang added.

    For cases of toxic envenomation, supportive care is the main treatment.

    "(These patients) will be managed in the intensive care unit for organ support till recovery. For example, dialysis for kidney failure, medications to support blood pressure."


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