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旅行者登革热疫苗接种。

Vaccination against dengue fever for travellers.

机构信息

Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.

Faculty of Medicine, University of Geneva, Geneva, Switzerland.

出版信息

Swiss Med Wkly. 2024 Sep 19;154:3858. doi: 10.57187/s.3858.

Abstract

Dengue fever, endemic to most tropical and subtropical countries, is a major cause of illness in travellers, but severe dengue, hospitalisation and death are considered rare in this population. Two vaccines against dengue fever, Dengvaxia® and Qdenga®, are available. While there is no recommendation for the use of Dengvaxia® in travellers, Qdenga® has been licensed for travellers in many European countries since December 2022, most recently (29 July 2024) in Switzerland by Swissmedic. The Swiss Expert Committee for Travel Medicine (ECTM), having assessed available data on the Qdenga® vaccine, issues the following recommendations: (1) Vaccination against dengue fever virus with Qdenga® is not recommended for persons with no previous dengue fever infection. (2) Vaccination with Qdenga® may be recommended for travellers aged 6 years and older who have evidence of previous dengue infection, defined as (a) a laboratory-confirmed dengue infection (PCR, antigen or seroconversion) or (b) a compatible history of dengue infection with a positive IgG serological test AND expected exposure to a region with significant dengue transmission. Travel medicine advisors should provide clear information in accessible language on the complexity of dengue vaccines and the risk/benefit evaluation for their use in travellers.

摘要

登革热流行于大多数热带和亚热带国家,是旅行者患病的主要原因,但严重登革热、住院和死亡在该人群中被认为很少见。有两种登革热疫苗,Dengvaxia®和 Qdenga®。虽然不建议旅行者使用 Dengvaxia®,但自 2022 年 12 月以来,许多欧洲国家已批准 Qdenga®用于旅行者,最近(2024 年 7 月 29 日)瑞士的 Swissmedic 也批准了该疫苗。瑞士旅行医学专家委员会 (ECTM) 在评估了 Qdenga®疫苗的可用数据后,提出了以下建议:(1)对于从未感染过登革热的人,不建议接种 Qdenga®预防登革热病毒。(2)对于有既往登革热感染证据(a)实验室确诊的登革热感染(PCR、抗原或血清转换)或(b)有登革热感染的相符病史和 IgG 血清学检测阳性,且预期暴露于登革热传播风险较高的地区的 6 岁及以上旅行者,可推荐接种 Qdenga®。旅行医学顾问应以通俗易懂的语言向旅行者提供关于登革热疫苗的复杂性和使用疫苗的风险/获益评估的清晰信息。

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