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Eine Stechmücke der Art «Aedes aegypti», auch Gelbfiebermücke, Denguemücke oder Ägyptische Tigermücke genannt. Sie überträgt verschiedene Krankheiten, darunter das Dengue-Fieber. Foto: Gustavo Amador/epa efe/dpa-tmn
Mückenstich mit Folgen Was Reisende über das Dengue-Fieber wissen sollten Frisch zurück von der Fernreise und plötzlich setzt hohes Fieber ein? Es könnte eine eingeschleppte Dengue-Infektion sein.
Mückenarten, die das Dengue-Fieber übertragen - ihnen begegnen Reisende vor allen in tropischen Regionen in Asien, Südamerika und Afrika.
Doch auch in Europa können Mücken Menschen damit infizieren, zum Beispiel auf der portugiesischen Insel Madeira. Darauf macht das CRM Centrum für Reisemedizin aufmerksam.
Pro Jahr werden in Deutschland mehrere 100 bis über 1000 eingeschleppte Dengue-Infektionen erfasst. Knapp jede und jeder dritte Betroffene kam von einer Thailand-Reise zurück.
Längst nicht jede Infektion kommt mit Symptomen Bei welchen Symptomen sollten Reisende und Reiserückkehrer an Dengue denken? Vorab: Nur rund jede vierte Infektion geht mit Krankheitssymptomen einher, heißt es vom CRM.
Wenn sie es tut, dann beginnt die Erkrankung oft mit plötzlichem, hohem Fieber. Weitere Anzeichen: Gliederschmerzen und Kopfweh, das gefühlt hinter den Augen sitzt. Außerdem kann es zu flächigen Hautausschlägen kommen, die wie ein Sonnenbrand aussehen.
Laut Tomas Jelinek, wissenschaftlicher Leiter des CRM, hört das Fieber nach vier bis fünf Tagen von alleine wieder auf. Hält es an oder verläuft in Schüben, spreche das gegen Dengue.
Das gilt auch, wenn sich erst mehr als zwei Wochen nach der Reiserückkehr Symptome zeigen. Denn: Die Inkubationszeit liegt meist bei vier bis sieben Tagen, in Einzelfällen kann sie länger sein.
Bei rund einem Prozent schwere Verläufe Bei einem kleinen Teil der Betroffenen - einem Prozent, so das CRM - kommt es zu schweren Verläufen. Ursache dafür ist, dass die Infektion feine Blutgefäße durchlässig werden lässt. So kann Flüssigkeit aus dem Gewebe ins Blut eintreten.
Warnsignale dafür sind Bauchschmerzen, anhaltendes Erbrechen, Luftnot oder Blutungen der Schleimhäute, zum Beispiel des Zahnfleisches.
Gerade um den fünften Krankheitstag herum sollte man darauf achten, ob sich diese Beschwerden zeigen, rät das CRM. Bleiben schwere Verläufe unbehandelt, können sie tödlich enden. Gut zu wissen: Bei der ersten Dengue-Infektion ist ein schwerer Verlauf selten.
So beugen Reisende vor Wer in ein Gebiet reist, in dem Dengue übertragen wird, braucht guten Mückenschutz. Vor Stichen können sich Reisende mithilfe von Repellents schützen, die auf die Haut aufgetragen werden und Mücken fernhalten. Auch Kleidung schützt.
Es gibt zwei Impfstoffe gegen das Dengue-Fieber - darunter einer, der für Reisende infrage kommt. Die Europäische Arzneimittelagentur EMA hat das Vakzin Qdenga Ende 2022 zugelassen, und zwar für Erwachsene und für Kinder ab vier Jahre. Die Ständige Impfkommission Stiko prüft derzeit eine mögliche Impfempfehlung für Reisende in Dengue-Gebiete.
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