Editing Dengue fever (section)

== Prevention ==

=== Vector control ===

[[File:Vector Control.jpg|upright=1.35|alt=A black and white photograph of people filling in a ditch with standing water|thumb|A 1920s photograph of efforts to disperse standing water and thus decrease mosquito populations]]{{Main|Mosquito control}}
The principal risk for infection with dengue is the bite of an infected mosquito.<ref name="WHO2023" /> This is more probable in areas where the disease is endemic, especially where there is high population density, poor sanitation, and standing water where mosquitoes can breed.<ref name="Bisen-2013" /> It can be mitigated by taking steps to avoid bites such as by wearing clothing that fully covers the skin, using mosquito netting while resting, and/or the application of insect repellent (DEET being the most effective);<ref name="Yellow102">{{cite web |author=Center for Disease Control and Prevention |title=Chapter 5 – dengue fever (DF) and dengue hemorrhagic fever (DHF) |url=http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-5/dengue-fever-dengue-hemorrhagic-fever.aspx |url-status=live |archive-url=https://web.archive.org/web/20101229212025/http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-5/dengue-fever-dengue-hemorrhagic-fever.aspx |archive-date=29 December 2010 |access-date=23 December 2010 |work=2010 Yellow Book}}</ref> it is also advisable to treat clothing, nets and tents with 0.5% [[permethrin]].<ref name="CDC-2023">{{Cite web |last=CDC |date=2023-10-20 |title=Traveling? Avoid Dengue |url=http://www.cdc.gov/ncezid/dvbd/media/avoid-dengue.html |access-date=2024-03-08 |website=Centers for Disease Control and Prevention |language=en-us |archive-date=8 March 2024 |archive-url=https://web.archive.org/web/20240308160645/https://www.cdc.gov/ncezid/dvbd/media/avoid-dengue.html |url-status=live }}</ref>

Protection of the home can be achieved with door and window screens, by using air conditioning, and by regularly emptying and cleaning all receptacles both indoors and outdoors which may accumulate water (such as buckets, planters, pools or trashcans).<ref name="CDC-2023" />

[[File:Church of the Immaculate Conception, JB (2025) - img 10.jpg|thumb|left|A [[holy water font]] at the [[Church of the Immaculate Conception (Johor)|Church of the Immaculate Conception]] in [[Johor Bahru]], [[Malaysia]] was closed as a part of open water sources elimination in retaliation to the dengue outbreak in the area.]]

The primary method of controlling ''A. aegypti'' is by eliminating its [[habitat]]s. This is done by eliminating open sources of water, or if this is not possible, by adding [[insecticide]]s or [[Biological pest control|biological control agents]] to these areas. Generalized spraying with [[organophosphate]] or [[pyrethroid]] insecticides, while sometimes done, is not thought to be effective.<ref name="Euro102">{{cite journal | vauthors = Reiter P | title = Yellow fever and dengue: a threat to Europe? | journal = Euro Surveillance | volume = 15 | issue = 10 | pages = 19509 | date = March 2010 | pmid = 20403310 | doi = 10.2807/ese.15.10.19509-en | url = http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19509 | url-status = live | doi-access = free | archive-url = https://web.archive.org/web/20110707070425/http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19509 | archive-date = 7 July 2011 }}</ref> Reducing open collections of water through environmental modification is the preferred method of control, given the concerns of negative health effects from insecticides and greater logistical difficulties with control agents. Ideally, mosquito control would be a community activity, e.g. when all members of a community clear blocked gutters and street drains and keep their yards free of containers with standing water.<ref name="www.nature.com-2024">{{Cite web |title=Controlling Dengue Outbreaks {{!}} Learn Science at Scitable |url=https://www.nature.com/scitable/topicpage/controlling-dengue-outbreaks-22403714/ |access-date=2024-03-08 |website=www.nature.com |language=en |archive-date=8 March 2024 |archive-url=https://web.archive.org/web/20240308160444/https://www.nature.com/scitable/topicpage/controlling-dengue-outbreaks-22403714/ |url-status=live }}</ref> If residences have direct water connections this eliminates the need for wells or street pumps and water-carrying containers.<ref name="www.nature.com-2024" />

=== Vaccine ===
{{main|Dengue vaccine}}As of March 2024, there are two vaccines to protect against dengue infection; Dengvaxia and Qdenga.<ref name="www.ecdc.europa.eu-2023">{{Cite web |date=2023-08-07 |title=Factsheet about dengue |url=https://www.ecdc.europa.eu/en/dengue-fever/facts |access-date=2024-03-08 |website=www.ecdc.europa.eu |language=en |archive-date=25 February 2024 |archive-url=https://web.archive.org/web/20240225174109/https://www.ecdc.europa.eu/en/dengue-fever/facts |url-status=live }}</ref>
[[File:Intradermal injection.jpg|alt=Subcutaneous injection|thumb|Illustration of a subcutaneous injection]]
'''Dengvaxia'''  (formerly CYD-TDV) became available in 2015, and is approved for use in the US, EU and in some Asian and Latin American countries.<ref>{{Cite web |title=Information on Dengvaxia® |url=https://www.sanofi.com/en/our-company/social-impact/responsible-business-values/information-on-dengvaxia |access-date=2024-03-08 |website=www.sanofi.com |language=en |archive-date=8 March 2024 |archive-url=https://web.archive.org/web/20240308212800/https://www.sanofi.com/en/our-company/social-impact/responsible-business-values/information-on-dengvaxia |url-status=live }}</ref> It is an attenuated virus, is suitable for individuals aged 6–45 years and protects against all four serotypes of dengue.<ref>{{Cite web |title=Dengvaxia : EPAR - Medicine overview |url=https://www.ema.europa.eu/en/documents/product-information/dengvaxia-epar-product-information_en.pdf |access-date=2024-03-09 |website=European Medicines Agency |archive-date=9 March 2024 |archive-url=https://web.archive.org/web/20240309191332/https://www.ema.europa.eu/en/documents/product-information/dengvaxia-epar-product-information_en.pdf |url-status=live }}</ref> Due to safety concerns about [[antibody-dependent enhancement]] (ADE), it should only be given to individuals who have previously been infected with dengue, in order to protect them from reinfection.<ref>{{Cite web |date=2017-12-01 |title=Sanofi restricts dengue vaccine but downplays antibody enhancement {{!}} CIDRAP |url=https://www.cidrap.umn.edu/dengue/sanofi-restricts-dengue-vaccine-downplays-antibody-enhancement |access-date=2024-03-09 |website=Center for Infectious Disease Research & Policy |language=en |archive-date=9 March 2024 |archive-url=https://web.archive.org/web/20240309191331/https://www.cidrap.umn.edu/dengue/sanofi-restricts-dengue-vaccine-downplays-antibody-enhancement |url-status=live }}</ref> It is given subcutaneously as three doses at six month intervals.<ref>{{Cite web |date=2023-04-26 |title=Administering the Dengue Vaccine |url=https://www.cdc.gov/vaccines/vpd/dengue/hcp/administration.html |access-date=2024-03-08 |website=www.cdc.gov |language=en-us |archive-date=8 March 2024 |archive-url=https://web.archive.org/web/20240308212735/https://www.cdc.gov/vaccines/vpd/dengue/hcp/administration.html |url-status=live }}</ref>

'''Qdenga''' (formerly TAK-003) completed clinical trials in 2022 and was approved for use in the European Union in December 2022;<ref name="www.ecdc.europa.eu-2023" /> it has been approved by a number of other countries including Indonesia and Brazil, and has been recommended by the [[Strategic Advisory Group of Experts|SAGE committee]] of the World Health Organization.<ref>{{Cite web |title=Message by the Director of the Department of Immunization, Vaccines and Biologicals at WHO - September 2023 |url=https://www.who.int/news/item/05-10-2023-message-by-the-director-of-the-department-of-immunization--vaccines-and-biologicals-at-who---september-2023 |access-date=2024-03-08 |website=[[World Health Organization]] |language=en |archive-date=16 March 2024 |archive-url=https://web.archive.org/web/20240316010658/https://www.who.int/news/item/05-10-2023-message-by-the-director-of-the-department-of-immunization--vaccines-and-biologicals-at-who---september-2023 |url-status=live }}</ref> It is indicated for the prevention of dengue disease in individuals four years of age and older, and can be administered to people who have not been previously infected with dengue. It is a live [[Attenuated vaccine|attenuated]] vaccine containing the four serotypes of dengue virus, administered subcutaneously as two doses three months apart.<ref name="www.ecdc.europa.eu-2023" />