Arbovirus-Infektionen sind wichtige Differenzialdiagnosen bei Tropenrückkehrern mit
Fieber, Gliederschmerzen und Exanthem. Arboviren haben sich in den letzten Jahrzehnten
stark verbreitet – ausschlaggebend sind Bevölkerungswachstum, Urbanisierung, Globalisierung,
Flugreisen und Klimawandel. In diesem Beitrag stellen wir die in Europa reisemedizinisch
wichtigsten Arbovirosen vor: Dengue-Fieber, Chikungunyavirus- und Zikavirus-Erkrankung.
Abstract
Arboviral infections are an important differential diagnosis in returning travelers
with fever, muscle or joint pain and rash. Arboviruses have spread widely around the
globe in the last decades. The most common arboviral infections in returning travelers
from tropical and subtropical areas are dengue, chikungunya and zika. Their most important
vectors, Aedes (Stegomyia) mosquito species, have adapted to the urban environment,
which enabled arboviruses to establish urban transmission cycles. Population growth,
urbanization, globalization, modern means of transportation and global warming are
speeding up their spread.
Laboratory confirmation of an arboviral infection can generally be obtained by direct
virus detection (PCR, antigen test) in the first week of illness; from the second
week of illness serology can be used. Treatment is mostly symptomatic.
Dengue fever is the most common cause of fever in returning travelers from South-East
Asia. Patients have to be educated about and observed for warning signs of severe
dengue that can rarely develop around day 5 of the disease and is marked by a rise
in hematocrit.
Chikungunya mostly occurs in epidemics and is characterized by severe and often long-lasting
arthritis.
Preconceptional screening for zika virus infection is not recommended. Instead, travelers
should delay conception for up to three months after returning from a zika endemic
area.
Dengue, chikungunya and zika vaccine development has been hampered by difficulties,
for example antibody-dependent-enhancement or the unpredictability of outbreaks, and
up to now no vaccines for travelers have been licensed. Yet several promising vaccine
candidates are currently under development.
Schlüsselwörter
Arbovirose - Dengue-Fieber - Chikungunyavirus-Erkrankung - Zikavirus-Erkrankung
Key words
arboviral disease - dengue - chikungunya - zika
