Sydney, if you are looking to escape the Australian winter for your next holiday, don't forget that where there is heat, there will also be mosquitoes.

In turn, tropical destinations can be hotspots for mosquito-borne diseases such as dengue. In fact, Australian health authorities have warned travelers to Bali to be aware of the risk of dengue fever, as cases are increasing in the region.

So here's how to protect yourself and your family during the holidays.What is dengue?

Dengue virus infection (commonly known as dengue or simply dengue) is caused by viruses that are transmitted by the bite of a mosquito. The mosquito species that usually transmit dengue are Aedes aegypti and Aedes albopictus.

There are four strains of the dengue virus. Each has the potential to cause illnesses that can range from mild to severe and life-threatening. Symptoms typically include rash, fever, chills, headache, muscle and joint pain, and fatigue. People also commonly report abdominal pain, nausea, and vomiting.

While infection with just one of these viruses can make you sick, subsequent exposure to other strains can have more serious health implications. In these cases, symptoms may also include blood in vomit, bleeding gums, and difficulty breathing.

Dengue infection must be confirmed by a blood test, but there are no specific treatments. Most people recover on their own; However, staying hydrated is essential and pain relief can help with symptoms. If more serious illness occurs, seek urgent medical attention. Are travelers at risk?

The disease is now endemic in around 100 countries and an estimated 4 billion people are at risk. Asian countries account for about 70 percent of the global burden of disease. Even Europe is at risk.

One of the worst years on record was 2023, but the burden of dengue continues to increase. In the first four months of 2024, Indonesia reported three times as many dengue cases compared to the same period in 2023. Dengue is not a new risk for Australian travelers. Before COVID disrupted international travel, the number of Australians returning from tropical destinations with dengue fever was steadily increasing.

For example, between 2010 and 2016, there was an average annual increase of 22 per cent in travelers returning to Victoria with dengue. Almost half of these people contracted the disease in Indonesia. It is well documented that Bali poses a dengue risk to travelers.

International travel restrictions due to COVID brought this trend to an abrupt halt. But now that Australians are embracing international travel again, cases are rising once again. Bali isn't the only destination with a rise in dengue, but we know it's a popular holiday destination for Australian travelers. There is no doubt that many families will be traveling to Bali during these school holidays.

How is the risk in Australia?

Not all mosquitoes can transmit dengue viruses. This is why the risk is different in Bali and other tropical regions than in Australia. Although there are more than 40 species of Australian mosquitoes known or suspected to transmit local pathogens, such as Ross River virus, Australia is generally free of local risk of dengue due to the limited spread of Aedes aegypti and Aedes albopictus.

While Aedes aegypti is found in some parts of Queensland, thanks to interventions by the Global Mosquito Program and local authorities, the risk of dengue is low. These interventions include the release of laboratory-bred mosquitoes that prevent mosquitoes in the environment from spreading viruses, as well as community education. But local cases occasionally occur.

Aedes albopictus is not currently found on the Australian mainland, but is found on the Torres Strait Islands. There was a dengue outbreak there this year. Keep mosquitoes away during the day, not just at night

While a vaccine is available, it is not recommended for short-term travelers. There are strict eligibility criteria for its use, so speak to a healthcare professional for advice.

For most travelers, preventing mosquito bites is the only way to prevent disease. But there are differences in the behavior of dengue mosquitoes, which means that normal measures to avoid mosquito bites may not be as effective. .

During the Australian summer, mosquitoes found in local wetlands can be incredibly abundant. We usually need to grab the repellent and cover up to stop the bites as soon as the sun starts to set.

Aedes aegypti and Aedes albopictus can bite people aggressively, but they are not as abundant as the summer mosquito swarms at home. They also bite during the day, not just at night. Therefore, for those traveling to Bali or other areas with risk of dengue, it is recommended to wear insect repellent throughout the day.

What to pack to protect yourself

If you are staying at a major resort, there is likely a mosquito control program in place. This may include minimizing the water available for mosquito breeding in combination with the use of insecticides. Mosquitoes are also less likely to be a problem in air-conditioned accommodation. But if you plan to spend time visiting local towns, markets or in nature, it's best to protect yourself from bites.

Loose-fitting, light-colored clothing will help stop mosquito bites (and help keep you cool). Covered shoes can also help: dengue mosquitoes love smelly feet.

Finally, it is best to carry some insect repellent with you. There may not be any available in your destination, and the formulations on sale may not have gone through the same extensive testing as products approved in Australia. (The conversation) GRSGRS