An Italian pediatric case series of Maldive-imported dengue fever

Dengue is a mosquito-borne disease frequently imported in Europe, where autochthonous outbreaks are potential since recent spreading of the vector. Primary infections usually produce a selflimited febrile syndrome. Secondary infections with different serotype, especially in children, may lead to a severe shock syndrome with plasma leakage and hemorrhagic features. We report a case series of 4 children infected with viral serotype 3 during a journey to the Maldive Islands, who developed symptoms after returning to Italy. Once diagnosed, they were admitted to hospital, followed with clinical and laboratory monitoring and treated supportively; they developed no complications. Dengue endemic areas are popular touristic destinations. Vector eradication may be incomplete where tourist resorts share water tanks with local dwellings. Diagnostic tests should be available in our hospitals for early recognition of cases. Awareness of a primary infection may help prevent re-exposure, avoiding a reinfection with a potentially severe clinical course.