Лихорадка денге в Москве: эпидемиологическая характеристика завозных случаев

Dengue fever in Moscow: epidemiological characteristics of imported cases

The current reorientation of tourist flow to foreign countries endemic for dengue haemmorhagic fever (DHF) has led to an increase in its incidence among travelers after their return to Russia. In this regard, it is necessary to perform an epidemiological analysis of cases of DHF importation to Moscow, which will allow us to indirectly assess the epidemiology of the importation of this infection into the Russian Federation. The objective of the study was the epidemiological characterization of introduced cases of dengue fever in Moscow in the period from 2015 to 2024. Materials and methods. We used data from the state reports of Rospotrebnadzor "On the state of sanitary and epidemiological wellbeing of the population in the Russian Federation' for the period from 2015 to 2024" and medical records of inpatients of medical organizations of Moscow (mainly SBHI Infectious Clinical Hospital No 1 of the Department of Health of Moscow and SBHI Infectious Clinical Hospital No 2 of the Department of Health of Moscow) from 2020 to 2024, CMD laboratory of FSBI Central Research Institute of Epidemiology, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing. Results. From 2015 to 2024, 520 cases of DHF were brought to Moscow (29.6% of the Russian total. The peak was in 2019 (126 cases), the decline was in the pandemic years 2020–2022 (39 cases in 3 years). The recovery of tourist flow to dengueendemic countries in 2023–2024 led to an increase in the number of imported DHF cases to Moscow (up to 91 in 2024). The countries with the highest proportion of imported cases of DHF are Thailand (44.9%), Maldives (18.2%), Indonesia (Bali) (10.8%), Sri Lanka (7%), India (5%). DHF importation was most intense in January–April (45.5% of cases), corresponding to the dry season in Southeast Asia, from which 36.9% of all DHF cases were imported during this period. From May to October, there was a peak of importation from South Asia (21.0% of all cases), mainly from Maldives (17.0% of all cases). The overwhelming majority of patients were 18–44 years old (81%), reflecting the structure of tourist traffic. In 15% of cases, different nosologies (acute respiratory viral infections, unspecifed intestinal infection, exanthema unspecified) were indicated as referral diagnoses, which did not imply laboratory examination for DHF. In the first 5 days of illness, the diagnosis of DHF was indicated as a referral to hospital in 9.8% of cases, after 5 days of illness – in 27.7%. Fever of unclear genesis was indicated in 48.2%. Diagnosis of DHF in 70.4% of cases was based on PCR diagnosis or a combination of PCR and ELISA (IgM detection). However, in 29.4% of cases the diagnosis was based only on ELISA method – single detection of IgM to DHF virus. Conclusion. The increase in imported DHF cases in Moscow reflects the reorientation of Russian foreign tourism to DHFendemic countries, as well as the growing epidemiological disadvantage of this disease in Southeast and South Asian countries. The annual dynamics of DHF importation to Moscow are connected to the rainy season in endemic countries and the peak times for foreign tourist trips to tropical regions. Insufficient vigilance among medical professionals regarding exotic infections sometimes results in erroneous initial diagnoses of tourists returning from tropical destinations. PCR testing alone or in combination with ELISA should be considered the primary method for confirming DHF. © 2025, Dynasty Publishing House. All rights reserved.