If suitable mosquito vectors are present in a region, returning infected travellers can initiate local transmission
Dengue outbreaks outside their usual geographic distribution — the subtropics and tropics of Asia, Africa, and Latin America — always attract media attention. The first major autochthonous dengue outbreaks in Europe were in Madeira (Portugal) in 2012;1 smaller clusters have been reported in France, Croatia,2 and Italy.3 Despite suitable mosquito vectors, the seasonal window for the establishment of dengue in Europe is short and the risk of its propagation, even in southern Europe, is low.4 It could, however, increase with global warming;5 for example, importation of dengue into more temperate climate zones in China has resulted in local outbreaks in cities such as Shanghai.6
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