Sleeping nets and dengue

The article “Dengue fever on the rise at tourist getaways” 1 recommends the use of bed nets to reduce the incidence of dengue. However, dengue is transmitted by day-active mosquitoes, with significantly high peak periods of activity in the early morning and, especially, early to late evening. Thus, for many travellers to the tropics and subtropics, the most hazardous time with respect to dengue may be at an outside evening meal. I recommend that in dengue-infested areas, diners wear long trousers, shoes and socks to the evening meal and ensure that they’ve treated their ankles, socks and lower legs or trousers with a good-quality repellent. Long-sleeved shirts will reduce the risk of bites on the arms, and judicious application of repellent to the ears and back of the neck will further reduce risk. Most travellers do not need night-time bed nets unless they are bothered by nocturnally biting mosquitoes or they are in malaria-endemic areas (in which case bed nets are essential).