Maternal Dengue

Dengue virus is a flavivirus that is transmitted by the bite of mosquitoes of the genus Aedes (Ae. Aegypti and Ae. Albopictus or Tiger mosquito) from infected reservoirs (human and animal). There is no person-to-person transmission. There are reported cases of transmission during pregnancy and by transfusions. ^{(Arragain 2017, MSA 2015)}

The genome (RNA) of the dengue virus has been isolated in a few mothers’ milk samples ^{(Desgraupes 2021, Arragain 2017, Barthel 2013)}, however, although suggested ^{(Van de Perre 2021)}, transmission by this means has not been clearly demonstrated. ^{(Mann 2018, Chen 2016)}

In most cases, the virus causes an asymptomatic illness or a mild flu-like illness (fever, arthralgia and rash). There are cases of severe dengue with hypovolemic shock, hemorrhage, thrombocytopenia, encephalitis, myocarditis, hepatitis, effusions, and nephritis. The disease produces permanent immunity, but with four serotypes of the virus, the disease can be passed several times in life. ^{(MSA 2015)}

The treatment of non-severe dengue (rest, hydration and paracetamol) is compatible with breastfeeding.

Although no specific antibodies against dengue have been found in human milk, there are antiviral factors that neutralize dengue in lipids from colostrum and human milk ^{(Chong 1989, Falkler 1975)}. Breastfeeding protects the baby from dengue infection.^{(MSA 2015)}, and is associated with a lower incidence of febrile illness. ^{(Libraty 2013)}

Given the apparent rarity of dengue virus transmission through human milk and its protective effects on the infant, breastfeeding during maternal or infant dengue disease should continue, as long as the clinical status of the mother and baby allows it.^{(Lawrence 2016 p 432. MSA 2015, Arya 2014)}

Although pyrethroid pesticides used in the control of malaria or dengue can accumulate in human milk, the estimated daily intakes for infants were found to be within the maximum levels acceptable by the WHO. ^{(Corcellas 2012)}

Dengue vaccine does not contraindicate breastfeeding. ^(LactMed).

See below the information of this related product:

• Dengue Fever Vaccines (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)