By Kate Kelland
LONDON, Oct 12 (Reuters) - Eighteen people are confirmed tobe suffering from dengue fever in the Portuguese archipelago ofMadeira and another 191 probably have the mosquito-borne diseasewhich is also called "breakbone fever" because of the severepain it can cause.
The European Centre for Disease Prevention and Control(ECDC) which monitors disease in the European Union, said theoutbreak was "significant but not entirely unexpected" giventhat the most efficient carriers of the disease, mosquitoesknown as Aedes aegypti, have an established presence in Madeira.
"Portuguese public health authorities are implementingcontrol measures to reduce the risk of sustained transmissionlocally, the export of infected vectors from the island, and tominimise the impact on the affected population," it said.
The first local transmissions of dengue fever in Europe wererecorded in France and Croatia in 2010.
Earlier this year, Greek health officials attributed thedeath of an 80-year-old man to its first case of dengue since anoutbreak there in 1927-28.
The ECDC said the risk for tourists visiting Madeira and forresidents of the island would "depend on the course of theoutbreak in the coming weeks and the effectiveness of thecontrol measures."
It did not recommend any restrictions on travel or tourismto Madeira, but advised people to protect themselves adequatelyagainst mosquito bites, particularly during the day which iswhen dengue-carrying mosquitoes are most active.
Jane Jones, a travel-associated infection expert at theBritain's Health Protection Agency (HPA), stressed that denguefever cannot be passed from person to person and infection canonly occur after being bitten by a mosquito carrying the virus.
"To minimise the risk of being bitten it is advisable towear appropriate clothing to cover up - such as long sleeve topsand trousers, and to use insect repellents," she said in astatement.
In the past 50 years there has been a thirty-fold jump indengue cases worldwide as the disease has thrived in themega-cities of the tropics and been spread by globalisation.
The disease is a viral infection that can cause a range ofsymptoms, from mild flu-like illness to more serious illnessesincluding rashes and bone pain. Severe and potentially deadlyforms develop in around 5 percent of patients.
The World Health Organisation officially puts dengueinfections at between 50 million and 100 million a year, thoughmany experts think this assessment from the 1990s is asignificant under-estimate. It is estimated to kill about 20,000people a year, and the majority of cases are in South-East Asiaand the Western Pacific.
The ECDC advised authorities in geographical areasneighbouring Madeira, such as the Canary Islands, as well asother EU member states to consider stepping up surveillance ofAedes mosquito populations to assess their risk of seeing denguefever spread.
(Additional reporting by Ben Hirschler; Editing by Jon Hemming)
((kate.kelland@thomsonreuters.com)(+44 207 542 0823)(ReutersMessaging: ))
Keywords: PORTUGAL MADEIRA/DENGUE