Dengue fever is a tropical, waterborne disease spread by mosquitoes. EPA
Dengue fever is a tropical, waterborne disease spread by mosquitoes. EPA
Dengue fever is a tropical, waterborne disease spread by mosquitoes. EPA
Dengue fever is a tropical, waterborne disease spread by mosquitoes. EPA

Global dengue fever cases surge, with rising numbers in Middle East


Nick Webster
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  • Arabic

Global cases of the debilitating tropical disease dengue fever are rising dramatically, with a number of Arab nations seeing a reported rise in cases in recent months.

Dengue fever is a waterborne disease spread by mosquitoes, and is rarely reported in the Emirates.

Cases internationally are increasing, with more than 4.2 million infections reported worldwide in 2023, compared with only 500,000 at the turn of the century. According to the University of Washington's Institute of Health Metrics and Evaluation, the Mena region registered an 88 per cent increase in cases of dengue fever from 1990 to 2019.

We are seeing dengue cases arising every year whereas before we didn't see any
Dr Ali Ahmed,
Canadian Specialist Hospital, Dubai

The institute also said there had been 1.2 million more incidents of the virus in the World Health Organisation's Eastern Mediterranean Region reported in that time.

Medics in Dubai said although numbers of infected patients requiring care were low, several cases had been reported to health authorities in recent months.

“In 2023, we saw an increased surge in vector-borne disease,” said Dr Nandkishore Mariswamy, an internal medicine specialist at NMC hospital in Dubai Investments Park.

“At the end of the summer, we saw multiple cases of local spread of dengue in Dubai, which was very surprising.”

Dengue fever is usually spread by the Aedes aegypti mosquito, often referred to as the yellow fever mosquito, an unheard of phenomenon in Dubai, Dr Mariswamy said.

“Usually, whenever there is a weather change or climate change, we find that warmer climates favour these vector-borne mosquitoes to thrive,” he said.

The estimated number of deaths caused by dengue fever in 2019, by country. Our World in Data
The estimated number of deaths caused by dengue fever in 2019, by country. Our World in Data

Steady rise in cases

According to the WHO, dengue and severe dengue epidemics were first reported in the Eastern Mediterranean region in 1998, and have continued to rise since then. Nine countries in the area, Egypt, Oman, Saudi Arabia, Somalia, Sudan, Yemen, Pakistan, Afghanistan and Djibouti have had outbreaks, with Pakistan, Saudi Arabia and Oman reporting the highest number of confirmed cases in 2023.

The government's Emirates Health Services website has not published any recent data, the site does have a page dedicated to dengue fever, with related information and preventive measures.

It is not just in the UAE where unusual numbers of cases have been reported.

An outbreak of Dengue fever was reported last summer in Egypt, particularly in the Red Sea governorate.

Research by the department of biology sciences at the King Abdulaziz University, Jeddah, Saudi Arabia, found numbers of dengue cases soared in 2023.

Data showed a major epidemic year in the kingdom for dengue, with infections reaching 4,099 in the first half of 2023, a significant increase on previous years.

Only 300 cases were reported in Jeddah in 1994, when disease surveillance was first established.

Common symptoms

Dr Nandkishore Mariswamy said he was surprised at the number of dengue cases he saw this summer in Dubai. Antonie Robertson / The National
Dr Nandkishore Mariswamy said he was surprised at the number of dengue cases he saw this summer in Dubai. Antonie Robertson / The National

Infection in human beings is caused by any one of four closely related dengue viruses that lead to a range of symptoms.

While vaccine research is continuing, the four subtypes of the virus make it a challenge to develop an effective prophylactic.

The most common signs are a high fever of 39ºC to 40ºC, severe headaches, joint and muscle pain, nausea, vomiting, mild nosebleeds and a skin rash.

Symptoms can be mild and almost unnoticeable but in more severe cases, such as in pregnant women, the young and elderly, or those with existing health problems, the symptoms can be fatal if left untreated.

In 2019, the WHO warned that an increase in global outbreaks was likely, particularly during seasonal changes and periods of heavy rainfall.

“With waterborne diseases, most of the time it causes abdominal symptoms like diarrhoea, vomiting and severe dehydration,” said Dr Ali Ahmed from the Canadian Specialist Hospital in Dubai.

Aedes aegypti mosquitoes can cause dengue, chikungunya, zika fever, mayaro and yellow fever. AP
Aedes aegypti mosquitoes can cause dengue, chikungunya, zika fever, mayaro and yellow fever. AP

“If someone is affected by the disease or their immune system gets activated, they are in a compromised situation,” Dr Ahmed said.

“When a patient comes with symptoms like high fever, we check for dengue as it usually presents with a very high temperature of 39ºC or 40ºC.”

To confirm a diagnosis, doctors will check a patient’s platelets – cell fragments in the blood that prevent heavy bleeding – because a low count could signal internal bleeding, another common symptom.

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An antigen blood test would follow to confirm the presence of the pathogen, before the case is reported to health authorities.

Dr Ali said he had recorded about 25 cases of dengue fever in his hospital in 2023, having typically reported about five cases annually in previous years.

Those testing positive for the virus had no history of travel, suggesting it was contracted in the UAE.

“There have been more cases here than in previous years, and I’ve had that confirmed in discussion with other doctors,” he said.

“We are seeing dengue cases arising every year whereas before we didn't see any.”

Many of the recently reported cases appear to be in Dubai, where people who have contracted dengue from mosquitoes have been warning others on social media to be on their guard.

In October, Al Zahra Hospital in Dubai published the details of a 58-year-old woman who had the disease, with no history of travel outside the UAE.

“We have been seeing dengue fever every now and then, with most of the cases we are seeing coming from endemic countries,” said Dr Dima Ibrahim, an infectious disease specialist at Burjeel Medical City in Abu Dhabi.

“It was almost unheard of to have this disease in the Middle East and North Africa because of the dry air. Some colleagues have described cases to have occurred without any history of travel, like in Dubai.”

Once doctors at BMC suspect dengue fever based on symptoms and laboratory testing, cases are reported to the Department of Health.

Hospitals offer supportive treatment, such as medication to treat headaches and to control the fever.

“There is no specific treatment that we give for dengue,” said Dr Ibrahim.

“The weather change has made the presence of mosquitoes more prevalent, so we must try to prevent transmission of the disease.

“If there is an area with mosquitoes, apply insect repellent to the skin and, sometimes, to the bedding. If you have activity outdoors, people should wear long sleeves to protect the skin from mosquito bites.”

It is not just in the UAE where unusual numbers of cases have been reported.

European cases

As of November, 122 cases had been reported in southern Europe in 2023.

According to the European Centre for Disease Prevention and Control, there were 76 confirmed cases in Italy, 43 in France and three in Spain.

The WHO said it was alarmed by the high number of cases in the second half of 2023, with cumulative cases for the year surpassing all previous yearly totals.

In some countries, cases extended beyond historically affected areas of transmission.

In the US, the Centres for Disease Control and Prevention investigated four cases of locally acquired malaria in Texas and Florida.

Mosquito surveillance and control measures were put in place in the affected areas as a result.

As the planet warms, infectious diseases could undergo a dramatic shift, experts said.

More frequent droughts and floods expose populations to more waterborne microbes, while migrating animals interact with species not encountered before, allowing pathogens to spread among new hosts.

Infectious disease specialists in the US called on doctors to update their education and training to adapt to new pathogens and viruses related to climate change.

Viruses, bacteria, fungi and parasites can all cause infectious diseases, many of which are transmitted between humans, or from animals.

Longer summers and shorter, warmer winters around the world with more rainfall and standing water, in which mosquitoes multiply, are driving up vector-borne diseases.

“Clinicians need to be ready to deal with the changes in the infectious disease landscape,” said Prof George Thompson from the department of medical microbiology and immunology at the University of California's Davis School of Medicine.

“Learning about the connection between climate change and disease behaviour can help guide diagnoses, treatment and prevention of infectious diseases.

“I think with improvements in our understanding of the disease, there will be more testing and we'll miss fewer cases that way.”

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Ten tax points to be aware of in 2026

1. Domestic VAT refund amendments: request your refund within five years

If a business does not apply for the refund on time, they lose their credit.

2. E-invoicing in the UAE

Businesses should continue preparing for the implementation of e-invoicing in the UAE, with 2026 a preparation and transition period ahead of phased mandatory adoption. 

3. More tax audits

Tax authorities are increasingly using data already available across multiple filings to identify audit risks. 

4. More beneficial VAT and excise tax penalty regime

Tax disputes are expected to become more frequent and more structured, with clearer administrative objection and appeal processes. The UAE has adopted a new penalty regime for VAT and excise disputes, which now mirrors the penalty regime for corporate tax.

5. Greater emphasis on statutory audit

There is a greater need for the accuracy of financial statements. The International Financial Reporting Standards standards need to be strictly adhered to and, as a result, the quality of the audits will need to increase.

6. Further transfer pricing enforcement

Transfer pricing enforcement, which refers to the practice of establishing prices for internal transactions between related entities, is expected to broaden in scope. The UAE will shortly open the possibility to negotiate advance pricing agreements, or essentially rulings for transfer pricing purposes. 

7. Limited time periods for audits

Recent amendments also introduce a default five-year limitation period for tax audits and assessments, subject to specific statutory exceptions. While the standard audit and assessment period is five years, this may be extended to up to 15 years in cases involving fraud or tax evasion. 

8. Pillar 2 implementation 

Many multinational groups will begin to feel the practical effect of the Domestic Minimum Top-Up Tax (DMTT), the UAE's implementation of the OECD’s global minimum tax under Pillar 2. While the rules apply for financial years starting on or after January 1, 2025, it is 2026 that marks the transition to an operational phase.

9. Reduced compliance obligations for imported goods and services

Businesses that apply the reverse-charge mechanism for VAT purposes in the UAE may benefit from reduced compliance obligations. 

10. Substance and CbC reporting focus

Tax authorities are expected to continue strengthening the enforcement of economic substance and Country-by-Country (CbC) reporting frameworks. In the UAE, these regimes are increasingly being used as risk-assessment tools, providing tax authorities with a comprehensive view of multinational groups’ global footprints and enabling them to assess whether profits are aligned with real economic activity. 

Contributed by Thomas Vanhee and Hend Rashwan, Aurifer

If you go

The flights

Emirates flies from Dubai to Seattle from Dh5,555 return, including taxes. Portland is a 260 km drive from Seattle and Emirates offers codeshare flights to Portland with its partner Alaska Airlines.

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Pox that threatens the Middle East's native species

Camelpox

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Falconpox

Falconpox can cause a variety of types of lesions, which can affect, for example, the eyelids, feet and the areas above and below the beak. It is a problem among captive falcons and is one of many types of avian pox or avipox diseases that together affect dozens of bird species across the world. Among the other forms are pigeonpox, turkeypox, starlingpox and canarypox. Avipox viruses are spread by mosquitoes and direct bird-to-bird contact.

Houbarapox

Houbarapox is, like falconpox, one of the many forms of avipox diseases. It exists in various forms, with a type that causes skin lesions being least likely to result in death. Other forms cause more severe lesions, including internal lesions, and are more likely to kill the bird, often because secondary infections develop. This summer the CVRL reported an outbreak of pox in houbaras after rains in spring led to an increase in mosquito numbers.

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More than 2.2 million Indian tourists arrived in UAE in 2023
More than 3.5 million Indians reside in UAE
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Why your domicile status is important

Your UK residence status is assessed using the statutory residence test. While your residence status – ie where you live - is assessed every year, your domicile status is assessed over your lifetime.

Your domicile of origin generally comes from your parents and if your parents were not married, then it is decided by your father. Your domicile is generally the country your father considered his permanent home when you were born. 

UK residents who have their permanent home ("domicile") outside the UK may not have to pay UK tax on foreign income. For example, they do not pay tax on foreign income or gains if they are less than £2,000 in the tax year and do not transfer that gain to a UK bank account.

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A VOISS computer costs between $200 and $250 depending on memory card capacity that ranges from 32GB to 128GB

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Subsequent computer versions will include improvements such as wireless keyboards

Arabic voice in affordable talking computer to be added next year to English, Portuguese, and Spanish synthesiser

Partnerships planned during Expo 2020 Dubai to add more languages

At least 2.2 billion people globally have a vision impairment or blindness

More than 90 per cent live in developing countries

The Long-term aim of VOISS to reach the technology to people in poor countries with workshops that teach them to build their own device

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Dos

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Gina MIller, anti-Brexit campaigner

Lord Smith, former Cabinet minister

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Labour dispute

The insured employee may still file an ILOE claim even if a labour dispute is ongoing post termination, but the insurer may suspend or reject payment, until the courts resolve the dispute, especially if the reason for termination is contested. The outcome of the labour court proceedings can directly affect eligibility.


- Abdullah Ishnaneh, Partner, BSA Law 

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Updated: April 01, 2024, 5:20 AM