The boom in low-cost airlines in the ASEAN region is helping people and mosquitoes spread dengue virus

Cheap flights have become the norm between the 10 members of the Association of Southeast Asian Nations (ASEAN) thanks to the arrival of low-cost carriers.

The introduction of the ASEAN Open Sky Policy – which allows airlines to fly freely within the region has made travel even more attractive and accessible.

Research shows a surge in demand across the region, with low oil prices fueling rapid growth.

Low-cost airlines and increased global travel make spreading dengue easier than ever before.

But there may be a downside. As experts gather in Bangkok for ASEAN Dengue Day (June 15), a leading expert is warning that planes are facilitating the spread of dengue fever and other vector-borne illnesses.

“The increase in the number of budget airlines in the region has been dramatic in the last 10 to 15 years,” says Prof Tikki Pang of the National University of Singapore. “This is obviously heeling dengue to move around the region.”

He says the low-cost travel phenomenon is not a direct threat to the Asian tourism industry – after all, the disease is endemic in every ASEAN country – but is making it difficult to get a grip on outbreaks.

“There is more movement of infected people. Flight distances in this part of the world are fairly short so people can get on a plane for an hour or two even if they have dengue fever. Then they could be bitten by a mosquito at their destination, and that mosquito may subsequently infect someone else,” Professor Pang explains.

It is also possible that infected mosquitoes are boarding aircraft when they are being loaded. Mosquitoes may enter the cabin or, perhaps more frequently, hitch a ride in the cargo hold. Upon arrival, the mosquitoes can find their next dengue victim with ease.

“In some parts of the world they routinely spray aircraft prior to landing but it is not standard practice here,” says Professor Pang. “I have seen cabin crew go along the aisle with bug spray but it’s unclear whether that is effective.”

In addition to the costs of spraying insecticide through aircraft, passengers may object to being doused with bug spray. Yet some form of action may be required.

There is little that can be done in terms of controlling the huge volume of travel but individuals can take measures to protect themselves from dengue.

“As individuals, we can reduce the risk of bites by using repellents and avoid staying outside,” says Professor Pang but the arrival of the first dengue vaccine is a game-changer.

“My big crusade at the moment is highlighting the importance of vaccination,” he says. To me, personal protection is the logical way of approaching this.”

While he doesn’t see the dengue vaccine as a travel vaccine per se, it may ease individuals’ concerns about the growth in travel.

“If someone takes it upon themselves to get the vaccine they would worry less about travel, particularly if visiting an area where there is an ongoing outbreak. But for most of us in the ASEAN region, dengue is an everyday risk whether you travel or not.”

—