Dengue in Pakistan: Travel Precautions

Dengue is present in Pakistan every year, but the risk is highest after the monsoon, from about September to November, and mostly in cities such as Lahore, Karachi and the Rawalpindi and Islamabad area. Research on Pakistani surveillance data puts the peak in September and October, with major outbreaks usually reported between late September and early December. If you are travelling then, the practical answer is simple: avoid mosquito bites all day, not just at night, and treat any fever seriously.

This guide covers when and where the risk is greatest, how to avoid bites, what the symptoms look like, and what to do if you fall ill. It is general travel information, not medical advice, so speak to a doctor before you go if you have a health condition, are pregnant, or are travelling with young children.

When is dengue season in Pakistan?

Cases build through August and rise steeply after the rains, because standing water in tyres, coolers, buckets and flooded ground gives the mosquitoes places to breed. Published analyses of Pakistani data describe most infections in the post-monsoon months, peaking in September and October, and Punjab's health department reported thousands of cases in the 2025 season, with the rise continuing into October and November.

A few cases turn up outside those months, because dengue can circulate at low levels through the year in warm parts of the country. But if you are choosing dates, mid-September to the end of November is the period when the risk is real, and a wet monsoon makes the following weeks worse.

Where is the risk highest?

Dengue is a disease of towns and cities. The Aedes mosquito lives close to people and breeds in small pools of clean water in and around homes, which is why the big outbreaks in recent years have been in urban areas.

• Lahore and other Punjab cities report the most cases in most years. Punjab's tally passed 3,900 in early October 2025, with Lahore accounting for several hundred.
• Karachi accounts for most cases in Sindh.
• Rawalpindi and Islamabad are a regular outbreak area, which matters because many northern trips pass through them.
• Peshawar and other low-lying KP towns have also reported outbreaks in past seasons.

Mountain valleys are a different picture. The cool nights and altitude of places like Hunza, Skardu or the upper Neelum valley are not where dengue outbreaks are reported, though a hot lower town on the way can still have mosquitoes. Do not assume any place is free of risk in September; simply expect it to be lower the higher and cooler you go.

If you are travelling north, the time you are most exposed is usually the night or two you spend in Lahore, Islamabad or another low city at the start or end of the trip.

How to avoid bites

The key fact is that dengue mosquitoes bite in the daytime. Peak biting is after sunrise and around sunset, but they bite through the day and night, so an evening-only routine is not enough. The US CDC's travel advice is the standard reference here.

1. Use a repellent every day. Choose one containing DEET, picaridin, oil of lemon eucalyptus (PMD) or IR3535. A higher percentage lasts longer. Put sunscreen on first and repellent over it.
2. Cover up in the morning and late afternoon. Loose, long-sleeved shirts and trousers work better than thin, tight clothes that a mosquito can bite through.
3. Sleep in a screened or air-conditioned room. If your room has open windows without screens, ask for a net or a mosquito coil or plug-in vaporiser.
4. Check for standing water. Under a cooler, in flower pots, buckets and old tyres near where you are staying. Ask the hotel to empty and scrub them.
5. Treat clothing with permethrin if you are staying somewhere for weeks rather than days.

Repellent and long sleeves are more reliable than any device. Wristbands and phone apps have no good evidence behind them.

What are the symptoms?

Symptoms usually begin four to ten days after the bite and last two to seven days. Typical signs are:

• Sudden high fever, up to about 40°C
• Severe headache and pain behind the eyes
• Muscle and joint pain, often severe
• Nausea, vomiting and a rash
• Swollen glands

Most people recover at home with rest and fluids. A minority develop severe dengue, and the warning signs often appear just as the fever falls, not while it is at its worst.

What to do if you get a fever

Any fever in September to November in a city, or up to two weeks after leaving one, deserves a check rather than a guess. Malaria, typhoid and other infections also cause fever, and only a test tells them apart.

1. See a doctor and ask for a dengue test. Pakistani hospitals and private labs in the big cities run these routinely; the timing matters because some tests are less reliable in the first day or two.
2. Take paracetamol for fever and pain. Avoid aspirin and ibuprofen and other anti-inflammatory painkillers, because they can increase bleeding risk.
3. Drink plenty of fluids and rest.
4. Return for a review if you feel worse once the fever drops, particularly if any of the warning signs above appear.

If you are far from a good hospital, do not wait to see whether a fever passes. Most of the north has clinics rather than well-equipped hospitals, so a person who is unwell in a mountain valley should head to Gilgit, Skardu, Abbottabad or another main city for a test. Our list of emergency numbers for the northern areas is worth saving before you set out.

Who should take extra care?

Anyone who has had dengue before can develop a more serious illness if infected by a different type, which is one reason families with a recent case should be careful. Young children, older adults, pregnant women and people with diabetes, heart disease or bleeding disorders are more likely to become seriously unwell. If that describes anyone in your group, consider moving a trip out of the September to November window or keeping to high, cool destinations, and talk to a doctor first.

For other health preparations, including routine and travel vaccines, see our guide to vaccinations for Pakistan travel. A policy that covers medical treatment is also worth having; see travel insurance for a northern areas trip.

Is it worth changing your plans?

For most Pakistani families, no. Dengue is a reason to be careful, not to cancel. The simplest adjustment is timing: if you can choose, the north in June to early September and again in October avoids the peak in the cities you pass through, and the mountains are cooler than the plains. Our guide to when to go covers the seasons region by region, and the monsoon season guide explains what the rains do to roads and rivers.

If you must be in Lahore or Karachi in October, follow the routine above, choose an air-conditioned hotel, and do not ignore a fever. Our FAQs cover other practical questions before you travel.

Frequently asked questions