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Dengue Fever

An increasing danger

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Dengue carrying mosquito

Dengue is a mosquito-borne viral disease and an endemic that has spread over more than 120 countries throughout Latin America, the Pacific, Asia and the southern USA. There are four dengue virus stereotypes which are continuing to spread rapidly and you need to be aware if you live or travel in these areas.

According to the WHO, dengue is the fastest growing mosquito-borne disease in the world today, causing nearly 400 million infections every year.  In the last 50 years dengue has spread from being present in a handful of countries to an endemic in 128 countries, where about 4 billion people live, and dengue incidence has likewise increased 30-fold in this time period.

It is estimated that 500,000, including children will develop dengue hemorrhagic fever (DHF) which is a severe form of the disease. DHF is a leading cause of hospitalization which places tremendous pressure on strained medical resources creating a heavy economic and societal impact.

Factors that have contributed to the dramatic increase in dengue fever include population increase, urbanization and increased travel which facilitates the dissemination of dengue viruses and the circulation of the disease. Although dengue affects people from all ages and socio-economic backgrounds, the greatest number of dengue cases worldwide occurs in the highly mobile and social segment of endemic populations that include pre-adolescents to adult ages of 9 years and older.

Nicknamed breakbone fever, dengue can be an extremely painful and debilitating flu-like illness that can lead to life-threatening complications such as dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). The disease is caused by four closely related virus serotypes of the genus Flavivirus. Infection with one provides lifelong immunity against the infecting stereotype but not the other three, but the consequences of infection by another strain makes that secondary infection much worse.

A simple explanation of dengue

Encouragingly, the number of deaths due to dengue is falling due to better clinical management and the implementation of PAHO/WHO guidelines.  Also the first vaccines came into use in 2015 but they remain limited in efficacy and availability.

The symptoms of dengue

There are a few people who will have very almost no symptoms beyond a lack of energy or as if they have a mild case of influenza. Therefore if one is in or travelling in a dengue affected country, any sense of unwellness that lasts for more than one or two days is cause to visit a doctor.
dengue
That mild sense of unwellness may also include a loss of appetite which accelerates the progress of dengue and other symptoms can include:

  • Sudden, high fever.
  • Severe headaches.
  • Pain behind the eyes.
  • Severe joint and muscle pain.
  • Fatigue.
  • Nausea.
  • Vomiting.
  • Skin rash, which appears two to five days after the onset of fever.

Examination and treatment

In some countries the doctors will take a blood sample and look for traces of the virus, but a more common method used is to take a blood sample and do a white blood cell count.  (Dengue rapidly depletes (WBCs that help fight infections and they are also called leukocytes.)

There is no medication to combat dengue, the only treatment is through nutrition and keeping the body strong. Therefore it is important to identify and treat the disease before becomes too severe.  As for treatment, there is none. What is required for recovery is rest and an abundant diet of healthy and nutritious food because it is only by feeding the body and stimulating the body's own immune system that people recover.

"I began to feel a little weaker than normal and as my family said I looked unwell, I went to a doctor. A blood test was taken and my white blood cell count was a little lower than normal but not dangerous. I was asked to return in 24 hours which I did and again a blood test showed my white cell count lower than the day before indicating that I most likely had dengue fever." ~ A personal experience

Treatment using the juice of papaya leaf

In cases requiring hospitalisation, an effective treatment is a mix of intravenous fluids and nutrients. But dengue does not produce long-term complications although there may be some oedema remaining around the site of infection for some years afterwards.

Dengue can be confused clinically with influenza, measles, malaria, Colorado tick fever, scarlet fever, typhus, yellow fever, and other hemorrhagic fevers. Infection with one provides immunity to that specific strain, nut not the others.  It is said the contracting another strain of dengue results in more severe symptoms and a greater likelihood of death.

Prevention

The only prevention against dengue virus is to avoid being bitten by mosquitoes. This means dressing appropriately to block the insects access to your skin or using some sort of bug off insect deterrent. When you reside in an affected area, work to eliminate places that mosquitoes can breed.

A simple method to reduce mosquitoes is to make a water trap - a soft drink bottle works well to make a mozzie hotel. Just cut off the top, paint the bottle black as mozzies like dark places and leave near to full with water in places around the property. Mozzies will breed, but the water is changed every week destroying the larvae - and over time mozzies are eliminated from places. To further attract mossies, CO2, 1-ocetn-3-ol (Octenol), Lactic acid, Phenols and Butanone, acetic acid and Amino acid are said to work. Learn more.

mozzitrp

Another mozzi trap is made using a coke bottle, cutting it in half, placing the topside into the base and adding water and an attractant (brown sugar and yeast is said to work). Very few escape

References:
Hadinegoro, Sri Rezeki S., et al. Efficacy and Long-Term Safety of a Dengue Vaccine in Regions of Endemic Disease Integrated Analysis of Efficacy and Interim Long-Term Safety Data for a Dengue Vaccine in Endemic Regions. July 27, 2015DOI: 10.1056/NEJMoa1506223.
http://www.paho.org/
http://www.salud.gob.sv/
Ibid.
http://www.paho.org/
http://www.who.int/mediacentre/factsheets/
http://www.who.int/csr/disease/dengue/impact/en/
Joseph R. Egger, Paul G. Coleman. Age and Clinical Dengue Illness. Emerg Infect Dis. 2007 June; 13(6): 924–927.
San Martin JL, Brathwaite O, Zambrano B, et al. The epidemiology of dengue in the americas over the last three decades: a worrisome reality. Am J Trop Med Hyg 2010;82:128-35.
Hadinegoro, Sri Rezeki S., et al. Efficacy and Long-Term Safety of a Dengue Vaccine in Regions of Endemic Disease Integrated Analysis of Efficacy and Interim Long-Term Safety Data for a Dengue Vaccine in Endemic Regions. July 27, 2015DOI: 10.1056/NEJMoa1506223.

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