Dengue Fever – now we have a vaccine!

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Many people were under the impression that Dengue is a mild illness, caused by a mosquito bite. However, with the Thai TV actor ending up in intensive care with Dengue Hemorrhagic Fever, this has brought home the realities of this disease.

The female Aedes aegypti mosquito, which carries the Dengue virus, is the culprit. Dengue fever is endemic locally and the change in the weather is partly to blame (not to be confused with “climate change”, by the way).

Since the beginning of this year, dengue fever is reported to have been seen in 14,000 people. The Disease Control Department says the rainy season each year is usually the breeding period for the dengue virus, and it has certainly rained recently.

So, despite my previous pleas (and those of the Public Health Department), Dengue Fever and its potentially fatal variant, Dengue Hemorrhagic Fever (DHF) is still with us. The latest information has now prompted me to repeat my advice on this subject. If you remember reading about it before, I apologize, but the subject matter is very important. This is an important ailment, which can be avoided.

However, first you should understand a little more about Dengue and its history. It was first described in 1780 by a Benjamin Rush in Philadelphia (so it didn’t start here) when the name Break Bone Fever was applied, with the symptoms of pain in the bones and rise in temperature. The name “Dengue” came in 1828 during an epidemic in Cuba. The new name was a Spanish attempt at a Swahili phrase “ki denga pepo” which describes a sudden cramping seizure caused by an evil spirit! Let me assure you that the local brand of Dengue Fever owes nothing to spirits, evil, bottled or otherwise.

The dengue virus is related to Japanese encephalitis, Murray Valley encephalitis and Yellow fever, and there are four “serotypes” or subgroups of it.

The mosquito lays its eggs in water containers, preferring the clean water found in water tanks and pots, in the saucers under pot plants and even under the pet’s food dish. Inside discarded car tyres is another favorite spot. These mosquitoes are not of the adventurous type and feed during the day and spend their time within 200 meters of their hatchery. Consequently, the eradication of any local breeding areas becomes very important towards maintaining your own health, as you can see. Keep your home free from lying water for a radius of 200 meters and you’re looking good!

Simple Dengue (if you can call it that) has an incubation period of around four to seven days and then the full blown symptoms of high fever and headache begin. The headache is usually behind the eyes and is made worse by eye movement. From there the pains progress to the limbs with acute muscle pains, which gave it the old name “Break Bone Fever”.

On the other hand, Dengue Hemorrhagic Fever (DHF) can certainly be fatal! It appears that Serotype 2 may be the culprit here, but does not usually produce DHF unless you have been previously bitten by types 1, 3 or 4. In addition to the symptoms of Classical Dengue the skin begins to bruise very easily as the blood hemorrhages into the skin. Children are generally more susceptible to this than adults. This also becomes much more of an emergency and is best treated in the Intensive Care Unit (ICU) of your favorite hospital.

With our ability to treat the viral ailments being very limited, the defense against the Dengue virus used to lie in the preventive measures. The other precautions are to wear long trousers and long sleeved shirts, especially at sun up and sun down, when the mosquito is at its most ravenous. The other factor to remember is “D” for Dengue and “D” for DEET. DEET is the magic ingredient in mosquito repellents, so when you go to buy some, check the label – if it has DEET, then get it. However, there is also now a vaccine against Dengue (ages 9-45), available at the Bangkok Hospital Pattaya till February 28. B. 9,600 for three injections. Looks worthwhile to me.