I have had dengue fever and also treated a number of patients with it over the years and can echo the sentiment "This is not a disease you want to fall ill with!".
What is dengue fever? What is dengue hemorrhagic fever?
Dengue fever is a flu-like illness spread by the bite of an infected mosquito.
Dengue hemorrhagic fever is a severe, often fatal
, complication of dengue fever.
What exactly causes dengue fever?
Dengue and dengue hemorrhagic fever are caused by any of four dengue viruses. This is important because infection with one virus does not protect a person against infection from another.
How is dengue fever spread?
Dengue is spread by the bite of an Aedes
mosquito. The mosquito transmits the disease by biting an infected person and then biting someone else.
Unlike the mosquitoes that cause malaria, dengue mosquitoes bite during the day.
Where is dengue found?
Dengue viruses occur in most tropical areas of the world. Dengue is common in Africa
, Asia, the Pacific, Australia
, and the Americas. It is widespread in the Caribbean basin. Dengue is most common in cities but can be found in rural areas. It is rarely found in mountainous areas above 4,000 feet.
What are the symptoms of dengue fever and dengue hemorrhagic fever?
Dengue fever usually starts suddenly with a high fever, rash, severe headache, pain behind the eyes, and muscle and joint pain. The severity of the joint pain has given dengue the name "breakbone fever." Nausea, vomiting, and loss of appetite are common. A rash usually appears 3 to 4 days after the start of the fever. The illness can last up to 10 days, but complete recovery can take as long as a month. Older children
and adults are usually sicker than young children
Most dengue infections result in relatively mild illness, but some can progress to dengue hemorrhagic fever. With dengue hemorrhagic fever, the blood vessels start to leak and cause bleeding from the nose, mouth, and gums. Bruising can be a sign of bleeding inside the body. Without prompt treatment, the blood vessels can collapse, causing shock (dengue shock syndrome). Dengue hemorrhagic fever is fatal in about 5 percent of cases, mostly among children and young adults.
How soon after exposure do symptoms appear?
The time between the bite of a mosquito carrying dengue virus and the start of symptoms averages 4 to 6 days, with a range of 3 to 14 days. An infected person cannot spread the infection to other persons.
Who is at risk for dengue?
Anyone who is bitten by an infected mosquito can get dengue fever. Risk factors for dengue hemorrhagic fever include a person's age and immune status, as well as the type of infecting virus. Persons who were previously infected with one or more types of dengue virus are thought to be at greater risk for developing dengue hemorrhagic fever if infected again.
What is the treatment for dengue and dengue hemorrhagic fever?
There is no specific treatment for dengue. Persons with dengue fever need rest and plenty of fluids. Dengue hemorrhagic fever is much more difficult to treat and may require blood transfusions, massive fluid replacement and diuresis to try and prevent kidney failure.
How common is dengue fever?
In tropical countries around the world, dengue is one of the most common viral diseases spread to humans by mosquitoes. Tens of millions of cases of dengue fever and up to hundreds of thousands of cases of dengue hemorrhagic fever occur each year.
In the United States, approximately 100 cases of dengue are reported each year in travelers returning from tropical areas. Many more cases probably go unreported.
Is dengue fever becoming an increasingly serious problem?
Yes. All types of dengue virus are re-emerging worldwide and causing larger and more frequent epidemics, especially in cities in the tropics. The emergence of dengue as a major public health
problem has been most dramatic in the western hemisphere. Dengue fever has reached epidemic levels in Central America
and is threatening the United States.
Several factors are contributing to the resurgence of dengue fever:
- No effective mosquito control efforts are underway in most countries with dengue.
- Public health systems to detect and control epidemics are deteriorating around the world.
- Rapid growth of cities in tropical countries has led to overcrowding, urban decay, and substandard sanitation, allowing more mosquitoes to live closer to more people.
- The increase in non-biodegradable plastic packaging and discarded tires is creating new breeding sites for mosquitoes.
- Increased jet air travel is helping people infected with dengue viruses to move easily from city to city.
Dengue hemorrhagic fever is also on the rise. Persons who have been infected with one or more forms of dengue virus are at greater risk for the more severe disease. With the increase in all types of virus, the occurrence of dengue hemorrhagic fever becomes more likely.
Can dengue fever be prevented?
There is no vaccine to prevent dengue. Prevention centers on avoiding mosquito bites.
- Use mosquito repellents (DEET) on skin and clothing.
- Use bednets if sleeping areas are not screened or air-conditioned.
- If you have symptoms of dengue, report your travel history to your doctor.
This information is not intended to ignite an attitude of fear, but hopefully to simply provide some awareness about a potential danger
for those of us who love the tropics. Yes you can die from this, but you can also die from Box and Irakanji jellyfish stings, or falling overboard
and drowning because you weren't wearing a harness on deck
. Like many other aspects of cruising, it's amazing how far a little common sense will go. So use some DEET when necessary and stay away from the mozzies!
All The Best,
John Kuapa'a, M.D.