Educate yourself on dengue and help reduce its spread
Earlier this month health officials from children’s hospitals in Myanmar reported higher than usual numbers of patients requiring admission for dengue fever (Myanmar Times, June 10, p.22). This trend, combined with WHO estimates that Myanmar has the highest incidence of dengue in Southeast Asia, means that families should be watching closely for dengue symptoms and taking steps to prevent its transmission.
Dengue disease is a fever caused by a virus that can either be like the flu or become something much worse. It is spread by a mosquito named Aedes aegypti that gets the virus by biting an already infected person and then spreads it to the next person.
The mosquito breeds in puddles of clear water and likes to live in cooler dark places like a closet or under a bed. The global spread of dengue has been facilitated by urban environments that give the Aedes mosquito access to many sources of standing water in the midst of population density. In fact it is thought that the trade of tires from used vehicles often causes the introduction of disease into new territories.
Most dengue infections will go unnoticed by the recipient of the mosquito bite. This means that although you’ve been exposed to the virus, your immune system fights it off and you never get sick. Unfortunately in some instances the virus is able to replicate sufficiently to cause symptoms. These are most commonly a few days of fever, headache, pain behind the eyes, muscle pain, joint pain, and perhaps a rash. From this point most people recovery spontaneously and require no further treatment. However a small proportion of patients go on to leak fluid from their blood vessels. This is obviously serious disease, its called Dengue Hemorrhagic Fever, and it requires hospitalization.
The serious complications of dengue occur more commonly in children, young adults, and people who are overweight. Doctors have blood tests to help with diagnosis, but we also use symptoms to tell us if dengue is becoming dangerous. Specifically we look for increasing abdominal pain, heavy vomiting, bleeding from nose/mouth/gums, swelling, and difficulty breathing. The appearance of any of these requires an immediate trip to the hospital.
New readers of this column will remember that the flu is more common during rainy season. So is dengue fever, and you’ll notice that based on the early symptoms described above it can be difficult for your doctor to differentiate between the two. Therefore we watch patients, and especially children, very closely to see which direction an illness with fever is heading.
The main thing to remember from today’s column is that if you have flu-like symptoms for 3 to 4 days and then your sickness gets worse, it’s time to visit the doctor. For children with flu symptoms, please call the doctor right away to make a plan to monitor your child’s illness for dengue.
Finally and most importantly, take steps to reduce your risk of dengue. To the extent to which you have control of your environmental surroundings, make sure to eliminate all sources of standing water. This includes barrels, drums, jars, pots, buckets, flower vases, plant saucers, tanks, discarded bottles, tins, tires, water coolers, refrigerator drip pans, and other places where rain-water collects or is stored. The Aedes aegypti bites in the daytime. If possible please keep screens on your window, use mosquito repellent or coils if necessary, and protect small children with bednets during daytime naps.
