Singapore dengue outbreak: Nearly 9000 cases through July – Outbreak News Today

Nicaragua declares alert over dengue fever – Washington Post

Bangladesh grapples with country’s worst dengue outbreak – Miami Herald

Three headlines about Dengue Fever this year? No, actually they’re all headlines just from one day: Aug 1^st, 2019. Dengue fever is a true pandemic, with community wide outbreaks in various regions throughout the world. Indeed, rates of Dengue infection are thought to have increased greatly since 1960 due to encroaching civilization and population growth in warmer regions. As a resident of South Florida, I believe that the development of residential air conditioning around that time may have precipitated the explosion in potential victims.

What is Dengue fever? It’s an infection caused by a virus that’s transmitted to humans by mosquitoes. If you live between latitude 35 degrees north and 35 degrees south, and lower than 3000 feet elevation, you’re in Dengue territory.

And you’re not alone. An estimated 400 million people get infected with the Dengue virus every year. Luckily for the grand majority, they don’t even know they have it. 96 million cases, however, aren’t so fortunate and develop sickness.

The mosquito in question is the Aedes Aegypti, but other species may possibly spread it. A mosquito bites a human with the Dengue virus and becomes infected. It doesn’t get sick, but the virus is now in its saliva for life. The mosquito passes Dengue onto the next human through its next bite.

There are actually four different but related viruses that cause dengue fever, but the symptoms are similar. If you’re in the unlucky minority that gets sick, you can expect to see signs about four to seven days after the infectious bite. You may experience:

• A high fever (up to 104 degrees Fahrenheit) of sudden onset
• Severe headaches
• Pain behind the eyes
• Severe joint, bone, and muscle pain
• Fatigue
• Nausea and vomiting
• Diarrhea
• Skin rashes (several days into the sickness)

Sometimes, the orthopedic symptoms are so painful that Dengue has been called “Breakbone fever”. Thankfully, most resolve their symptoms in one to two weeks and are immune to the virus (at least the specific strain they contracted; remember, there are four). If someone with a history of dengue fever gets sick again, it is likely with a different strain. Second Dengue infections tend to be worse than the first.

Having said that, a small minority of sufferers will develop a life-threatening version of the disease called “Dengue Hemorrhagic Fever”. Complications such as resistant fevers, bleeding from nose and gums, blood and lymphatic vessel damage, and liver enlargement can occur. The disease may progress to “Dengue Shock Syndrome” where massive bleeding, organ failure, and circulatory collapse occurs. If you had to compare it to another disease, think of end-stage Ebola.

There is no cure for Dengue fever, and treatment is symptomatic; that is, you treat the fever with acetaminophen, give oral hydration, and enforce bedrest. A controversial vaccine was approved by the FDA this year, but is only for a certain subgroup of patients and not for the general population.

If you live in an area where Aedes Aegypti makes its home, you can best protect yourself with a few precautions:

• Use DEET or other mosquito repellant regularly (even indoors in some areas)
• When outdoors, wear long-sleeved shirts
• When outdoors, wear long pants and tuck the cuffs into your socks
• Clothing can be sprayed with the insecticide Permethrin 0.5% (but not skin)
• If you have air conditioning, keep the windows and doors shut
• If you don’t have air conditioning, use mosquito netting and door/window screens

The best way to prevent bites is reducing the mosquito population. They require water in which to lay their eggs, so begin by removing items that collect water wherever possible. Eliminate junk like tin cans, flowerpots, and old tires that could serve as breeding grounds. Bird baths and your pet’s water dish may also contain mosquito larvae.

Mosquitoes transmit more than just Dengue fever: They’re responsible for more human deaths than any other creature on Earth through diseases like malaria, West Nile, Yellow fever, and others. If you take steps to prevent bites, you’re taking steps to keep your family healthy and prevent a new outbreak of the Dengue pandemic.

Joe Alton MD

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