Dengue

By Dr. Mark Wise

Dengue, which rhymes with shmengee, is a viral infection which has been with us for at least two hundred years. It has a worldwide distribution throughout the tropics.

Dengue is contracted via the bite of the Aedes aegypti mosquito. This species of mosquito differs from the Anopheles mosquito which transmits malaria in two ways. Firstly, it likes to breed in close proximity to humans, in water containers such as discarded tires, barrels, flower vases and buckets. Therefore it is a risk to travellers who spend time in urban areas. Secondly, it is a day biter, preferring its meals at daybreak and the late afternoon.

This infection is not one you would wish on your worst enemy. It begins abruptly with a high fever, severe headache and tremendous pains in the muscles and bones. The name actually means "breakbone fever". A rash sometimes follows on the fourth or fifth day of the illness. Symptoms usually subside within a week, though the victim may be left with prolonged fatigue, aches and pains and depression. There is no vaccine against dengue, and no specific treatment other than symptomatic care.

A more severe form of the infection, dengue hemorrhagic fever, occasionally occurs and may prove fatal. This, however, is much more likely to happen in children, particularly if they have been exposed to the virus before. It is rare in tourists.

Insect avoidance is the main means of preventing dengue. Protective clothing and staying indoors are not always practical. Electric buzzers, garlic and playing reruns of I Love Lucy are also not very effective.

Use insect repellent containing DEET. There is some controversy regarding the safety of DEET. In small children, it is probably best to use a milder concentration, say 35%. In adults, a stronger preparation may be used, which will provide for longer protection.

As with other tropical diseases, the risk of dengue to the average tourist is quite low. With the proper precautions, it is even lower. So cover up, grease up....and enjoy.

© Copyright 2000 Dr. Mark Wise

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