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Join date : 2009-04-03

PostSubject: DENGUE   Fri Jul 23, 2010 1:19 pm


There has been much interest of lately in the DR about this tropical disease. The following is purely an informational piece for the benefit of those anxious to possess a wider knowledge about this condition, which hopefully, may motivate some to take a few steps to prevent this disease.

What is it?
This is a disease prevalent (endemic) in tropical and subtropical zones throughout the world, with a geographical spread akin to that of malaria. This does not mean it cannot be found anywhere else in the world, considering the frequency and reach of travel these days. Several hundred cases occur yearly in the US alone.

What causes it?
It is caused by any of 4 different but closely related dengue viruses.

Is it possible to have dengue more than once?
Most definitely yes! There is sadly, no lasting immunity after suffering a bout of dengue.

How does one catch it?
It is transmitted by the bite of a feeding mosquito (Aedes aegypti) that has previously bitten someone else already sick with dengue. This mosquito tends to feed (bite) during the day. So, it is not a disease contacted by touch, cough droplets, eating with unclean utensils, something in the water or transmitted by animals.

Why are we having this problem now?
The DR has been affected by an unprecedented number of storms and heavy rains in the last several months, which have undoubtedly left innumerable pools of stagnant water where mosquitoes can breed. That is the primary factor causing the present surge in dengue cases. The offending mosquito has a predilection though, for standing water in artificial containers like drums, cups, bottles, flower vases/pots, tires, etc., some of which are often found in or around dwellings. It does prefer clean to dirty water to breed, whence the importance of getting rid of indoor flower vases and water-containing decorations.

What are the symptoms?
After a period of 3-14 days between mosquito bite and start of symptoms (called the “incubation period”), there is usually the sudden onset of fever, severe bone, muscle and/or joint pains (whence its nickname of “break-bone fever”), accompanied by significant pain felt behind the eyeballs. A skin rash may well appear at some point. This scenario lasts some 3-5 days, after which the fever falls with varying degrees of sweating, leaving the patient feeling better. The fever may soon return though, but only for a brief period before actual recovery ensues. Some cases have mild symptoms. Rarely a severe form occurs, called “hemorrhagic dengue”.

How is it diagnosed?
The diagnosis is usually suspected by the clinical picture outlined above. The presence of fever without an obvious cause is reason for suspicion. There are some lab (blood) findings that are highly suggestive of the diagnosis, reason why a physician ought to be consulted as soon as dengue is suspected.

How is it treated?
There is no curative treatment as yet and no vaccine available for prevention. Symptomatic treatment is basically all that is available. However, the treatment of dengue is also best left to a qualified physician and not placed in the hands of well-meaning friends or relatives, since some circumstances may demand a significant departure from the usual symptomatic treatment. Caveat emptor!

What can one do to prevent this?
After digesting the information given above, it seems logical to take the following steps inside your home:
- use screening as much as possible and do not leave doors/windows open for the mosquito to gain access indoors.
- eliminate all pooled/standing water inside and around the home. Yes, that means even your lovely flower in vases with a bit of water!!
- consider using mosquito nets and/or ceiling fans to sleep..
- use repellents, if deemed necessary.
- start swatting and killing all flying critters in your home.

If outdoors:
- wear clothes covering most of your body, a good idea even indoors.
- use insect repellent.
- minimize time of exposure to mosquitoes. Purposely avoid “high mosquito hours”, as before and after dusk.

Hope this may debunk some myths and help someone.

Rafael G. Belliard, MD

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