DENGUE FEVER Ciwec Clinic Health News

DEFINITION : Dengue Fever is caused by a virus transmitted by day biting mosquitoe called Culex. This disease causes fevers in large number of personnes in south and South East Asia, yet not come in Nepal in January 2009.

The culex Mosquitoes are mostly confined to urban areas where they breed in the relatively clean water found in storage jarsa, discarded tires and tin cans. Because they bite during the day, especially late afternoon, as well as the night it makes  it hard to avoid exposure. Once bitten by an infective mosquito a person will become sick within 2 to 8 days.

 SYMPTOMS : The disease is characterized by sudden onset of high fever, frontal headache, backache, joint and muscle pain.

The severity of the joint pain has made it named the "Break Bone Fever ". It is often accompanied by a rash that looks like a red flush on both chest and abdomen. Fever returns to normal within a week but may leave a person feel tired and depessed for a few weeks more.

PREVENTION : As for malaria, the prevention is based on covering exposed areas when possible even at day time, using a 30%DEET Repellent. Pregnant women should use this repellent sparingly.

Air Conditioned accomodation is a good way to avoid mosquitoes too.

VACCINE : No vaccine until now.

Dengue Fever is to be suspected each time a travaller with fever comes back from n infected country, as well as Typhoid and Malaria.

TREATMENT : There is no specific treatment and spontaneous recovery is usualy the rule.Rehydration is often necessary.

LOCATION : Some regular dengue epidemics are in Sri Lanka, India, Thailand, Malaysia,Singapore and Indonesia.

In SE Asia dengue is transmitted all year round, particularly during summer wet months and post-monsoon.

Denge fever shows a marked seasonal pattern in India where travelers get infected dutring late september and october, once the rain has stopped.

DENGUE HAEMORRHAGIC FEVER (DHF) and DENGUE SCHOCK SYNDROM (DSS) : These are complications of dengue fever that are mostly confined to people that live in endemic areas, where dengue fever is currently a problem., causing death mainly to indigenous people.

Travallers are at lower risk from those, as it generally requires a repeated exposure to a different serotype of dengue. However, with the increasing incidence of Dengue Fever worlwide due to urbanization and failure pf mosquito eradication campaigms, it's likely that these coomplications become more common to travellers. DHF and DSS are characterized by bleeding complications and shcock during an episode of fever and require IMMEDIATE HOSPITALIZATION AND TREATMENT.

                                                                                                                                                                   photo A. Bommelaer

                                               CIWEC CLINIC-Trvel Medicine Center, Lainchour, Kathmandu, Nepal

                                                                                         www.ciwec-clinic.com