Dengue fever: Fears of epidemic as four times as many cases reported in Thailand

[DrTuner]

I think the probability of dying from from frustration while trying to discuss dengue with some one suffering from what I'd diagnose as PMS symptoms is higher than actually managing to develop hemorragic fever and croaking from it.

[atyclb]

37 minutes ago, atyclb said:

15 hours ago, KarlS said:

15 hours ago, atyclb said:

 

 

may i ask where you completed your id fellowship?

I do not have one but I do have a FRACEM and a FCICM - Does that answer your question? FYI I have published 17 case studies relating to dengue shock syndrome. What is your publication count on this topic? 

 

again in reviewing lots of literature from multiple respected sources including; mayo clinic, www.ncbi.nlm.nih.gov/pubmed, emedicine medscape, etc etc

"There is no specific pharmacologic treatment for dengue infection"       treatment is supportive and can include treating complications if they occur.

 

 

WHO guidelines recommend obtaining a baseline hematocrit measurement. Thrombocytopenia and hemoconcentration are consistent findings in dengue infection. [10] When the plasma leakage phase starts to resolve, the hematocrit level begins to fall, making identification of significant occult hemorrhage difficult. Administer blood transfusion if significant hemorrhage ensues (GI bleeding may be profound). Administer fresh frozen plasma or platelets if DIC is extensive and the patient is hemodynamically unstable. Prophylactic platelet transfusions in a stable thrombocytopenic patient are not needed.

There is no specific pharmacologic treatment for dengue infection. Initiate early supportive care by administering isotonic NS solution intravenously, as clinically indicated, to maintain adequate blood pressure and adequate urine output of 0.5-1 mL/kg/hour. The plasma leakage period is short (24-48 hours), and intravenous fluids may be reduced based on clinical response.

Administer acetaminophen for fever control (not salicylates or ibuprofen, which can further hinder platelet function and increase bleeding complications). Glucocorticoids are not indicated.

Corticosteroids are not helpful.

No antiviral therapy is available.

Patients with suspected dengue infection who are maintaining adequate hydration orally and have no warning signs/symptoms may be treated on an outpatient basis with appropriate anticipatory guidance and outpatient follow-up within 24 hours for reassessment.

https://emedicine.medscape.com/article/781961-overview#a3

 

 

i have no argument at all about treating complications if/when they occur. they should and must be treated. basic precepts come into play, maintaining volume, controlling fever and blood pressure, following urinary output, following renal numbers, liver numbers.  core concepts that anyone ever having rotated/spent time in an icu or floor ward learns.

[Lemonltr]

19 hours ago, foxboy said:

Prevention is better than cure. I've just had a month in Thailand with not one mosquito bite (and believe me they do like the taste of me generally!) I've taken to wearing long trousers and long sleeve shirts if out after 4pm, and using repellent on any exposed areas. This strategy has been working for me for years now.. very seldom get bitten these days. 

I have read repeatedly that dengue is passed on exclusively by the Aedes mosquito and at it bites only during the daytime. If that is correct then wearing long trousers after 4pm will be of little help with that disease. 

[Lemonltr]

I have also read advice from "experts" that a mixture of 30% deet is recommended. I have for years used a cheap one with the logo "15" on a blue bottle and available in supermarkets but not in 7/11 or chemists - deet 25%.

We are often given the advice to empty water from old tyres etc., but Pattaya authorities have these painted and used for central road dividers right throughout the city. Waiting for the rainy season to provide welcome nurseries for mosquitos. 

[Kieran00001]

1 hour ago, KarlS said:

Welcome to my ignore list 

 

This is coming from the one who conflated as far as they know with there being no robust scientific evidence.

 

This is coming from the one who wanted us to believe he knew what he was talking about when claiming that a study of over 200 people is a small study rather than as I correctly referred to it, a medium sized study.

 

This is coming from the one who wanted us to believe that he knew what he was talking about when he explained how he thought that a government funded research institute dedicated to preventing quack herbal treatments reaching the market and which has won research awards is not reputable, a claim they could not support in any way, and so instead changed the goal posts and pretended that unless in the top 50 institutes in the world it is not reputable.

 

Exactly nothing they said was true, hence why instead of arguing their point, presenting evidence and the like, they sulked off and put me on their ignore list to avoid being embarrassed further.

 

And they probably expect us to believe that they are a professional, hilarious stuff. 

 

A blatant quack, don't give him attention.

 

 

 

 

[Kieran00001]

30 minutes ago, Lemonltr said:

I have read repeatedly that dengue is passed on exclusively by the Aedes mosquito and at it bites only during the daytime. If that is correct then wearing long trousers after 4pm will be of little help with that disease. 

 

They can bite any time of day but most frequently at dawn and dusk.

[atyclb]

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https://cytosorbents.com/first-successful-treatment-of-dengue-fever-and-dengue-shock-syndrome-using-cytosorb/

[foxboy]

2 hours ago, Lemonltr said:

I have read repeatedly that dengue is passed on exclusively by the Aedes mosquito and at it bites only during the daytime. If that is correct then wearing long trousers after 4pm will be of little help with that disease. 

Partially true, but not quite correct. The sun was setting at 18:30 when I was last there, making 4pm onwards prime time for these little pests - "Aedes aegypti is a day biting mosquito. That means that the mosquito is most active during daylight, for approximately two hours after sunrise and several hours before sunset."

[HiSoLowSoNoSo]

I got it in Patong in the 80s', was a terrible experience. Two of my friends in Phuket died from it.