Thailand On Alert As Dengue Fever Cases Rise

[george]

Thailand on alert as dengue fever cases rise

BANGKOK: -- Thailand's Ministry of Public Health is on full alert to prevent the spread of dengue fever after the disease claimed four people's lives so far this year, and the number of dengue fever patients nationwide has risen to 6,000.

The focus of the outbreak is in Trat province, 400 km southeast of Bangkok on the Cambodian border, and in the southernmost provinces along the Malaysian border.

Trat has almost five times the frequency of the disease -- 46 patients per 100,000 population -- compared to the national average of 10 per 100,000, according to Public Health Minister Mongkol Na Songkhla, while Pattani experences 42 per 100,000 and Yala has 33 per 100,000 residents.

Earlier than usual rains has meant that dengue is a greater concern this year than before, Dr. Mongkol said. The insurgency in the far South means that anti-mosquito measures are more difficult to apply.

More breeding grounds for dengue-carrying mosquitoes emerge during the rainy season, he explained, especially in the three southernmost provinces where heavier rainfall contributes to a higher population of mosquitoes than in the country's other regions.

Dr. Mongkol said that the outbreak could become a severe problem in the border provinces as health officials can't implement pro-active strategies to fight the disease due to the ongoing violence.

The number of dengue fever patients is normally higher from May to August due to the rainy season. So far there have been 6,070 dengue fever patients in the first four months of this year.

The nationwide ratio amounted to nearly 10 patients per 100,000 persons in the population, he said. However, almost 1,000 new dengue fever cases have been reported in the past two weeks.

The highest concentration of dengue fever patients was reported in the eastern province of Trat with the ratio of 46:100,000, followed by the southern provinces of Pattani at 42: 100,000 and Yala at 33: 100,000 respectively.

The public health minister said he ordered health officials to work with local authorities to prevent the further spread on any outbreak.

--TNA 2007-05-03

[marc288888]

helpfull link for anyone worried http://www3.niaid.nih.gov/healthscience/healthtopics/dengue/

[flyx]

How we can be out of high risk ?

it made me worrid because i wanted buy airticket monday

[egeefay]

I got dengue fever in Thailand about 40 years ago.

At the time we lived in a wooden house over a pond in Bangkok

A lot of mosquitos came up through the cracks in the floor.

It was one of the worst fevers I've ever had. I remember it to this day.

If you live near standing water, do whatever you can to minimize exposure to mosquitos that breed there.

[Baan Kiki]

HOW ABOUT THE PANAMA CANAL THEY SPRAYED FOOM THE AIR UNLESS THE BAD GUYS FROM THE SOUTH NOW HAVE ANTI-ARI-CRAFT CAPABILITY

[kenk3z]

So the news article indicates four (4) people have died.

I feel that the focus should be more on highway safety - the highways claim a LOT more lives in Thailand than Dengue fever.

But if there is a need to create news for public consumption, I guess this is something for today.

kenk3z

[Jimjim]

It's just human nature. If something can make you seriously ill or kill you, the media has a resonsibility to tell us about it. We already know the roads can kill us every day, that's nothing new. And I think the thing with dengue fever is not so much fear of death as that it can make you seriously ill and you should be aware of it. What's wrong with that?

[distortedlink]

As global warming progresses across the world, there will be horrific

consequences for all populations in every country of biblical proportions.

Floods, famine, drought, pestilence, disease and mass extinctions of species possibly including our own.

So called experts tell us to use cleaner fuels, not to use spray cans etc, etc to help save the environment.

The truth is that only the governments and big companies have any real power to halt global warming that is of course if it isn't already too late.

Edited May 3, 2007 by distortedlink

[Otis]

helpfull link for anyone worried http://www3.niaid.nih.gov/healthscience/healthtopics/dengue/

The NIH article said you can get infected by any of 4 types of dengue fever, but only 1 time. Does this mean once you have contracted a type, your body develops immunity to that type? Otis

[Head Snake]

As global warming progresses across the world, there will be horrific

consequences for all populations in every country of biblical proportions.

Floods, famine, drought, pestilence, disease and mass extinctions of species possibly including our own.

So called experts tell us to use cleaner fuels, not to use spray cans etc, etc to help save the environment.

The truth is that only the governments and big companies have any real power to halt global warming that is of course if it isn't already too late.

Global warming gave me a bad hair day last week. Global warming also gave me irritable bowel syndrome last year.

Be Careful out there!!!

[Tony Clifton]

So the news article indicates four (4) people have died.

I feel that the focus should be more on highway safety - the highways claim a LOT more lives in Thailand than Dengue fever.

But if there is a need to create news for public consumption, I guess this is something for today.

kenk3z

Yup, I`m more worried about the road viruses than water borne mosquitoes.

[steve73]

I visited Trat for 4 days in late March, staying in a "typically" Thai resort just off the road down to Hat Lek. Then two weeks later toured around the south. OK so I missed out Pattani, Yala, & Nara(whatever), but I did visit Songkla, then down to Malaysia on the west coast. Hope I didn't carry it, but I've been feeling a bit peaky since I got back to the UK.

What's the symptoms? ;-)

[nikster]

helpfull link for anyone worried http://www3.niaid.nih.gov/healthscience/healthtopics/dengue/

The NIH article said you can get infected by any of 4 types of dengue fever, but only 1 time. Does this mean once you have contracted a type, your body develops immunity to that type? Otis

AFAIK you do not develop immunity. The wording in the article is pretty vague - also says that dengue can be much worse at second infection.

Just make sure mozzies don't bite you during the day and you will be fine. The dengue carrying mosquitos are active only during daytime (including mornings and evenings).

[kippers]

I caught dengue last year in pattaya, it was the most miserable and painful periods in my life, all my joints ached all my muscles ached, a deep depression and the worst part of it was that there is no treatment, it took 12 weeks to clear up and i have had small recurrences ever since maybe 1 or 2 days each time, this apparently was the weakest or less debilitating of the various strains of dengue.

A very horriffic thought is that each time you contract it, it increases in severity finally ending up in a haemorragic type disease similar to ebola, to which there is similarily no treatment and eventually death.

Mosquitos breed in stagnant water, i have ensured that none equists around my house, even down to long lasting puddles on the road, we make sure that we put small fish into any other water collection or pond to eat the larvae. Half a cup of kerosene floats on top of our water supply has the same effect as does a similar amount of salt. we also have UV zappers in each room.

So far so good and since then ,there does seem to be a noticeable decrease in mozzies.

Maybe these precautions seem extreme, but if you are ever a recipient of this disease you will not disagree.

[MarcHolt]

As global warming progresses across the world, there will be horrific

consequences for all populations in every country of biblical proportions.

Floods, famine, drought, pestilence, disease and mass extinctions of species possibly including our own.

So called experts tell us to use cleaner fuels, not to use spray cans etc, etc to help save the environment.

The truth is that only the governments and big companies have any real power to halt global warming that is of course if it isn't already too late.

What utter bullshit! What are you? Some sort of doomsday prophet working for Ted Haggart?

Everyone can help keep the planet cleaner. If we all do our bit we can all make a HUGE difference. Why don't you go back to reading your bible? That's about the only thing you seem to be good for!!!

[ignis]

I take 1x Vitamin B1 everyday 100mg tablet…. This works for me, 1000 tablet bottle is 360 baht [bought last week.. gone up 20 baht since my last bottle 2 ½ yrs ago]…

not sure if you’re a drinker, a friend says you need to take another tablet at night if you drink

[Galong]

HOW ABOUT THE PANAMA CANAL THEY SPRAYED FOOM THE AIR UNLESS THE BAD GUYS FROM THE SOUTH NOW HAVE ANTI-ARI-CRAFT CAPABILITY

I would prefer to put a less poisonous repellent on myself. Having the government spray me with their choice of poison is not something I want to happen. My guess is that they would choose the cheapest poison.

Also, please turn your CAP LOCK OFF... it's annoying.

[s.pylos]

I take 1x Vitamin B1 everyday 100mg tablet…. This works for me, 1000 tablet bottle is 360 baht [bought last week.. gone up 20 baht since my last bottle 2 ½ yrs ago]…

not sure if you’re a drinker, a friend says you need to take another tablet at night if you drink

As useless as garlic.... Save your money for a drink !

http://www.uspharmacist.com/index.asp?show...page=8_1768.htm

[sandy]

[willi2006]

... we also have UV zappers in each room. ...

Your fear is well understood and imho all the measures are meaningful but one. Mosquitos do not go to light neither visible nor UV. They locate their victims through scent and temperature, shower and air condition help. UV zappers might catch mosquitos by accident but kill many useful insects.

Mosquito - Wikipedia, the free encyclopedia: "The females of blood sucking species locate their victims primarily through scent. They are extremely sensitive to the carbon dioxide in exhaled breath and exuded through the pores, as well as several substances found in sweat. Some people seem to attract mosquitoes more than others. Empirical studies of mosquito bites suggest that the risk of being bitten follows an approximately negative binomial distribution. Being male, being overweight, and having type 'O' blood may increase the risk of being bitten. Mosquitoes can detect heat, so they can find warm-blooded mammals and birds very easily once they get close enough."

Bug zapper - Wikipedia, the free encyclopedia:

"Drawbacks

• Mosquitoes – Although many people use bug zappers to control mosquito populations, the actual number of mosquitoes that are attracted to the devices is quite low to none at all (depending on the species and area), as mosquitoes are attracted to carbon dioxide, water vapor, and motion, rather than to UV light.
  
• Beneficial insects, or those that are harmless to humans are killed indiscriminately.
  
• The strong UV light attracts many insects indoors or to the patio that would not otherwise be present. Those who are not killed may bring pathogens dangerous to humans or animals.
  
• Improperly designed insects zappers can incinerate insects (due to excessive power), in some instances their bodies virtually explode, becoming an aerosol which may settle onto nearby food or be inhaled by humans. This could cause contamination, as viruses, fungi and bacteria can travel on particles.
  
• Bug zappers can attract other animals or pests feeding on the dead insects if not maintained. Creatures such as Geckoes are instinctively attracted to light sources in order to feed on insects similarily attracted. Often these creatures are indiscriminately killed by Bug Zappers.
  

Given the design, placement, and maintenance consideration bug zappers are usually subject of health guidelines and or regulations for public and commercial premises, for example in hospitals and food processing plants."

Edited May 4, 2007 by willi2006

[ChiangMaiAmerican]

They actually have several manufacturers of mosquito traps in the US. The traps use CO2 as bait and are quite effective. A link to one such manufacturer is below. Encouraging some bat populations is another effective way to control mosquitos. A bat wll eat an enormous amount of insects including mosquitos every night. Bat house plans are available on the internet. However, it generally takes some time before bats will move into a newly built bat house.

http://www.megacatch.com

Bat house plans

http://www.eparks.org/wildlife_protection/...s/bat_house.asp

More on bats and bat houses

http://www.batconservation.org

Edited May 4, 2007 by ChiangMaiAmerican

[whitespider]

I caught dengue last year in pattaya, it was the most miserable and painful periods in my life, all my joints ached all my muscles ached, a deep depression and the worst part of it was that there is no treatment, it took 12 weeks to clear up and i have had small recurrences ever since maybe 1 or 2 days each time, this apparently was the weakest or less debilitating of the various strains of dengue.

Firstly, its worth pointing out that Chonburi has (historically) the 2nd highest incidence of Dengue in Thailand. Bankok on the other hand has very LOW incidence. This means that visitors to Pattaya need to be particularly careful.

Why do you say there is no treatment? Of course there is - but its advisable to catch it early. If you feel flu like symptoms coming on (don't wait for the breaking bones) get a blood test early, any high street surgery/doctors will do this for around 500 baht.

I am curious about the figure of 6000 cases so far this year. Last years figures show 200,000+ cases so 6000 in over 4 months would be exceedingly low.

Finally - keep it in proportion. Less that 0.05% of cases prove fatal and they are "usually" the very elderly or very young.

I am not detracting from the seriousness of this illness, I have seen it first hand on quite a few occassions and it is awful - you should take every care you possible can but as a previous poster said you are far more likely to have a traffic accident.

It is certainly NOT a reason not to book the plane ticket.

[Pi Sua]

helpfull link for anyone worried http://www3.niaid.nih.gov/healthscience/healthtopics/dengue/

The NIH article said you can get infected by any of 4 types of dengue fever, but only 1 time. Does this mean once you have contracted a type, your body develops immunity to that type? Otis

AFAIK you do not develop immunity. The wording in the article is pretty vague - also says that dengue can be much worse at second infection.

Just make sure mozzies don't bite you during the day and you will be fine. The dengue carrying mosquitos are active only during daytime (including mornings and evenings).

According the doctors specialized in tropical diseases that I met, you can't get the same type twice. However, they say that the second infection can be very dangerous.

Personnally I got it three times and it's terrible each time. The last time was less stronger than the first and second time but it still took two weeks for me to recover. Three weeks the first time.

I just hope that they are right so only one more time and I'll be free of dengue fever for ever...or dead ?

Edited May 4, 2007 by Pi Sua

[Whiplash]

I got the Dengue in November 2003, here's a forum entry about that experience from back then:

http://www.thaivisa.com/forum/index.php?showtopic=3544&st=0&p=26473entry26473

The Doctor told me that I probably had attracted all 4 versions of the virus and once that had happen i would never get the Dengue again.

Healthy since then, without really changing my habits except for some mosquito oil..

Keep Healthy, Andy

[Prakanong]

First death this year in Singapore last week

Malay cases double the same period of last year!

No treatment except for the symptoms so protection from being bitten is the primary response to take.

Dengue vaccines are in trial by a number of companies / orgs but do not expect anything in the nar erm - malaria will be before Dengue

I do know trials are starting on some phase II studies this year and next in Thailand for vaccines

[Prakanong]

"Why do you say there is no treatment? Of course there is"

To be pedantic there is no treatment for the Dengue itself - you only treat the symptoms.

"Prehospital Care:

Initiate supportive therapy

Intravenous (IV) crystalloids, as needed to keep systolic blood pressure above 90 mm Hg

O2, empirically

Emergency Department Care:

Supportive therapy

IV access, O2, and monitoring are helpful.

IV crystalloids may be necessary for hypotension; central line may be needed.

Correct electrolyte abnormalities and acidemia.

Implement therapy for DIC if indicated.

Corticosteroids are not helpful.

No antiviral therapy is available."

I do not know about the blood test being available anywhere for 500THB - I will check this as I work with researchers into Dengue. I suppose it depends which of the following tests are done and how much it costs

"Lab Studies:

Isolation of virus in serum and detection of immunoglobulins (IgM and IgG) by enzyme-linked immunosorbent assay (ELISA) antibody capture, monoclonal antibody, or hemagglutination

Complete blood count

Hemoconcentration (hematocrit increased 20%)

Thrombocytopenia (platelet count <100 x 109/L)

Leukopenia

Chemistry panel

Electrolyte imbalances

Acidemia

Elevated BUN

Liver function tests

Elevated transaminases

Hypoproteinemia

Guaiac test for occult blood in stool

DIC panel, as indicated"

"There are 4 strains of dengue viruses. Infection with one strain will provide protection against only that particular strain. Future infection by other strains is possible."

"Background: Dengue has been called the most important mosquito-transmitted viral disease in terms of morbidity and mortality. Dengue fever is a benign acute febrile syndrome occurring in tropical regions. In a small proportion of cases, the virus causes increased vascular permeability that leads to a bleeding diathesis or disseminated intravascular coagulation (DIC) known as dengue hemorrhagic fever (DHF). Secondary infection by a different dengue virus serotype has been confirmed as an important risk factor for the development of DHF. In 20-30% of DHF cases, the patient develops shock, known as the dengue shock syndrome (DSS). Worldwide, children younger than 15 years comprise 90% of DHF subjects; however, in the Americas, DHF occurs in both adults and children.

Dengue is a homonym for the African ki denga pepo, which appeared in English literature during an 1827-28 Caribbean outbreak. The first definite clinical report of dengue is attributed to Benjamin Rush in 1789, but the viral etiology and its mode of transmission via mosquitos were not established until the early 20th century.

Pathophysiology: Dengue viral infections frequently are not apparent. Classic dengue primarily occurs in nonimmune, nonindigenous adults and children. Symptoms begin after a 5- to 10-day incubation period. DHF/DSS usually occurs during a second dengue infection in persons with preexisting actively or passively (maternally) acquired immunity to a heterologous dengue virus serotype. Illness begins abruptly with a minor stage of 2-4 days' duration followed by rapid deterioration. Increased vascular permeability, bleeding, and possible DIC may be mediated by circulating dengue antigen-antibody complexes, activation of complement, and release of vasoactive amines. In the process of immune elimination of infected cells, proteases and lymphokines may be released and activate complement coagulation cascades and vascular permeability factors."

[Prakanong]

"I just hope that they are right so only one more time and I'll be free of dengue fever for ever...or dead ? "

I think thats the theory - let me ask a medical researcher I know into this as I am interestd in the answer as I am sure you are? ;-))

Disclaimer - This advice is worth what its cost you though and its in a private non-clinical capacity ;-))

[ignis]

As useless as garlic.... Save your money for a drink ! rolleyes.gif

http://www.uspharmacist.com/index.asp?show...page=8_1768.htm

[sandy]

Well they work for me, I have a large pond in my garden which I go in most days to clean stuff out, 100's of moskitoes fly around me but in the past 3+ yrs never had a bite

[rak sa_ngop]

I do not know about the blood test being available anywhere for 500THB - I will check this as I work with researchers into Dengue. I suppose it depends which of the following tests are done and how much it costs

I have just had Dengue and Rickettsia (typhus etc) tests carried out at the BNH hospital and they are not cheap. Requires growing a blood culture. The Dengue test takes 3-4 days to complete, longer for typhus. Total cost 8380 baht (without physical evaluation)

Obviously better to go to a public hospital if money is an issue.

[Prakanong]

I do not know about the blood test being available anywhere for 500THB - I will check this as I work with researchers into Dengue. I suppose it depends which of the following tests are done and how much it costs

I have just had Dengue and Rickettsia (typhus etc) tests carried out at the BNH hospital and they are not cheap. Requires growing a blood culture. The Dengue test takes 3-4 days to complete, longer for typhus. Total cost 8380 baht (without physical evaluation)

Obviously better to go to a public hospital if money is an issue.

I thought the costs would be in the region of what you describe with 500THb being low!

I wonder if the Thai Red Cross do them cheaply???

The majority of cases are not diagnosed through blood tests I bet - just too expensive

[rundmw]

...we make sure that we put small fish into any other water collection or pond to eat the larvae.

Our rented bungalow has a wooden deck which is built over a now-unused swimming pool that predictably has a permanent collection standing water inside. I want to push the landlord to fill it in, but my wife and her group of old-wives tell the tale that the fish and the frogs/tadpoles down there are enough to keep the mosquitoes at bay.

So, is there really something to the idea that the fish and frogs have a substantial impact?