My Battle With Dengue Fever

[PeaceBlondie]

Nobody has commented on this, but the OP says he went to a highly acclaimed expatriate hospital, McCormick, and the examining physician misdiagnosed him and didn't do a blood test. Then, a Thai took the OP to a govt. hospital in a small town (San Patong), where they quickly did a blood test and made the correct diagnosis!

I understand San Patong has no govt. hospital. Maybe a clinic? Maybe a misprint?

[Thai at Heart]

Is it possible to see the stripes when one is actually flying in front of you? Obviously that's not a life-size pic. I'm not sure I've ever seen one and I'm not sure I could identify one if I did.

Visible black and white stripes on the back of the abdomen also.

[geriatrickid]

Interesting read. Now I know why my Thai friends always wear pants at night. I usually am the tasty morsel of the night when I wear shorts and I can't tell you the number of times the crew has taken pity on me and run down to the 7-11 for those DEET towlettes because ting tong boy didn't spray his deep woods "OFF". I have learnt my lesson from this and will spray at night even though phuket doesn't have the problem, but I'm due to visit chiang mai & chiang rai soon and won't be so cavalier about precautions. Thanks for taking the time and reminding me to not be dumb.

[Sheryl]

Nobody has commented on this, but the OP says he went to a highly acclaimed expatriate hospital, McCormick, and the examining physician misdiagnosed him and didn't do a blood test. Then, a Thai took the OP to a govt. hospital in a small town (San Patong), where they quickly did a blood test and made the correct diagnosis!

Absolutely. Not only did they misdiagnose, but they misdiagnosed an exteremely common disease with fairly obvious symptoms and the wrong diagnosis provided makes no sense whatsoever....

BTW there is no blood test to diagnose dengue in the acute stage (yet). Blood tests can identify a drop in platlets early on, a warning if impending DHF (the dangerous hemorrgahioc form of dengue). Beyind that what blood tests can do is help make tghe diagnosis of denguie on clinical grounds by eliminating other possibilities.

This is the first time I have heard of McCormack Hospital. The only expat hosp in CM I had heard iof before (also with many bad reports) was Ram. I take it these are 2 different places?

[Goldtown23]

Not sure if this works but have heard about it a few times before and found this on the web:

"I would like to share this interesting discovery from a colleague's son

who has just recovered from dengue fever. Apparently, his son was in the

critical stage at the SJMC ICU when his platelet count dropped to 15

after blood transfusion also.

His father was so worried that he sought another friend's recommendation

and his son was saved. He confessed to me that he give his son raw juice

of the papaya leaves. From a platelet count as low as 45 after blood

transfusion, it jumped to 135 after drinking the raw papaya leaf juice.

Even the doctors and nurses were surprised. After the second day he was

discharged. So he asked me to pass this good news around.

Accordingly it is raw papaya leaves 2 pcs just clean and pound and

squeeze the juice thro cloth filter. You will only get one tablespoon

per leaf. So two tablespoons per serving once a day. No need to boil or

cook or rinse with hot water, it will lose its strength. Only the leafy

part has to be taken, no stem or sap. It is very bitter and you have to

swallow it.

But it works wonders!!!!

Papaya Juice - Cure for Dengue

You may have heard this elsewhere, but if not, I am glad to inform you

that papaya juice is a natural cure for dengue fever. As dengue fever is

rampant now, I think it's good to share this with all. A friend of mine

had dengue last year. It was a very serious situation for her as her

platelet count had dropped to 28,000 after 3 days in hospital and water

had started to fill in her lungs. She had difficulty in breathing. She

was only 32-years old. Doctor said there's no cure for dengue. We just

have to wait for her body immune system to build up resistance against

dengue and fight its own battle.

She already had 2 blood transfusions and all of us were praying very

hard as her platelet continued to drop since the first day she was

admitted.

Fortunately her mother-in-law heard that papaya juice would help to

reduce the fever and got some papaya leaves, pounded them and squeezed

the juice out for her. The next day, her platelet count started to

increase, her fever subsided. She was given papaya juice regularly and

she recovered after 3 days!!! Amazing but true.

Papaya juice has a cooling effect thus, it helps to reduce the heat in

one's body. I found that its also good when one is having sore throat."

[bruceboy]

This sounds just terrible.

[chiang mai]

Nobody has commented on this, but the OP says he went to a highly acclaimed expatriate hospital, McCormick, and the examining physician misdiagnosed him and didn't do a blood test. Then, a Thai took the OP to a govt. hospital in a small town (San Patong), where they quickly did a blood test and made the correct diagnosis!

Absolutely. Not only did they misdiagnose, but they misdiagnosed an exteremely common disease with fairly obvious symptoms and the wrong diagnosis provided makes no sense whatsoever....

BTW there is no blood test to diagnose dengue in the acute stage (yet). Blood tests can identify a drop in platlets early on, a warning if impending DHF (the dangerous hemorrgahioc form of dengue). Beyind that what blood tests can do is help make tghe diagnosis of denguie on clinical grounds by eliminating other possibilities.

This is the first time I have heard of McCormack Hospital. The only expat hosp in CM I had heard iof before (also with many bad reports) was Ram. I take it these are 2 different places?

Absolutely agree, a friend of mine was misdiagnosed by a rural hospital many years ago and was repeatedly given vitamin shots as a treatment for flue over a three day period (on an out patient basis) - I subsequently flew that person to Bangkok from Petchabun because I knew it was something far more serious and Bumrungrd recognized it for what it was almost as soon as we walked in the front door. I think most people will recognize the intense fever caused by Dengue as being something serious - (this fact posted for the benefit of others and not for Sheryl who is a nurse).

My question on this subject however is this: many people, including myself, take blood thinners and anticoagulants such as Aspent, Plavix and/or Herapin (sp). Is the hemorrhagic risk higher in such folks because of the anti-clotting factors and how would a doctor treat such people for Dengue? It seems to me that in the case of Dengue one of the objectives is to make sure that people do not bleed yet that seems counter to the mission of drugs such as Plavix!

[sabaijai]

Interesting read. Now I know why my Thai friends always wear pants at night. I usually am the tasty morsel of the night when I wear shorts and I can't tell you the number of times the crew has taken pity on me and run down to the 7-11 for those DEET towlettes because ting tong boy didn't spray his deep woods "OFF". I have learnt my lesson from this and will spray at night even though phuket doesn't have the problem, but I'm due to visit chiang mai & chiang rai soon and won't be so cavalier about precautions. Thanks for taking the time and reminding me to not be dumb.

The mozzies that bite at night do not carry dengue virus. Only day-biting skeeters carry it, with the odds of human infection estimated at about 10,000 to one for any given bite.

I've had dengue once, after being bitten hundreds of times during the day at a small rural temple in central Thailand. I never had to be hospitalised and was up and around after about a week, although I was noticeably weak for another week or two. A friend visiting from abroad came down with it in Chiang Mai, and had to spend a day or two in ICU as he came close to haemorrhaging.

I realise one's immune system reaction explains why some folks are hit harder by dengue than others, but I'd like to know whether there may also be a difference in severity of symptoms among the four serotypes in Thailand.

[sabaijai]

This is the first time I have heard of McCormack Hospital. The only expat hosp in CM I had heard iof before (also with many bad reports) was Ram. I take it these are 2 different places?

There are around 20 hospitals in Chiang Mai. Founded by American missionaries over a century ago, McCormick is the oldest, and enjoys a decent reputation overall although I do know people who have been misdiagnosed there. CM Ram is the most expensive but not necessarily the best (although I think the whinge rate here on TV isn't representative). Lanna Hospital is often compared favourably, but is nearly as expensive as Ram. The main government hospital, Maharat (aka Suandok), is a teaching hospital for Chiang Mai University and from personal experience I'd say it's very good. Many of the doctors and specialists who work at Ram, Lanna and other private hospitals also put in clinic hours at Maharat, so the treatment is often fairly similar.

[degilbo]

How do dengue mosquitoes transmit dengue?

Dengue mosquitoes are common in Queensland but often do not carry dengue. A female mosquito can only become infected with dengue after biting an infected human who is viraemic, ie. there are enough dengue virus particles in the person's blood to infect a mosquito.

An infected person can transmit dengue to mosquitoes at home, at work or anywhere they visit. This can happen within 3-4 days of being bitten and can continue to do so up to 12 days. (Dengue is not spread directly from person to person.)

In 8-10 days the infected mosquito is able to transmit the virus to other people. Thus the cycle of transmission takes only 14 days. One dengue-infected female mosquito is capable of biting and infecting several people during one feeding session.

Source: Queensland, Australia Health internet site.

Sorry if off tpoic as this has to do with North Queensland in Australia where we are also experiencing outbreaks to the same:

http://www.cairns.com.au/article/2009/0 ... -news.html

Dengue fever travel warning

Henry Tuttiett

Thursday, February 5, 2009

© The Cairns Post

A POPULAR British travel website has posted a travel warning about Cairns' dengue fever outbreak in a worrying sign for the Far North's tourism industry.

Carrentals.co.uk, a site where tourists can compare rental car prices when travelling to Australia, posted the warning, saying the disease is rapidly spreading through the Far North, causing authorities major concern.

The warning says dengue fever has been on the rise throughout summer in Queensland, despite it "usually being associated with developing countries".

"The government of Queensland is publicly vowing to stop the spread of the disease to other regions, and had told residents to stay away from areas of stagnant water," the travel warning says.

"Most at risk from the debilitating effects of the disease are babies and young children."

Tourism Tropical North Queensland chief executive Rob Giason said dengue fever was a constant factor in many tropical areas visited by international tourists but was confident it would not affect the tourism industry.

"We have to make sure it does not alarm people," he said.

"We know the authorities are doing everything they can, but it is a tropical region and we need to be sure the correct information is out there."

Mr Giason said there were ways for tourists to protect themselves against dengue fever, which he said would ensure the long-term viability of the tourism industry.

"We are confident people can enjoy the destination and will continue to come here, as they are now," he said.

Mr Giason's optimism came as the number of confirmed cases in the Cairns outbreak hit 255 and Yorkeys Knob was added to the list of infected suburbs.

[meadish_sweetball]

Lanna Hospital is often compared favourably, but is nearly as expensive as Ram.

Since a while back, Lanna Hospital is also under the same ownership as Ram.

[Samuian]

had a talk with someone about pests

he was stung by a scorpion in his house in Thailand

on the subject of mosquitos he said that dengue and malaria are not on the coast

true? not true?

As I have been infected by it on the Island of Ko Samui's northern beaches, Ban Bang Po, my House was approx. 100 mtr. from the seashore, but nearby was a klong, which, in dry season, dried up to a puddle large enough to accomodate 2-3 water buffalos, in rainy season it started to fill slowly and when a certain level was reached it used to break through the sand barrier of the beach and empty in to the sea, but if it was a weak rainy season this never happened!

I was infected 3 x always in October (rainy season) and WHEN I MOVED TO ANOTHER PLACE I WAS NOT ANYMORE INFECTED!

So the OP and any other one exposed to dengue infection, might take this under careful consideration!

Ko Phagan is also known for infections with dengue!

It seems to be territorial!

The Papapya part is interesting... and yes, loads of liquid/water as much as possible, cold wraps (lower leg), paracetamol help to bring down the fever!

[richard_smith237]

Nobody has commented on this, but the OP says he went to a highly acclaimed expatriate hospital, McCormick, and the examining physician misdiagnosed him and didn't do a blood test. Then, a Thai took the OP to a govt. hospital in a small town (San Patong), where they quickly did a blood test and made the correct diagnosis!

I was misdiagnosed just last week. We know our own bodies and when something is more seriously wrong I believe we should trust in our instincts.

In my case, I couldn't help but feel that my Doctor was incorrect but I didn't have the medical knowledge to question him. I sought out a second opinion and my instinct was correct. The first Doctor had guessed incorrectly.

It was the end of the day, he was probably very tired. Everyone is human and while these events shouldn't happen we have to be realistic and accept that they do.

I believe that its good advice to trust your instincts and when in doubt always get a second opinion.

I hope the Op recovers fully....

[Freddie_fly]

Intersting posts on Dengue, which seems to be on the rise. A good friend of mine caught it in Singapore in 1989, he was a body builder and very fit, he lost a huge amount of weight, came out of hospital like a weak kitten, it took him almost a year to get over it and start weightlifting again.

like anopheles (malarial) osquito, there are some things you can do.

Wear light coloured clothing (white if possible)

long sleeves and long pants.

Dont allow any standing water around your house.

If you develop a fever go immediately to hospital and (if you are back home wherever) inform them that you were in "whatever" country.

This is the most important, because dengue amd malaria may not show up until you go home, (malaria up to 70 days, not sure about dengue).

Dont be fobbed off at any hospital, insist on blood tests.

regards

Freddie

[Sheryl]

My question on this subject however is this: many people, including myself, take blood thinners and anticoagulants such as Aspent, Plavix and/or Herapin (sp). Is the hemorrhagic risk higher in such folks because of the anti-clotting factors and how would a doctor treat such people for Dengue? It seems to me that in the case of Dengue one of the objectives is to make sure that people do not bleed yet that seems counter to the mission of drugs such as Plavix!

Need to understand that there is a difference between "simple" dengue and Dengue Hemorraghic Fever (DHF). (I put "simple" in quotes because it is simple in medical terms but can be hel_l to go through).

Even among Asians, the incidence of simple dengue vastly exceeds DHF, only a small subset develop the latter. Among westerners this is even more true. It can happen, but it is rare for a farang to develop DHF.

Simple Dengue has no treatment other than supportive care (rest, fluids, analgesics). It also has a wide spectrum of severity and can be so mild as to be almost unnoticeable, or shrugged off as a mild flu, or so bad that hospitalization is required for IV hydration, pain relief and basic nursing. (I have had dengue myself twice and ther first time was in the last category - flat on my back in hospital for 2 weeks plus another week convalesence).

The standing joke "simple" dengue is that it won't kill you but you'll wish it would.

Being on anti-coagulant medication will not increase your risk, should you have dengue, of having DHF, and there is no need to discontinue such medications if you have "simple" dengue. In the very unlikely case that you develop DHF then yes, of course such drugs would have to be discontinued temporarily.

Full blown DHF is pretty unmistakable. Early warning that a dengue patient is heading in that direction starting to develop can be found from monitoring the platlet count, a simple blood test. Platlet count is not reduced in people on anti-coagulant medications as those drugs have a different mechanism of action. Should the platlet count drop significantly in someone with dengue it would be prudent to stop anti-coagulants at that point. But in the vast majority of cases of dengue in a farang this will not occur.

[chiang mai]

My question on this subject however is this: many people, including myself, take blood thinners and anticoagulants such as Aspent, Plavix and/or Herapin (sp). Is the hemorrhagic risk higher in such folks because of the anti-clotting factors and how would a doctor treat such people for Dengue? It seems to me that in the case of Dengue one of the objectives is to make sure that people do not bleed yet that seems counter to the mission of drugs such as Plavix!

Need to understand that there is a difference between "simple" dengue and Dengue Hemorraghic Fever (DHF). (I put "simple" in quotes because it is simple in medical terms but can be hel_l to go through).

Even among Asians, the incidence of simple dengue vastly exceeds DHF, only a small subset develop the latter. Among westerners this is even more true. It can happen, but it is rare for a farang to develop DHF.

Simple Dengue has no treatment other than supportive care (rest, fluids, analgesics). It also has a wide spectrum of severity and can be so mild as to be almost unnoticeable, or shrugged off as a mild flu, or so bad that hospitalization is required for IV hydration, pain relief and basic nursing. (I have had dengue myself twice and ther first time was in the last category - flat on my back in hospital for 2 weeks plus another week convalesence).

The standing joke "simple" dengue is that it won't kill you but you'll wish it would.

Being on anti-coagulant medication will not increase your risk, should you have dengue, of having DHF, and there is no need to discontinue such medications if you have "simple" dengue. In the very unlikely case that you develop DHF then yes, of course such drugs would have to be discontinued temporarily.

Full blown DHF is pretty unmistakable. Early warning that a dengue patient is heading in that direction starting to develop can be found from monitoring the platlet count, a simple blood test. Platlet count is not reduced in people on anti-coagulant medications as those drugs have a different mechanism of action. Should the platlet count drop significantly in someone with dengue it would be prudent to stop anti-coagulants at that point. But in the vast majority of cases of dengue in a farang this will not occur.

Thanks for that Sheryl. It's a little worrying to know however that in the event of DHF it's a toss up whether the DHF or stopping Plavix will kill the patient. Note to self: buy more Deet on next shopping trip.

[Aussie7]

Hi, just wondering if anyone can assist. Recently holidayed in Phuket for 10 days and after coming home started to feel unwell. For the past 6 weeks I have had high temp, low blood pressure, muscle aches (biceps and thighs mainly), joint pain, headaches, neck pain (quite severe), sore throat and ears. I have had numerous blood tests and other scans and tests and nothing has been picked up. All I have been told so far is that I have picked up a virus in Thailand and will have to wait it out. I am living in Australia as at yesterday the Dr thinks I may also have Viral Meningitis. The person I was travelling with is perfectly ok and have just been told about another friend who arrived in Australia today and has the same symptoms as me. Can you suggest any advice, what to say or ask from my Dr etc...I have never been this ill in my life.

[FBN]

Hi, just wondering if anyone can assist. Recently holidayed in Phuket for 10 days and after coming home started to feel unwell. For the past 6 weeks I have had high temp, low blood pressure, muscle aches (biceps and thighs mainly), joint pain, headaches, neck pain (quite severe), sore throat and ears. I have had numerous blood tests and other scans and tests and nothing has been picked up. All I have been told so far is that I have picked up a virus in Thailand and will have to wait it out. I am living in Australia as at yesterday the Dr thinks I may also have Viral Meningitis. The person I was travelling with is perfectly ok and have just been told about another friend who arrived in Australia today and has the same symptoms as me. Can you suggest any advice, what to say or ask from my Dr etc...I have never been this ill in my life.

This is clearly not Dengue as it will always be an acute illness. The other viruses that may cause this picture over such a prolonged time, may be EBV (Infectious Mononucleosis) or CMV (less likely).

It is not stated in this post if these have been excluded but it may be a good starting point.

An accurate history of travels and activities should also be helpful but I assume this has been done.

[Aussie7]

Thanks for responding. These are the following tours we participated in whilst staying at Phuket:

Elephant tour

Canoeing in caves

Speed boat tour (fed monkeys, snorkelled around islands etc)

We also shopped at Patong (night markets).

With what you mentioned, is that a virus/illness specific to Thailand?

Thanks so much for your assistance, greatly appreciated.

Hi, just wondering if anyone can assist. Recently holidayed in Phuket for 10 days and after coming home started to feel unwell. For the past 6 weeks I have had high temp, low blood pressure, muscle aches (biceps and thighs mainly), joint pain, headaches, neck pain (quite severe), sore throat and ears. I have had numerous blood tests and other scans and tests and nothing has been picked up. All I have been told so far is that I have picked up a virus in Thailand and will have to wait it out. I am living in Australia as at yesterday the Dr thinks I may also have Viral Meningitis. The person I was travelling with is perfectly ok and have just been told about another friend who arrived in Australia today and has the same symptoms as me. Can you suggest any advice, what to say or ask from my Dr etc...I have never been this ill in my life.

This is clearly not Dengue as it will always be an acute illness. The other viruses that may cause this picture over such a prolonged time, may be EBV (Infectious Mononucleosis) or CMV (less likely).

It is not stated in this post if these have been excluded but it may be a good starting point.

An accurate history of travels and activities should also be helpful but I assume this has been done.

[FBN]

Both EBV and CMV are not unique to Thailand but are perhaps the more common (EBV) of the "chronic" viral diseases and is quite easily spread. Phuket is an international tourist hub so exposure would also be to a relatively international collection of viruses and bugs.

Toxoplasmosis may also need to be in the differential diagnosis and to be excluded.

Spelunking could have exposed you to Cryptococcus as well.

On a forum such as this, one can at best list a few possibilities but without actually reviewing tests done it would not be possible to get much closer.

Hopefully, as happens often on this forum, someone may respond with similar experiences and have good advice.

Basic full blood count with a differential count may give a clue as to whether this is chronic viral, parasitic or fungal.

Further investigations should be based on that.

The bottom line is I think that you should have a diagnosis in order to decide if the best option is just to "sit it out"..

[Aussie7]

Thanks for your response. I have noted your comments and will discuss same with my Dr when I return for my next appointment.

Appreciate your comments.

Both EBV and CMV are not unique to Thailand but are perhaps the more common (EBV) of the "chronic" viral diseases and is quite easily spread. Phuket is an international tourist hub so exposure would also be to a relatively international collection of viruses and bugs.

Toxoplasmosis may also need to be in the differential diagnosis and to be excluded.

Spelunking could have exposed you to Cryptococcus as well.

On a forum such as this, one can at best list a few possibilities but without actually reviewing tests done it would not be possible to get much closer.

Hopefully, as happens often on this forum, someone may respond with similar experiences and have good advice.

Basic full blood count with a differential count may give a clue as to whether this is chronic viral, parasitic or fungal.

Further investigations should be based on that.

The bottom line is I think that you should have a diagnosis in order to decide if the best option is just to "sit it out"..

[sabaijai]

Lanna Hospital is often compared favourably, but is nearly as expensive as Ram.

Since a while back, Lanna Hospital is also under the same ownership as Ram.

Perhaps the separate administrations make a difference. Most of my experience is at McCormick, Lanna and Ram but I've been to most of the hospitals in CM at least once. I prefer Lanna to Ram.

[evitas]

Did someone know the medicin 'DEMBARAH200'? It seems to be a alternative homoeopatic treatment for dengue and also a protection.

I don't know if we can believe it. What do you think?

[FBN]

Blueturtlegroup seems to be yet another of those quasi websites peddling quasi drugs.

The initial outline of the disease was actually reasonable accurate butit all comes apart at the seams when it goes into the explanation of the immunological reaction.

There are 5 Dengue virus variants. The subsequent DHF and heamorrhagic complications happens because of an "oversensitising" of the immune response resulting in a reaction not dissimilar to an extreme allergic reaction. Therefore, stimulating the immune response by this medication would aggravate this reaction.

Viruses are made of either DNA strands or RNA strands; "poisoning" a virus is not possible.

Alas, back to preventing mosquito bites, no miracle cure here..

[Sheryl]

I think that:

1. commercial sites selling products are not a rfeliable source of objective information

2. there is no evidence whatsoever that this drug works

and I know that many of the things written on the site regarding the supposed pathophysiology of dengue are inaccurate.

[thailandlover]

I had a bout with dengue fever when I first came to Thailand but it was nothing like VIBE's experience. While I had the bone aching and fever (loss of appetite as well) I was fortunate that I did not have vomiting, diarrhea or pain in the eyes. I must have been lucky and had a light dose of the thing.

I have read that if you have dengue fever you develop an immunity to it, ie if you have one kind of dengue you won't get it again, but you could get a different kind. Is this true? I have never had it again, so I have to wonder.

[patklang]

About a month ago i had a horrible flu like bug,and as i have never been ill in 6 years in Thailand my decision was to fight it without antibiotics.

My head was banging for over a week and my joints were aching and i could hradly walk,and my eyes were killing me.After 7 days i was feeling a little bit betetr,maybe 20% of which i should have felt.I had no appetite and lost 6 kilo in 7 days and still felt like poo poo.

Within 2 weeks i was feeling about 80% better but i still wonder if this was a mild dose of dengue fever.Whatever it was i hope my body has got immune antibodies now because i dont want that again,even to lose weight.A trim 85 kilo now at 6ft tall so some good came from it

[Sheryl]

Sounds exactly like dengue or one of the related viruses.

[sbk]

dengue fever can be found in the very most southern parts of the US as well, its not just a Thailand disease.

http://www.cdc.gov/ncidod/dvbid/dengue/map...bution-2005.htm

[BigSnake]

Glad to hear some good News for a change, bad things(Dengue fever) can find anyone at anytime, you made it that is the most important thing. Cheers, wish you many many happy years ahead.