Dengue Fever In Phuket

[DonaldFreeman]

Hi to anyone who can help me. I am typing from the Bang phuket hospital now.

I have lived in puket for 3 months then took a trip to indonesia for 3 weeks and 4 days after returning to phuket health began to decline. I am 40 and healthy in good shape.

day 1 had diorea

day 2 diorea and fever starting

day 3-7 max temp 102.5 and with paracetemal about 101.

the pain is severe in legs and arms, for days 1-5 no eye pain or headache, but now painful headach and eyes.

day 6 fever not better and not sleeping at not due to pain, went to hospital outpatient and they did blood test, normal cell counts. they said no dengue but ran another test and said agian no dengue and I went into stay at the hospial because I was in too much pain.

the doctor said the test said no dengue and put me on a fluid IV and a broad antibiotic until he can do more tests. So the antibiotics I am on are for typhod fever and liptoseptos (rat urine) infection.

since getting too the hospital I have gone down hill. Diorea and vomiting in the hospital (on day 7 now). sweating, bones breaking certainly.

so I have never been in a hospital thai) and am wondering if I am doing the right thing. He is just throwing a few darts at me and I think the antibiotics are making me worse. I never vomited until here. he did chest xray to rule infection in chest (negative) and has me on celebrex for pain and some other pain pill and muscle relaxor.

now today he says he will do another blood test in the morning (day 7 or 8) and seee if dengue. He will take me off the antibiotics in morning if it is dengue.

I am so confused. I want to tell them to get me off the 2 antibiotics but not sure. I want to get better.

Any input from you would be helpful, I am in hospital and will read any responses tonight or in am.

thank you in advance

Don

[rken]

If its Dengae fever you should have a rash on arms and legs. My wife and a friend of hers just went through it. can last from 10 to 14 days but usually less. Good luck.

[Sheryl]

Dengue does not always cause a visible rash.

It also does not usually cause diarrhea, and this is the part that is puzzling to me. If it were not for the diarrhea I would say that it is indeed most likely dengue or a related disease.

Possibly the diarrhea is unrelated, just a coincidence, especially if it has stopped. In which case my guess would be dengue, although they are right to rule out typhoid just in case.

Be aware that the blood test they are talking about is probably just a platlet count (the part iof the blood involved in clotting) and that while this does decline in hemorraghic forms of the disease it may remain normal in non-hemorrghagic forms which is what we farang tend to get posisble because, unlike the Thais, we had no prior exposure in childhood.

In other words, it is not a reliable means of ruling out dengue, especially in a westerner. The only blood test that really confirms or rules out dengue is an antibody titer that will be positive only late in the course of the disease and takes several days to get the results of so it is of little or no use to in patient management and therefore rarely done except for surveillance of epidemics.

It is quite possible that the medications are the cause of your vomiting. Maybe the antibiotics, maybe the pain killers. Ask the doctor to give you something for the nausea. If that doesn't work, ask about going off the antibiotics once they have gotten lab work back and ruled out typhoid (they will not be able to rule out lepto quickly, I'm afraid). It may also prove necessary to change the pain medication. When I had dengue, they gave me paracetemol with codeine and that made ne vomit, I did better with just plain para. But perhaps anti-emetic drugs will control the vomiting.

If it is dengue, the fever and pain should subside pretty soon. It is unusual for fever to continue more than 7 days or so, give or take; if it does, then another cause is likely. And the possible other causes are pretty much the things they are already considering, i.e. typhoid, leptospirosis.

One point that you didn't mention is whether the fever is accompanied by shaking chills. Dengue usually is, whereas typhoid usually is not.

If it is any comfort, from what you describe they seem to be treating you appropriately.

Good luck! and see my PM

[cme]

I had Dengue 2 years ago, no diarrhea or rash just the very high fever and terrible break-bone pain. I would suggest your diarrhea is from another source, maybe just simple food poisoning or a reaction to you antibiotics which do nothing for the fever. I spent a week in hospital and just had a saline infusion and pain killer tablets, but NOT Aspirin etc as these tend to thin the blood, which is the last thing you need with Hemorrhaging type illness.

Good luck.

[corker]

Hi to anyone who can help me. I am typing from the Bang phuket hospital now.

I have lived in puket for 3 months then took a trip to indonesia for 3 weeks and 4 days after returning to phuket health began to decline. I am 40 and healthy in good shape.

day 1 had diorea

day 2 diorea and fever starting

day 3-7 max temp 102.5 and with paracetemal about 101.

the pain is severe in legs and arms, for days 1-5 no eye pain or headache, but now painful headach and eyes.

day 6 fever not better and not sleeping at not due to pain, went to hospital outpatient and they did blood test, normal cell counts. they said no dengue but ran another test and said agian no dengue and I went into stay at the hospial because I was in too much pain.

the doctor said the test said no dengue and put me on a fluid IV and a broad antibiotic until he can do more tests. So the antibiotics I am on are for typhod fever and liptoseptos (rat urine) infection.

since getting too the hospital I have gone down hill. Diorea and vomiting in the hospital (on day 7 now). sweating, bones breaking certainly.

so I have never been in a hospital thai) and am wondering if I am doing the right thing. He is just throwing a few darts at me and I think the antibiotics are making me worse. I never vomited until here. he did chest xray to rule infection in chest (negative) and has me on celebrex for pain and some other pain pill and muscle relaxor.

now today he says he will do another blood test in the morning (day 7 or 8) and seee if dengue. He will take me off the antibiotics in morning if it is dengue.

I am so confused. I want to tell them to get me off the 2 antibiotics but not sure. I want to get better.

Any input from you would be helpful, I am in hospital and will read any responses tonight or in am.

thank you in advance

Don

[corker]

Hi Don-If you want to contact me directly about your situation i can help you out with some information.I am in Pattaya,my cell is 087055 0561 cheers,Lux

[nidhogg]

1. It also does not usually cause diarrhea, and this is the part that is puzzling to me. If it were not for the diarrhea I would say that it is indeed most likely dengue or a related disease.

Possibly the diarrhea is unrelated, just a coincidence, especially if it has stopped. In which case my guess would be dengue, although they are right to rule out typhoid just in case.

2. Be aware that the blood test they are talking about is probably just a platlet count (the part iof the blood involved in clotting) and that while this does decline in hemorraghic forms of the disease it may remain normal in non-hemorrghagic forms which is what we farang tend to get posisble because, unlike the Thais, we had no prior exposure in childhood.

(snipped and my numbering)

1. dengue can definately be associated with gastritis, including diarrhea and vomitting (one link, I can give you 10 more)

http://www.symptoms101.com/med/archives/20...engue_fever.php

2. The relationship between hemorrhagic and non hemorrhagic is more to do with a prior infection than infection during childhood. A western adult who gets its twice as a adult is as likely to develop a hemorrhagic form as a Thai who got it once in childhood and once in adulthood.

[GungaDin]

I read Don's plight.

Is there a center for tropical diseases in BKK?

Don, have you got a mobile phone with you in hospital?

[DonaldFreeman]

Thank you everyone for your help!

Sheryl,

I am out of hospital, grateful for the experience but wow.

It turned out to be Dengue. yes had shakes and chills. But the doctor after first blood test(day5) said no dengue so put me on antibiotics in case it was thyphoid. but then on day 7 another test came back positive for dengue.

I still belive diorreha and vomiting was from not eating and 2 new antibiotics. I was only on them 24 hours but yuck. they really push pills in thailand. you must advocate for yourself.

Thankful I had google and Thai visa in the hospital.

One last question: My smell has always been lacking. but during dengue and now my sense of smell has return very much so. any ideas you can point me to?

thank you all

don

Dengue does not always cause a visible rash.

It also does not usually cause diarrhea, and this is the part that is puzzling to me. If it were not for the diarrhea I would say that it is indeed most likely dengue or a related disease.

Possibly the diarrhea is unrelated, just a coincidence, especially if it has stopped. In which case my guess would be dengue, although they are right to rule out typhoid just in case.

Be aware that the blood test they are talking about is probably just a platlet count (the part iof the blood involved in clotting) and that while this does decline in hemorraghic forms of the disease it may remain normal in non-hemorrghagic forms which is what we farang tend to get posisble because, unlike the Thais, we had no prior exposure in childhood.

In other words, it is not a reliable means of ruling out dengue, especially in a westerner. The only blood test that really confirms or rules out dengue is an antibody titer that will be positive only late in the course of the disease and takes several days to get the results of so it is of little or no use to in patient management and therefore rarely done except for surveillance of epidemics.

It is quite possible that the medications are the cause of your vomiting. Maybe the antibiotics, maybe the pain killers. Ask the doctor to give you something for the nausea. If that doesn't work, ask about going off the antibiotics once they have gotten lab work back and ruled out typhoid (they will not be able to rule out lepto quickly, I'm afraid). It may also prove necessary to change the pain medication. When I had dengue, they gave me paracetemol with codeine and that made ne vomit, I did better with just plain para. But perhaps anti-emetic drugs will control the vomiting.

If it is dengue, the fever and pain should subside pretty soon. It is unusual for fever to continue more than 7 days or so, give or take; if it does, then another cause is likely. And the possible other causes are pretty much the things they are already considering, i.e. typhoid, leptospirosis.

One point that you didn't mention is whether the fever is accompanied by shaking chills. Dengue usually is, whereas typhoid usually is not.

If it is any comfort, from what you describe they seem to be treating you appropriately.

Good luck! and see my PM

[Sheryl]

I can't specifically tell you about the smell aspect, but various mental/mood changes are quite normal after dengue. Most important to know is that depression occurs, it can be quite severe in some cases, and it is totally normal, due to the disease and will go away with time (a couple of weeks usually)

In addiition to depression people find that their emotions are just "different"from their norm (I remember bursting into tears oover a cartoon in the New yorker...and I'm one of those people who never cry!). So I suppose sense of smell could be affected to.

Plus one usually feels exhausted and it takes a few weeks to get your energy back. Meanwhile just take it easy.

Welcome to the "Dengue Club"! I've had it twice.....

[evitas]

I can't specifically tell you about the smell aspect, but various mental/mood changes are quite normal after dengue. Most important to know is that depression occurs, it can be quite severe in some cases, and it is totally normal, due to the disease and will go away with time (a couple of weeks usually)

In addiition to depression people find that their emotions are just "different"from their norm (I remember bursting into tears oover a cartoon in the New yorker...and I'm one of those people who never cry!). So I suppose sense of smell could be affected to.

Plus one usually feels exhausted and it takes a few weeks to get your energy back. Meanwhile just take it easy.

Welcome to the "Dengue Club"! I've had it twice.....

[evitas]

I had dengue type 1 last august 2008. I stay for one week in the hospital in Phuket.

I was very ill. Now I'm very very very affraid to get it once again, because they said that it can be fatal.

I'm happy to read that there are people who get it twice. Was it hemorrhagic dengue?

Can anyone reassure me because I'm really panic and have serieus fear.

[Sheryl]

There are 4 known serotyopes of dengue in Thailand.

I know plenty of people who have had it twice, even three times. Neither I nor any of them had the hemorrhagic form (DHF) which is what you refer to.

It used to be thought that DHF was the result of getting dengue a second time with a different strain, but this explanation now seems incomplete. Other theroized factors include specific genotypes of the virus and host genetioc factors. In short, it really is still not well understood why a minority of dengue infections take a hemorrhagic form.

Dengue by itself, be it your first, second or whatever, will not kill you. DHF can, but with prompt treatment mortality rates are below 1%.

I really wouldn't stress yourself over this. Statistically your odds of dying from a motor vehicle accident in Thailand are far greater than your odds of getting, let alone dying of, DHF.

But if worry you must, focus on avoiding the bites that cause it. As you probably know it is a daytime biting mosquito, so insect repelelent in the daytime. It is also a mosquito that likes to breed in stagnnat water and does not fly very far from its breeding place, so if you can, avoid having stagnnat water around where you live, keep any water jars covered and with treat with the larvicide drug Abata or add in tilipia (small fish that eat mosquito larvae). Simply digging ditches to drain water away from residential areas can make a big difference.

[Foreverford]

I had dengue type 1 last august 2008. I stay for one week in the hospital in Phuket.

I was very ill. Now I'm very very very affraid to get it once again, because they said that it can be fatal.

I'm happy to read that there are people who get it twice. Was it hemorrhagic dengue?

Can anyone reassure me because I'm really panic and have serieus fear.

PIN THIS SUBJECT!!!!!!!!! Now! and everybody report every and all cases of dengue and the date and any and all info you can this is one of the diseases that can be prevented thru info by alerting folks of where and when it is hitting so they can avoid or protect themselves (long sleeve shirt massive amounts of bug spray and clening up their local enviroment. If I could say dam_n it I would and and then I'd say dam_n it Pin it!!!!!

[evitas]

Thank you, Sheryl!!!!!

[evitas]

Is there a greater risk of second infection for a person who already had?

I mean, a mosquito smell that? (I know it's a strange question)

[geriatrickid]

Is there a greater risk of second infection for a person who already had?

I mean, a mosquito smell that? (I know it's a strange question)

Yes and no. Yes, if there were favourable factors such as living in a bug zone, depressed immune system, being a bug target (some people just attract mosquitos through scents and clothing) as well as the usual bad luck. No, if you are thinking that a prior infection makes one automatically predisposed. All one can do is use the repellent in bug peak hours and dress appropriately.

One of the reasons there appears to be a bigger incidence is that there are good conditions for the bugs now (stating the obvious) and there is better reporting of the cases. Alot of cases were not getting recorded in prior years. People are more aware because they are reading up on it (as per this) and because the MoH is disseminating info.