Dengue Fever: 13,200 Cases Reported In Thailand

[Nisa]

My Thai doctor told me if I have Dengue fever once this has an innoculation effect if I catch the disease again.

The second time is not so bad.

But I read a journal that said the second time is worse and you can be seriously ill.

So who do I believe?

And what symptons should we be looking out for?

There are two kinds of Dengue fever. The ordinary Dengue fever is usually not fatal if treated promptly. The nastier version is called Dengue Hemorrhagic Fever and is much more deadly. Years ago I used to edit reports for Uncle Sam on this subject. Don't recall all the details now. To get more info, google "dengue hemorrhagic fever." If I recall folks who have had Dengue fever are susceptible to the nastier version.

I believe there are actually 4 strains and all have the potential to cause Dengue Hemorrhagic Fever. About 80% of those infected with Dengue have no symptoms or mild cold/flu type symptoms. There is no real treatment except rest and keeping yourself hydrated and controlling any fever with things like Tylenol but am sure many people go to their doctor or hospital as they might any flu. However, if symptoms are severe then you should go to the hospital as you may have developed dengue hemorrhagic fever or Dengue shock syndrome.

There are numerous sites on the internet with information about symptoms and prevention which is great to know but keep in mind only 16 people have died in a country of 70 million in a 6-week period and chances are these people had some underlying disease or condition that allowed DF to take them out. My guess is a heck of a lot more people die as a result of bad food they bought at a street vendor.

A couple good links ...

http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/dengue-fever-and-dengue-hemorrhagic-fever.htm

http://en.wikipedia.org/wiki/Dengue_fever

Edited March 18, 2013 by Nisa

[Nisa]

My Thai doctor told me if I have Dengue fever once this has an innoculation effect if I catch the disease again.

The second time is not so bad.

But I read a journal that said the second time is worse and you can be seriously ill.

So who do I believe?

And what symptons should we be looking out for?

I am no expert but I do know that you do NOT build up an immunity, just as you do not to many other vector borne diseases. That's why so many servicemen died of it in WWII.

In my cases, symptoms were similar to malaria - fevers, delirium, headaches, temperature over the top and excruciating pain. It used to be called 'break bone fever' because of very severe pains in the joints. Other distinguishing features in my case were photophobia, as in migraines and a peculiar rash, that in WWII they called 'gloves and boots', where you have inflammation on your lower arms and lower legs. The inflammation is that type where if you press it a white spot emerges briefly, if you know what i mean.

I was misdiagnosed as having malaria or some other mosquito borne disease, such as Ross River virus ( a type of encephalitis). The weird rash should have given it away.

There was also a peculiar incubation period of 1-2 days where the symptoms briefly disappear. That is the time to move and get out (as I did the second time in Indonesia).

I had been very conscientious about mosquito repellent and anti-malarials. However, on the bright side, its a great way to lose a lot of weight very quickly

You actually do become immune once you have had it but only to the type you had (there are 4). There is a catch here and that is often if you get another type your symptoms will be more severe and your odds of developing DHF or DSS are greater. In a nutshell, the reason for this is basically that if you build an immunity to one but get another, your body thinks it has the one you are immune. This is also at least part of the reason why a vaccine is so hard to come up with.

See: http://www.stanford.edu/group/virus/flavi/2000/dengue.htm

Edit: Glad you made it through okay. Sounds like you may have developed DHF.

Edited March 18, 2013 by Nisa

[HerbalEd]

This is an epidemic proportion and "suddenly" announced. Scary. Yet another good reason to stay away from Thailand.

How many "good" reasons do you have?

[nikster]

Own precautions against the mosquito is the best advice so far.

The mosquito breeds on the surface of water and so the firt thing to do is empty all jugs, containers, stagnant ponds or unused swimmimg pools around your houses to take away the breeding site. Also keep checking these remain empty as it will only take one small rain shower to fill them again.

If you like ponds around your house make sure the water is moving and you put in some fish as these will eat the larvae and keep the problem managed to a beter level.

If you do all of the above and still have issues then investigate further within surrounding properties as many remain un-occupied and this often means ponds and pools become heavily infested.

Good luck and take care as this is a serious problem.

Actually ive been meaning to try this out: Place a couple of black containers with water around your house - the perfect mosquito breeding ground. Then empty them every morning and refill with fresh water. The idea is that mozzies will breed in those containers but pouring out the water destroys the larvae.

Mosquitos dont leave the area theyre breeding in - i have read they only ever travel 7-10 meters so it might work...

[nikster]

I remember the days when drains used to be sprayed. Haven't seen this preventative action in years!

And the I see that the infection is four times higher than last year - wow. Could mean that the mossie population carrying these diseases has increased fourfold - lack of spraying?

I dont think its because of the spraying or lack thereof, but there was a big mosquito outbreak after the summer rains this year. I guess the weather made for very good breeding conditions. Was easy to see, mozzies everywhere.

For adults its easy to avoid - wear long pants, use repellent, and avoid areas with lots of mosquitos and you are not going to get Dengue. For kids its a much bigger concern... we are constantly running after them, keeping them inside, etc...

[nikster]

If Thai people were just a little bit concerned with Mosquitoes (Thet don't get bite by them, very rare, mosquitoes are aftar Farang blood and smell!), it would be great. Somehow they don't care, they continue to leave water outside where mosquitoes can multiply by ten.

Not sure how you can state that Thais don't get bitten by Mosquitos, they certainly do, at least where we live.

Incidentally this article is referring to Thais that have caught the disease.

The problem is in Thailand there are always large areas of stagnant water (rice fields) a bit outside the house is hardly going to magnify the population by much is it?

Yeah but the mozzies dont actually go very far, only 7-10m. So stagnant water further away is of no concern .... Unless theres a wind...

[Keesters]

I remember the days when drains used to be sprayed. Haven't seen this preventative action in years!

And the I see that the infection is four times higher than last year - wow. Could mean that the mossie population carrying these diseases has increased fourfold - lack of spraying?

Agree with you 100%. Not seen spraying in Pattaya for at least 4 or 5 years when I caught Dengue.

[tominbkk]

Again it would be nice for them to tell us where most cases are contracted, in Thailand, and in Bangkok in particular. Not very useful otherwise.

I think this is them telling us enough information.. ALL PROVINCES... and this is very typical of health departments the world over not just Thailand to be VAGUE. Anyway ALL PROVINCES tells us that Dengue fever is now widespread and at dangerous levels so people SPRAY. YOU DO NOT WANT this illness.

I'm sure some have it worse than others. It would be nice for them to point them out.

Edited March 20, 2013 by tominbkk

[Sheryl]

My Thai doctor told me if I have Dengue fever once this has an innoculation effect if I catch the disease again.

The second time is not so bad.

But I read a journal that said the second time is worse and you can be seriously ill.

So who do I believe?

There is a complicated form of Dengue called Dengue Hemorraghic Fever (DHF) which can be quite serioius and even fatal. Whereas "simple" dengue itself is a self-limiting disease that feels awful but is rarely serious.

It is not really known what causes some people to develop DHF. It used to be believed that it was the result of an exaggerated immune response in people previously sensitized to dengue hence the concerns about repeat infection (though it is also clear that most repeat infections do not lead to DHF and are indeed usually milder than the initial infection, i.e. there is some cross-immunity between the various dengue serotypes).

This idea that DHF occurs only in (a minority of) repeat infections has come under question lately though, as there are an increasingto number of documented cases of DHF in people who never had dengue before, e.g. very young infants and expats who never before travelled to an endemic area.

Dengue is endemic (constantly present) throughout South-Asia. Every 2-3 years, there is an epidemic, i.e. a greater than usual number of cases. This seems to be one of those years. Young children are usually the most affected, but expats newly living in SE Asia are also quite susceptible if they haven't had it before.

It is spread by a day-time biting mosquito that breeds in stagnant water. Household water jars and the puddles around many fresh markets are prime sites.

[55Jay]

"The survey conducted by the Department of Disease Control on mosquito larva population in 190 districts found that over 70 percent of mosquito larvae originated from water containers in households."

I don't know about anyone else, but around my piece 'o paradise, like many areas in Thailand, there are large tracts of low lying agricultural ground or just undeveloped/low land, which holds shallow, stagnant water very nicely. I presume much of this is privately held land, so that may be counted as household standing water. At any rate, I can prevent standing water at my place all day long, but I'm surrounded by mozzie incubators on an industrial scale. It's SE Asia, fact of life and one of a few tradeoffs living here I reckon.

A micro-scale compared to vast Thailand, but one year where I lived in the Middle East, had a bad mozzie problem and we had no standing water laying around. Government, which was irritatingly trying to demonstrate they were responsible and responsive to the citizenry or, they actually cared, paid for big lorries to go around and spray white power in all municipal neighborhood areas. Mozzie problem over, guess it killed larvae too. Read here recently somebody had seen that once in their village, but the head man quit doing it, guess the money is better spent elsewhere.

I wouldn't propose anything so dramatic as action on the part of the Thai government. How to address this massive scale yet natural, cyclic problem? Maybe that's the problem, it's too big, they just can get their head around it, don't know where to start? Rather, perhaps, doing so would take a lot of money (ding ding ding!) and the large incubators, if that's true, are privately owned - so not the domain of government? Folding of arms and not taking responsibility seems easy here. Can we expect individual land owners to take action and spend 1 satang, even if ordered top down from BKK to muni offices? Probably not.

So I reckon every year, more news stories, facts and figures indicating a National "outbreak" is going on, the root cause of which is known, problem predicted to get worse, case load and deaths rising, establishment of a "war room" with flashing lights and people holding important looking clip boards I presume, but all we get is another government "survey" telling us the same as last year.

Last posted article directed public health offices to control the mozzie population, but my take away was you're on your own, wear repellent.

Dengue mosquitos do not breed in stagnant water, such as swamps, bush land or mangroves. Neither do they breed in flowing water such as creeks and rivers. See more info here: http://www.health.qld.gov.au/dengue/info/mosquito.asp

Thank you, yes, I did some brief reading a few months ago but didn't catch that byte. Thanks for link.

I personally don't pre-examine mozzies with a magnifying glass to determine what kind they are. I'm an equal opportunity kind of guy, so all mozzies, stripes, no stripes, diseased or not, get the treatment. I would prefer not to be the test case to determine if the one (out of a hundred) that just siphoned me is carrying one of the dengue strains, or malaria, or fecal matter from my dogs arse.

[HereIAm]

Some posters have mentioned stagnant water as the breeding place of the dengue mosquito. Take note that the Aedes mosquito which causes dengue breeds in dry spots around the house and office where waste is accumulating. Uncleared dry waste, including dead wood, old rubber tyres, flower pots. etc . These are the types of danger spots to avoid. If you notice such waste or debris around your workplace or residence get them cleared.

[55Jay]

Some posters have mentioned stagnant water as the breeding place of the dengue mosquito. Take note that the Aedes mosquito which causes dengue breeds in dry spots around the house and office where waste is accumulating. Uncleared dry waste, including dead wood, old rubber tyres, flower pots. etc . These are the types of danger spots to avoid. If you notice such waste or debris around your workplace or residence get them cleared.

Right on, so I must be whacking lots of them when go out and kick the piles of (dry) crap in the car park and swing my mozzie bat around.

Getting FIL to part with any of it ain't easy, but he does reorganize things..... I have the theme song from the American TV series "Sanford and Son" going in my head, but I am making slow progress.

[Thai at Heart]

My Thai doctor told me if I have Dengue fever once this has an innoculation effect if I catch the disease again.

The second time is not so bad.

But I read a journal that said the second time is worse and you can be seriously ill.

So who do I believe?

And what symptons should we be looking out for?

I am no expert but I do know that you do NOT build up an immunity, just as you do not to many other vector borne diseases. That's why so many servicemen died of it in WWII.

In my cases, symptoms were similar to malaria - fevers, delirium, headaches, temperature over the top and excruciating pain. It used to be called 'break bone fever' because of very severe pains in the joints. Other distinguishing features in my case were photophobia, as in migraines and a peculiar rash, that in WWII they called 'gloves and boots', where you have inflammation on your lower arms and lower legs. The inflammation is that type where if you press it a white spot emerges briefly, if you know what i mean.

I was misdiagnosed as having malaria or some other mosquito borne disease, such as Ross River virus ( a type of encephalitis). The weird rash should have given it away.

There was also a peculiar incubation period of 1-2 days where the symptoms briefly disappear. That is the time to move and get out (as I did the second time in Indonesia).

I had been very conscientious about mosquito repellent and anti-malarials. However, on the bright side, its a great way to lose a lot of weight very quickly

You actually do become immune once you have had it but only to the type you had (there are 4). There is a catch here and that is often if you get another type your symptoms will be more severe and your odds of developing DHF or DSS are greater. In a nutshell, the reason for this is basically that if you build an immunity to one but get another, your body thinks it has the one you are immune. This is also at least part of the reason why a vaccine is so hard to come up with.

See: http://www.stanford.edu/group/virus/flavi/2000/dengue.htm

Edit: Glad you made it through okay. Sounds like you may have developed DHF.

Bumped into an Australian researcher about 5 years ago, who was in Isaan studying dengue, after a lot of Australian soldiers had caught it while being in Aceh.

He told me, that for some unknown reason, outbreaks cycle in 6 year cycles, and this they didn't understand. Interesting to read up the page that dengue mosquitos don't proliferate in water. We are absolutely inundated at home this year, and there is no difference from previous years in the environment. Where they are all coming from, we have absolutely no idea, but there has to be a source somewhere, we just don't know where.

[jamhar]

"Dengue Fever: 13,200 Cases Reported In Thailand"

Dang! That's a lot

PS if someone has already used that joke

I humbly apologize

[wilcopops]

"dengue mosquitos don't proliferate in water" - where does it say that?

[Thongkorn]

Just give every arriving passenger a small bottle of aeroguard once they clear immigration, problem solved.

There is no cure for Dengue fever, or inoculation, Even mossies are getting immune to deet. Belive me you will know when you have dengue fever because you will not have any energy, and you will need to be hydrated in a Hospital and it can take months to get rid of it. Flu type symptoms and pains in all your joints. Many people die, because they do not eat and just get weaker and de hydrated, Then its to late for the body to recover.

Edited March 21, 2013 by Thongkorn

[maxheadroom007]

Did you know: -

Mosquitos are attracted to bright clothing, so wear a Hawian top or something luminous and they will come after you.

Also Mosquitos are attracted to Carbon Dioxide, which we all breath out, and so if you are in a large group of people, at a beach party for instance, the chances of being bitten are quite high.

Fat peaople produce more carbon Dioxide than normal and also pregnant women do the same. If you excercise this also produces more carbon dioxide and also lactic acid which sweats out onto your skin, which is also an attractant.

A good way to repell them is to rub Tiger Balm onto your skin as they hate the smell! Also they dont like smoke so these mosquito coils are a good idea, or just start smoking.......

In conclusion - Top Tips to stop getting attacked my mosquitos - Wear really boring clothes, dont go to parties, stop breathing, dont keep fit, take up smoking, dont get fat, dont get pregnant and rub tiger balm all over yourself so you stink like a gooden!

Hope these valid suggestions go some way to help......

[hawker9000]

My Thai doctor told me if I have Dengue fever once this has an innoculation effect if I catch the disease again.

The second time is not so bad.

But I read a journal that said the second time is worse and you can be seriously ill.

So who do I believe?

As far as I know, there are several types,4?, if you get one you´ll be immune to that one.........if catching one of the others you could be in trouble.

This is my understanding as well. 4 different "serotypes" (I believe that's the right term...); having had one provides no protection at all against infection with the others, nor any indication WRT what you can expect as far as severity of the others should you catch them later on. 'Not sure there's any rhyme or reason to severity vs the order you catch them in... And individual reactions vary widely as well I believe. IOW, it's a total crap shoot. But you really don't want to catch it (or them?); you can just be sort o' sick, very sick, very very sick, or die... In the immortal words of Forrest Gump, "It's like a box of chocolates.".

Here in the states you can buy stuff at REI with which to "treat" your clothes so that they're insect repellant. 'Will survive some good number of washings (but not dry-cleanings). You can also buy plastic repellant "bracelets" to put around your wrists and/or ankles. Good for 96 hours of use. 'Not a good time to be sleeping with the windows open... Funny, but I seem to have the worst time in Bangkok taxis - there ALWAYS seem to be a few mossies buzzing around and I've been bitten while riding in them more than once.

[wilcopops]

My Thai doctor told me if I have Dengue fever once this has an innoculation effect if I catch the disease again.

The second time is not so bad.

But I read a journal that said the second time is worse and you can be seriously ill.

So who do I believe?

As far as I know, there are several types,4?, if you get one you´ll be immune to that one.........if catching one of the others you could be in trouble.

This is my understanding as well. 4 different "serotypes" (I believe that's the right term...); having had one provides no protection at all against infection with the others, nor any indication WRT what you can expect as far as severity of the others should you catch them later on. 'Not sure there's any rhyme or reason to severity vs the order you catch them in... And individual reactions vary widely as well I believe. IOW, it's a total crap shoot. But you really don't want to catch it (or them?); you can just be sort o' sick, very sick, very very sick, or die... In the immortal words of Forrest Gump, "It's like a box of chocolates.".

Here in the states you can buy stuff at REI with which to "treat" your clothes so that they're insect repellant. 'Will survive some good number of washings (but not dry-cleanings). You can also buy plastic repellant "bracelets" to put around your wrists and/or ankles. Good for 96 hours of use. 'Not a good time to be sleeping with the windows open... Funny, but I seem to have the worst time in Bangkok taxis - there ALWAYS seem to be a few mossies buzzing around and I've been bitten while riding in them more than once.

there IS some science to suggest that subsequent infections may be more severe.. It can be found on google even. I think it's something to do with how antibodies reaction or rather misreact to a second dengue virus.

As with anything like this is will take a lot of time, cases and trials to paint a convincing picture.

There is also research into vaccines - but again they have to deal with 4 strains....serotypes -whatever.

[aubreystrawberry]

As mentioned by Samuibruno, the mosquitos that transmit Dengue bite during the day so to be safe you need to use a repellant as soon as you get up in the morning. Personally, I don't use DEET products for a variety of reasons and have found alternatives which are just as effective but it seems that the little b*****s are now becoming tolerant to DEET anyway! http://www.bbc.co.uk/news/science-environment-21519998.

Do you live in Thailand and not use DEET? What do you do to prevent them from biting. I also do not use DEET for a variety of reasons. I am going to be there in 2 weeks so just really curious what the alternative is to DEET. Thanks!