33 People Die Of Dengue Fever In Thailand During Jan 1 To April 30

[Nisa]

33 People registered as having a cause of death attributable to complications due to dengue. Many people die in Thailand and do not have an autopsy. The number is much higher.

You don't need an autopsy if they know the cause of death and you don't need an autopsy to confirm DF as the cause of death.. DF is not an instant killer and takes on very serious symptoms before you can die. In a country with free medical and where people are aware of the risks and symptoms of having DF, I'd suspect the vast majority of people suffering these symptoms would go to the hospital. Pretty sure the number is fairly accurate but could be too high because of misdiagnosis since doctors at this point are going to assume DF if the symptoms fit. The only way the number could be off by any meaningful way is if lots of people are not reporting deaths and disposing of bodies on their own.

On the other hand the number of reported case is probably considerably lower than actual cases because many people get DF and don't even know it and the symptoms are fairly mild.

[techboy]

Dengue Fever is hard to control in these places , as there is no cure ,a high death rate from most countries in the region is the norm, until Asians ,as a whole can see filth and clean up their rubbish, this will continue to the end of time

Mosquito larvae do not incubate in "rubbish" per se. They thrive in warm stagnant water which is naturally abundant in tropical and subtropical environments. If you wish to reflect on things that "will continue to the end of time" perhaps you should begin with ignorance.

[fasteddie]

He is blaming global warming... lolol

But of course:

>>>>thanks to the inclement weather like global warming and off-seaso

n rain

You get extra points if you can work "global warming" into your statements. It makes you sound intelligent to your superiors.

Given that Dengue Fever takes place in certain climates and large outbreaks can directly be related to weather and no informed person denies that Global warming is happening (may debate the cause) and that it has an effect on both climate and weather ....

I beg to differ, many informed people deny global warming. it's climate change, always happened, always will.

[JDGRUEN]

Dengue Fever ...

Dengue viruses -- DENV 1, DENV 2, DENV 3, and DENV 4

Vector - Mosquito-borne (Aedes Aegypti) a nocturnal and mainly urban dwelling species of mosquito

Urbanization has increased the occurrence of the disease probably due to increase mosquito water breeding areas utilizing pots, puddles, collections of water in draining systems, etc. Domestic animals could contribute to the occurrence of Dengue to the extent that their activities create pools or puddles of standing water that assists mosquito breeding. Dengue is not a disease related to filth or trash except to the extent that containers (cans and bottles) collect water.

A variant of Dengue - Sylvatic Dengue (from the forest) may have a wild reservoir of monkeys and perhaps bats. I could not find mention of any other animal reservoirs in the research literature such pigs, cows, horses, chickens,etc.

The virus does not have an intermediate host.

Increased severe and fatal disease in children under 15 years

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0053535

http://www.sciencedaily.com/releases/2011/06/110613142235.htm

http://www.cdc.gov/dengue/faqFacts/fact.html

Edited May 3, 2013 by JDGRUEN

[Nisa]

Dengue Fever ...

Dengue viruses -- DENV 1, DENV 2, DENV 3, and DENV 4

Vector - Mosquito-borne (Aedes Aegypti) a nocturnal and mainly urban dwelling species of mosquito

Urbanization has increased the occurrence of the disease probably due to increase mosquito water breeding areas utilizing pots, puddles, collections of water in draining systems, etc. Domestic animals could contribute to the occurrence of Dengue to the extent that their activities create pools or puddles of standing water that assists mosquito breeding. Dengue is not a disease related to filth or trash except to the extent that containers (cans and bottles) collect water.

A variant of Dengue - Sylvatic Dengue (from the forest) may have a wild reservoir of monkeys and perhaps bats. I could not find mention of any other animal reservoirs in the research literature such pigs, cows, horses, chickens,etc.

The virus does not have an intermediate host.

Increased severe and fatal disease in children under 15 years

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0053535

http://www.sciencedaily.com/releases/2011/06/110613142235.htm

http://www.cdc.gov/dengue/faqFacts/fact.html

I am guessing the increase in populated areas is because that it spreads much more rapidly from person to mosquito to person where you have more people. And since they prefer the blood of humans and in metro areas there are considerably more people, it would seem like a good place for them to live. Keep in mind they need to feed on blood to reproduce and there is no lack of snacks for them in a city..

If anything, I would guess cities in tropic regions have less standing water than before their were cities and that a few old tries and trash don't come close to the standing water that existed in a pre-drainage city.

[Robby nz]

Do what we and most other people around here do, put one of two small fish in every water container.

They eat any Mossie eggs that are laid in the water and often get the mossie as well when it has its tail in the water laying the eggs.

Will not completely eradicate mossies but sure keeps the numbers down.

[bunnydrops]

Mosquitoes need still water to lay eggs and breed. One way to stop them using stored water is to pour a little cooking oil on top which floats on the water and the mozzies can't land.

Also suffocates the larvae.

[SantiSuk]

"According to the director-general, Northeast of Thailand has been the region with the fastest spreading of the deadly disease in the past 5 years."

"Most of Thailand's patients and deaths were found in the southern region, followed by the northeastern region."

Two different takes (but not contradictory).

[SantiSuk]

Dengue Fever is hard to control in these places , as there is no cure ,a high death rate from most countries in the region is the norm, until Asians ,as a whole can see filth and clean up their rubbish, this will continue to the end of time

Asians? Trash? So you think you are more a risk being in a city where there is tons of trash and Asians than being out in the jungle or remote area?

So you think you are less at risk in an urban area, Nisa? Wrong. "Aedes aegypti prefers to lay its eggs in artificial water containers, to live in close proximity to humans" (wiki). I may be wrong but I think like malaria the mosquitos are not born naturally infected but they pick up the virus from one infected host (mostly human) and pass it on to others. If so, presumably that's why, together with their preference for contained water higher density population areas are more at risk than sparsely populated areas.

If you are paranoid about the risk move your hosue to the outskirts of a village (mozzies have a very limited flight range of a few hundred meters) or the jungle.

[geriatrickid]

33 People registered as having a cause of death attributable to complications due to dengue. Many people die in Thailand and do not have an autopsy. The number is much higher.

You don't need an autopsy if they know the cause of death and you don't need an autopsy to confirm DF as the cause of death.. DF is not an instant killer and takes on very serious symptoms before you can die. In a country with free medical and where people are aware of the risks and symptoms of having DF, I'd suspect the vast majority of people suffering these symptoms would go to the hospital. Pretty sure the number is fairly accurate but could be too high because of misdiagnosis since doctors at this point are going to assume DF if the symptoms fit. The only way the number could be off by any meaningful way is if lots of people are not reporting deaths and disposing of bodies on their own.

On the other hand the number of reported case is probably considerably lower than actual cases because many people get DF and don't even know it and the symptoms are fairly mild.

Your statements are factually incorrect. The DDC does not ascribe a cause of death to dengue without a post mortem examination having been performed. Dengue is a reportable disease under WHO reporting guidelines, and Thailand's MoH does try to comply. In the event of a death with a patient presumed to have had dengue or previously diagnosed with dengue, a post mortem exam is conducted and this includes the taking of tissue samples for analysis. Please do not tell me that the DDC

puts on a magic diagnostic hat and reports a COD as dengue on a whim. Whatever Thailand's public health weaknesses are, when it comes to infectious diseases, Thailand's public health department makes an effort to report reliable data. They may under report because of infrastructure and access to health care, but the MoH does not intentionally report an uncorroborated/unverified infectious disease death.

There are different types of autopsies, and they are dictated by the specific case. COD is categorized as Immediate or Proximate. A patient can be diagnosed with dengue by way of serological testing such as an Elisa varient, but this is best done if a patient reports within 5 days of the onset of fever. Due to the costs associated with other types of tests and the equipment and its associated technical support, other tests such as PCR are not common. Provincial hospitals in Ubon and Udon are just not equipped, nor staffed for fancy lab tests. I'd wager that the 26,000 reported cases had Elisa tests done and that all of the dead patients had post mortems. I was just with one of the hospital administrators in Udon and he assists in the reporting of data for his hospital. I can assure you that he is not passing invented data to the DDC in Bangkok.

Your comments are infuriating because of their simplistic approach to a complex virus with 4 serotypes. A patient that presents with symptoms of dengue, does not necessarily die of dengue. If the patient has an underlying health condition such as HIV, cancer , heart disease etc., the dengue can exacerbate the underlying condition, and hasten a demise that is due to the underlying health condition. In the event of death, in order to determine the severity of the virus, and to assess the impact related to the virus, a post mortem examination is most certainly required for reporting under the WHO guidelines.

[Nisa]

33 People registered as having a cause of death attributable to complications due to dengue. Many people die in Thailand and do not have an autopsy. The number is much higher.

You don't need an autopsy if they know the cause of death and you don't need an autopsy to confirm DF as the cause of death.. DF is not an instant killer and takes on very serious symptoms before you can die. In a country with free medical and where people are aware of the risks and symptoms of having DF, I'd suspect the vast majority of people suffering these symptoms would go to the hospital. Pretty sure the number is fairly accurate but could be too high because of misdiagnosis since doctors at this point are going to assume DF if the symptoms fit. The only way the number could be off by any meaningful way is if lots of people are not reporting deaths and disposing of bodies on their own.

On the other hand the number of reported case is probably considerably lower than actual cases because many people get DF and don't even know it and the symptoms are fairly mild.

Your statements are factually incorrect. The DDC does not ascribe a cause of death to dengue without a post mortem examination having been performed. Dengue is a reportable disease under WHO reporting guidelines, and Thailand's MoH does try to comply. In the event of a death with a patient presumed to have had dengue or previously diagnosed with dengue, a post mortem exam is conducted and this includes the taking of tissue samples for analysis. Please do not tell me that the DDC

puts on a magic diagnostic hat and reports a COD as dengue on a whim. Whatever Thailand's public health weaknesses are, when it comes to infectious diseases, Thailand's public health department makes an effort to report reliable data. They may under report because of infrastructure and access to health care, but the MoH does not intentionally report an uncorroborated/unverified infectious disease death.

There are different types of autopsies, and they are dictated by the specific case. COD is categorized as Immediate or Proximate. A patient can be diagnosed with dengue by way of serological testing such as an Elisa varient, but this is best done if a patient reports within 5 days of the onset of fever. Due to the costs associated with other types of tests and the equipment and its associated technical support, other tests such as PCR are not common. Provincial hospitals in Ubon and Udon are just not equipped, nor staffed for fancy lab tests. I'd wager that the 26,000 reported cases had Elisa tests done and that all of the dead patients had post mortems. I was just with one of the hospital administrators in Udon and he assists in the reporting of data for his hospital. I can assure you that he is not passing invented data to the DDC in Bangkok.

Your comments are infuriating because of their simplistic approach to a complex virus with 4 serotypes. A patient that presents with symptoms of dengue, does not necessarily die of dengue. If the patient has an underlying health condition such as HIV, cancer , heart disease etc., the dengue can exacerbate the underlying condition, and hasten a demise that is due to the underlying health condition. In the event of death, in order to determine the severity of the virus, and to assess the impact related to the virus, a post mortem examination is most certainly required for reporting under the WHO guidelines.

As I stated, you don't need an autopsy to determine DF and the Who doesn't require one to accept numbers provided to them just as much as they don't need to see a body or an autopsy report to accept traffic death reports from countries. Autopsies are generally performed to determine cause of death and if somebody is already diagnosed and being treated and dies in hospital there is generally no need for an autopsy.

From the CDC

Dengue can be diagnosed by isolation of the virus, by serological tests, or by molecular methods. Diagnosis of acute (on-going) or recent dengue infection can be established by testing serum samples during the first 5 days of symptoms and/or early convalescent phase (more than 5 days of symptoms). http://www.cdc.gov/dengue/clinicallab/laboratory.html

As for your comment " Many people die in Thailand and do not have an autopsy" this is pretty much the case everywhere. Few deaths result in actual autopsies.

About 20 percent of the deaths in the United States are subject to investigation by coroners or medical examiners. While autopsies are commonly performed in the course of such investigations, they are not always required. Each case is evaluated to determine a cause and manner of death. http://www.glenoakspathology.com/facts.shtml

[Nisa]

Dengue Fever is hard to control in these places , as there is no cure ,a high death rate from most countries in the region is the norm, until Asians ,as a whole can see filth and clean up their rubbish, this will continue to the end of time

Asians? Trash? So you think you are more a risk being in a city where there is tons of trash and Asians than being out in the jungle or remote area?

So you think you are less at risk in an urban area, Nisa? Wrong. "Aedes aegypti prefers to lay its eggs in artificial water containers, to live in close proximity to humans" (wiki). I may be wrong but I think like malaria the mosquitos are not born naturally infected but they pick up the virus from one infected host (mostly human) and pass it on to others. If so, presumably that's why, together with their preference for contained water higher density population areas are more at risk than sparsely populated areas.

If you are paranoid about the risk move your hosue to the outskirts of a village (mozzies have a very limited flight range of a few hundred meters) or the jungle.

While I admit I didn't know that DF was different in terms of where you are more likely to get it than Malaria, the point I was trying to make is it didn't have much to do with trash and in major cities they have mosquito control and this is probably most deaths and reported cases in Thailand seem (based on recent reports) to happen outside the larger metro areas.

[geriatrickid]

The issue is not traffic injuries nor the guidelines for autopsies in the USA.

The sole issue of relevance is the reporting protocol for a cause of death attributable for dengue in Thailand. The procedure is very clear. In order to report a dengue fever cause of death under the WHO guidelines tissue samples at the post mortem, aka autopsy must be taken and the result registered.

You do not have the slightest clue as to what you are writing about. In Thailand, Dengue fever is a reporting illness. A confirmed report is not made without serological testing. It can be performed on someone living or deceased. For health reporting purposes a cause of death is not ascribed to dengue without a post mortem examination. You haven't the slightest idea of how DDC registers and tracks infectious diseases. Do you even understand what you are writing? You are basically saying that the DDC is violating its own protocols and the WHO requirements by reporting unqualified CODs. If anything, the CODs are under reported because post mortems compliance is not going to be good in areas where there are no facilities to do the tests. Are you even aware of how the samples are gathered and where they are sent for analysis? No, but you provide a definitive opinion as to how the DDC compiles, verifies and reports its data to the WHO.

Brilliant. Absolutely, brilliant.

[thatluckyboy]

I had my first taste of Dengue Fever a couple of weeks back. In a few hours I went from boxing at the gym to the moaning in my bed. That's where I stayed for the best part of a week. Horrible. I can't help but suspect Chiang Mai Songkran might have had something to do with it.

Edited May 13, 2013 by onthedarkside
link removed

[cobra1]

i had dengue fever here in thailand approx 4 years ago,my wifes mother khmer made me up herbal medicine from crushed papaya

leaves this made me feel a whole lot better after 2 days was ok, still the symptoms come and go very similar to malaria but there is no known cure .it's like having the worse case of flu you ever, headaches ,cramps,fever, the shits every part of you aches so hope you guys/girls out here in thailand dont get it