Sharp Rise In Haemorrhagic Dengue Fever

[Lite Beer]

Sharp rise in haemorrhage dengue fever
Pongphon Sarnsamak
The Nation on Sunday

BANGKOK: -- The drastic rise in haemorrhage dengue fever cases has prompted the Public Health Ministry to launch a massive nationwide campaign to cope with the situation.

There have been 44 deaths among the 39,029 patients in the past five months.

More than 23,000 schools nationwide have been instructed to eliminate mosquito-breeding sources such as water containers.

Revealing that about 50 per cent of the patients were children under-15, the Public Health Minister's permanent secretary, Dr Narong Sahamethaphat, expressed his concern over the rising number of people suffering from dengue fever and said the situation was very critical.

Only the past week, some 4,000 people had been affected, double the number in the previous two weeks.

The haemorrhage dengue fever has affected people of all age groups.

The ministry estimates that 26 provinces are affected. Songkhla province has the highest number of deaths at seven, followed by Nakhon Si Thammarat, Surin, and Loei with three deaths in each province.

To reduce fatality from dengue fever, the ministry will launch a nationwide campaign, urging the public to eliminate mosquito-breeding places in communities. "We have to beef up our measures to get rid of mosquito-breeding places within 90 days," Narong said.

Narong said strong cooperation from local authorities was needed to handle this critical situation. He also instructed medical workers at the ministry's hospitals to stand by around the clock to provide timely treatments for haemorrhage dengue fever patients.

"People shouldn't buy medicines like painkiller, inbuprofen, aspirin and steroid to relieve haemorrhage dengue fever symptoms on their own, as they could develop into a more severe condition," Narong warned, adding the infected people should undergo treatments as soon as possible.

Meanwhile, the ministry's deputy permanent secretary Dr Sophon Methon, who oversees the dengue fever war room, said he had sent an official letter asking the Education Ministry to instruct 23,000 schools across the country to eliminate mosquito-breeding sources at least once a week.

-- The Nation 2013-06-09

[assayer]

More than 23,000 schools nationwide have been instructed to eliminate mosquito-breeding sources such as water containers.

The most prevalent water container in LOS is the rice paddy! What does the DOH propose for that?

[A Member]

The Permanent Secy. is still telling infected people to see a doctor as early as possible despite the fact that it has been proven dengue is very hard to diagnose.

How many folks will arrive at clinics saying they think they have dengue and get tossed out on their ears with some half arsed diagnosis by a doctor who is aggrieved that a patient thinks he knows more than him ?

[soihok]

My 10 year old contracted Dengue last year, unfortunately she is mentally disabled and can't communicate, the tell tale sign was when she came out in a rash all over her body.

Spent a few days in hospital in Korat.

Not nice, hospital was spot on though (Bangkok Hospital).

Edited June 9, 2013 by soihok

[noitom]

This is a global scale crisis in Thailand. This dengue fever and zika and what ever else.

[Scott]

A lot of schools use the containers next to the toilet and water is left in them. I would assume that the constant use during the week would make them ineffective as a breeding grounds, but left full on weekends and holidays, it might be different.

I also note the bathrooms have a lot of mosquitoes in them anyway.

[Thai at Heart]

A lot of schools use the containers next to the toilet and water is left in them. I would assume that the constant use during the week would make them ineffective as a breeding grounds, but left full on weekends and holidays, it might be different.

I also note the bathrooms have a lot of mosquitoes in them anyway.

Do what you like in your own property. These little buggars fly 500m.

It needs a city wide integrated effort to also clear brush land. Not very easy if you live in the countryside, but in Bangkok, there is always a vacant lot of land filled with crap 500 metres away.

And then of course, the drains beneath your feet. Full of mozzies.

[timber]

Hard to get aspirin in Thailand. Thai's seem to feel aspirin is dangerous

[GentlemanJim]

More than 23,000 schools nationwide have been instructed to eliminate mosquito-breeding sources such as water containers.

The most prevalent water container in LOS is the rice paddy! What does the DOH propose for that?

No worries about that one, the Ministry of Commerce is destroying all that as we speak.

Kenya was bread basket to Africa

Thailand was bead basket to the world

260 Billion would have gone a long way to eradicating all mosquito diseases world wide, what a fine way to spend money!!

Edited June 9, 2013 by GentlemanJim

[davejones]

Hard to get aspirin in Thailand. Thai's seem to feel aspirin is dangerous

It is.

[tigermonkey]

Hard to get aspirin in Thailand. Thai's seem to feel aspirin is dangerous

It is.

Instead of fear mongering, why don't you tell us why in your informed opinion, you believe that aspirin is dangerous.

...or do you mean that uninformed and/or indiscriminate use of any medication can be dangerous ? Any medication has both benefit and risk - knowledge of both allows the appropriate decisions to be made.

[Phronesis]

Hard to get aspirin in Thailand. Thai's seem to feel aspirin is dangerous

Ridiculous statement.

I have a tub of 1000 x 325mg tablets sitting right here next to my key board.

I bought them at supercheap and they are manufactured locally.

[GentlemanJim]

Hard to get aspirin in Thailand. Thai's seem to feel aspirin is dangerous

Ridiculous statement.

I have a tub of 1000 x 325mg tablets sitting right here next to my key board.

I bought them at supercheap and they are manufactured locally.

Not quite as ridiculous as having 1000 asprin next to your keyboard though, I prefer a bag of almonds So because it was easy for you to get loacally manufactured (yuk!) asprin, it is therefore by default easy for everyone else to get. Maybe the national shortage is caused by people in the locality of the manufacturing plant buying buckets of a 1000 at a time

[tigermonkey]

While I laud the attempts to reduce the areas where mosquitoes breed, I am very discouraged that the Public Health Ministry's lack of any campaign to inform/ encourage any personal protection against mosquito bites. There is never any mention of wearing arm and leg coverings and using a Deet based repellant, during daylight hours, especially in high risk areas such as Songkhla. Free repellant distribution would not be overkill in high risk areas at this point.

I am also very suspect of the data being presented. They say that 39,029 cases are confirmed ( with 44 deaths), but I am sure that these numbers are far from accurate. Knowing that the data is derived from cursory symptom diagnosis ( fever, headache, sore joints, morbilliform rash - OK - it's Dengue), I am sure that the cases could be a mixture of many mosquito borne virus infections, such as Dengue, Zika, Chikunggunya, etc. I see nowhere any information as to whether these infections are DENV!, DENV2, DENV3, DENV$4, ZIKV, CHIKV or other. This is critical information.

The death statistics are also incomplete. How many of the deaths were due to haemorrhagic fever and how many were from dengue shock syndrome ? Were thay mostly young people ? How many of them had a previous dengue infection, which greatly increases chances of death ? A previous DENV1 infection makes a patient much more vulnerable to severe problems from a new DENV2 or DENV3 infection.

In the meantime, we need to lather on the Deet !

[Always18]

Hard to get aspirin in Thailand. Thai's seem to feel aspirin is dangerous

Ridiculous statement.

I have a tub of 1000 x 325mg tablets sitting right here next to my key board.

I bought them at supercheap and they are manufactured locally.

Unfortunately both statements are true - the 325mg tabs are very easily obtained over the counter but just try buying the tiny 82mg tabs and you are told to get a letter from your doctor - crazy Thailand!

[BradinAsia]

More than 23,000 schools nationwide have been instructed to eliminate mosquito-breeding sources such as water containers.

The most prevalent water container in LOS is the rice paddy! What does the DOH propose for that?

From what I understand about the mosquitos which transmit dengue, they breed in stagnant

(non flowing) water. Since the water in rice paddies flows, mosquito larvae are found in various

containers in rice paddies, but not in the rice paddy water.

http://209.61.208.233/LinkFiles/Dengue_Bulletins_c26.pdf

[drdoom6996]

Hard to get aspirin in Thailand. Thai's seem to feel aspirin is dangerous

Aspirin is the miracle drug of the last hundred years. It is natural and is used for many purposes, not just a pain killer.

[steinghan]

Discussions about the availalabilty of aspirin in a topic about denque hemorrhagic fever better come with a warning. Quote from http://wikitravel.org/en/Dengue_fever

Medicines such as aspirin and ibuprofen, commonly sold as headache remedies, increase the risk of dengue hemorrhagic fever".

[tigermonkey]

Hard to get aspirin in Thailand. Thai's seem to feel aspirin is dangerous

Ridiculous statement.

I have a tub of 1000 x 325mg tablets sitting right here next to my key board.

I bought them at supercheap and they are manufactured locally.

Unfortunately both statements are true - the 325mg tabs are very easily obtained over the counter but just try buying the tiny 82mg tabs and you are told to get a letter from your doctor - crazy Thailand!

Not so crazy - the 325 mg ASA is an uncoated tablet designed for analgesic and anti-inflammatory use. If you have pain or inflammation, you can take one or two. Why anyone woukd buy 1000 is quite beyond me.

The 81 mg tablet is an enteric coated tablet designed for long-term therapy. This therapy should not be undertaken without a doctor's assessment of the risk/benefit ratio for the individual patient.

[BradinAsia]

While I laud the attempts to reduce the areas where mosquitoes breed, I am very discouraged that the Public Health Ministry's lack of any campaign to inform/ encourage any personal protection against mosquito bites. There is never any mention of wearing arm and leg coverings and using a Deet based repellant, during daylight hours, especially in high risk areas such as Songkhla. Free repellant distribution would not be overkill in high risk areas at this point.

I am also very suspect of the data being presented. They say that 39,029 cases are confirmed ( with 44 deaths), but I am sure that these numbers are far from accurate. Knowing that the data is derived from cursory symptom diagnosis ( fever, headache, sore joints, morbilliform rash - OK - it's Dengue), I am sure that the cases could be a mixture of many mosquito borne virus infections, such as Dengue, Zika, Chikunggunya, etc. I see nowhere any information as to whether these infections are DENV!, DENV2, DENV3, DENV$4, ZIKV, CHIKV or other. This is critical information.

The death statistics are also incomplete. How many of the deaths were due to haemorrhagic fever and how many were from dengue shock syndrome ? Were thay mostly young people ? How many of them had a previous dengue infection, which greatly increases chances of death ? A previous DENV1 infection makes a patient much more vulnerable to severe problems from a new DENV2 or DENV3 infection.

In the meantime, we need to lather on the Deet !

TM, very good post.

The questions you ask are the crucial questions, but are not even mentioned in the Nation article.

[JetsetBkk]

A friend of mine was suffering from dengue last Sunday. He was still alive this Sunday but had horrible stories to tell about blood coming from his gums and nearly having to have a blood transfusion. Not really what I wanted to hear but great the he is now feeling a bit better after 10 days. He is older than me but was always pretty active. This week he is still hobbling around like a man 20 years older.

[pjuk]

Hard to get aspirin in Thailand. Thai's seem to feel aspirin is dangerous

Aspirin is the miracle drug of the last hundred years. It is natural and is used for many purposes, not just a pain killer.

Aspirin can increase bleeding by preventing blood from clotting and as Dengue is a illness that can cause haemorrhage anything that thins the blood is not good.

If you suspect you have Dengue DO NOT take Aspirin

[Scott]

I think we can stop the discussion on the availability of aspirin in Thailand. A couple of other posters have also posted a caution.

Aspirin prevents blood from clotting and in a haemorrhagic fever is extremely dangerous. Here's a quote from the OP:

"People shouldn't buy medicines like painkiller, inbuprofen, aspirin and steroid to relieve haemorrhage dengue fever.."

[rdcny1]

All of this begs the question - what is the treatment for Dengue? Is the treatment the same for the different strains of the disease?

I know not to take aspirin - but short of going to the Doctor/Hospital, what should one do if one has Dengue (or perhaps stated a bit more clearly, are there any medicines that Doctors prescribe for the disease?)

[Scott]

I believe that there is no specific treatment for Dengue fever. I had it many years ago and just suffered through it. Quite unpleasant, but fortunately, I was mostly sort of unconscious most of the time I was sick. I really don't recall about 3 days and then after that it was sort of like having the flu. It hung on for a long time and I was quite unwell for a couple of weeks.

An altogether unpleasant experience.

[bri1guy]

All of this begs the question - what is the treatment for Dengue? Is the treatment the same for the different strains of the disease?

I know not to take aspirin - but short of going to the Doctor/Hospital, what should one do if one has Dengue (or perhaps stated a bit more clearly, are there any medicines that Doctors prescribe for the disease?)

There is no specific treatment for dengue fever. You will need fluids if there are signs of dehydration. Acetaminophen (Tylenol) is used to treat a high fever.

#1 is to see a DR or go to the Hospital as soon as you think you may be infected!!!

[taffbkk]

All of this begs the question - what is the treatment for Dengue? Is the treatment the same for the different strains of the disease?

I know not to take aspirin - but short of going to the Doctor/Hospital, what should one do if one has Dengue (or perhaps stated a bit more clearly, are there any medicines that Doctors prescribe for the disease?)

For the treatment being same for different stains definitely not, I had Dengue "A" at the same time as my son about 5yrs ago and it was just like a bad flu, had a rash and basicly just took paracetamol till it cleared. I got DHF the hemorrhagic strain about 18months later, apparently its easier if you've had the milder form previously. At first I just did the usual thing of putting it off as a bad flu, after three days I couldnt even keep water down and black fluid was coming out of both ends. I went (got taken) to the local hospital who quickly did the diagnosis and my liver was swollen badly, after a couple of drips and a few days rest in the hospital everything was fine, and the good news is if you've had "A" and "B" C is still rare here.

[Pesche]

Hard to get aspirin in Thailand. Thai's seem to feel aspirin is dangerous

It is.

Aspirin is used nowadays as "Blood thinner" for patients suffering a stroke or heart attack !!

(In your blood there are 'sticky' cells called platelets. When you cut

yourself, the platelets stick to each other (clot) to seal the wound.

Sometimes platelets stick to each other inside a blood vessel - this is

called a thrombus. A thrombus can block a blood vessel, and this is

often the cause of a stroke or heart attack. This is more likely to

happen if you have thickening of your arteries, which can occur if you

have cardiovascular (heart and blood vessel) disease.)

It is therefor in NO WAY a medicine to take in case of hemorrhagic Dengue Fever !!

I survived the 3rd Dengue Fever attack (since 21 years here) and all I can say is:

Paracetamol in NORMAL doses + drink as much as you can!!

Take Isotonic drinks to prevent dehydration!

Dehydration is extreme during Dengue Fever.

[Thai at Heart]

All of this begs the question - what is the treatment for Dengue? Is the treatment the same for the different strains of the disease?

I know not to take aspirin - but short of going to the Doctor/Hospital, what should one do if one has Dengue (or perhaps stated a bit more clearly, are there any medicines that Doctors prescribe for the disease?)

There is no specific treatment for dengue fever. You will need fluids if there are signs of dehydration. Acetaminophen (Tylenol) is used to treat a high fever.

#1 is to see a DR or go to the Hospital as soon as you think you may be infected!!!

Should someone be quarantined since that means you can infect mosquito's which can pass it on?

I.e. if someone in your family or your neighbours get it, be very wary of fresh bites?

[NanLaew]

... despite the fact that it has been proven dengue is very hard to diagnose.

You are making that up. The symptoms are pretty much standard across the board in that most people get the tell-tale rash and most people have the debilitating 'break bone' pain. I was provisionally diagnosed when I presented my sick arse to the Bangkok Pattaya Hospital after 3 days of misery. When I came back for the follow-up visit 3-days later (to check the blood platelet count and determine exactly how my body was coping with it) they confirmed the type (from the blood taken earlier) and assessed that I was low-risk and let the self-healing begin.

The one aspect that didn't seem to be stressed enough IMHO, was the fact that for a given period, I was considered infectious in that I could transmit the fever via mossie bites, to people near me. They mentioned a sort of quarantine should be considered which was easy for me as I was working in Bangkok and just canceled a couple of weekends when I would normally have flown home to see the family.