Dengue Outbreak

[Sheryl]

Posts with quackery and posts responding to same have been deleted.

Denby,

If you tested negative for dengue antibodies then Chikungunya is a very possible diagnosis. The lci nical management is identical in any case is is the clinical presentation. Although there has been at least one documented Chikungunya outbreak in Thailand in recent years, Thai doctors are much less familiar with it than with dengue which has been endemic here for many decades at least and which virtually every doctor will have had experience with.

From what you describe it sounds to me like you are in good hands.

[richardjm65]

I feel I must respond to Wilcopop's assertion that a possible cure for dengue, (the use of papaya leaf juice), might be dangerous. How so? My understanding is that there is no part of the papaya tree that is toxic. Indeed, it has many medicinal properties for several conditions.

I do understand that the curative effects of papaya leaf juice is anecdotal - however, these anecdotes not only originate from Thailand alone, but from Indonesia, the Philippines, Nigeria, and several South American countries where Dengue is also endemic. There must be more. Given that we generally understand that there is not yet a clinical cure for dengue but mostly only medicines to relieve the symptoms to some degree, it would seem reasonable to at least consider that folk medicine might offer a possibility of a cure, even if taken as an addition to the symptom relief medicines.

I'm reminded that many of our modern medicines are derived from plants and I do remain convinced that a cure exists for every condition - we just have to find it, which is what research laboratories are for. I think that if either my wife or I were to be diagnosed with dengue, I should certainly try the papaya leaf juice treatment in the hope of establishing, to my own satisfaction, its efficacy, (or otherwise). Could it further harm us? I think not.

I don't believe this to be 'quackery', but rather more curiosity about the potential of alternatives.

[Chicog]

FYI Chikungunya is steadily creeping north...

[denby45]

Posts with quackery and posts responding to same have been deleted.

Denby,

If you tested negative for dengue antibodies then Chikungunya is a very possible diagnosis. The lci nical management is identical in any case is is the clinical presentation. Although there has been at least one documented Chikungunya outbreak in Thailand in recent years, Thai doctors are much less familiar with it than with dengue which has been endemic here for many decades at least and which virtually every doctor will have had experience with.

From what you describe it sounds to me like you are in good hands.

Thanks Sheryl I also believe I will be ok without further treatment. I did mention the Indian connection on purpose. Although there probably have not been many outbreaks in Thailand, there have been many outbreaks of Chikungunya in various parts of India in the past. I am guessing (pure speculation) there may be many carriers from over there. If you visit Pattaya you will see how many Indians are actually visiting there these days it can only be a matter of time before there are many more outbreaks. This disease is no fun at all, If you get it you just want to die.

Den

[denby45]

FYI Chikungunya is steadily creeping north...

I think there should be one dot right about where Pattaya is on the map.

OH I just noticed it's a bit out of date. Check out the link

http://www.cdc.gov/chikungunya/map/index.html

Den

Edited July 14, 2013 by denby45

[jrtmedic]

There has been a lot of nonsense and misinformation posted on this topic

For those who wish to inform themselves about Dengue -----go to this link

http://whqlibdoc.who.int/publications/2009/9789241547871_eng.pdf

[wilcopops]

as the frog said to the chicken - read-it! read-it!

[Sheryl]

I feel I must respond to Wilcopop's assertion that a possible cure for dengue, (the use of papaya leaf juice), might be dangerous. How so? My understanding is that there is no part of the papaya tree that is toxic. Indeed, it has many medicinal properties for several conditions.

I do understand that the curative effects of papaya leaf juice is anecdotal - however, these anecdotes not only originate from Thailand alone, but from Indonesia, the Philippines, Nigeria, and several South American countries where Dengue is also endemic. There must be more. Given that we generally understand that there is not yet a clinical cure for dengue but mostly only medicines to relieve the symptoms to some degree, it would seem reasonable to at least consider that folk medicine might offer a possibility of a cure, even if taken as an addition to the symptom relief medicines.

I'm reminded that many of our modern medicines are derived from plants and I do remain convinced that a cure exists for every condition - we just have to find it, which is what research laboratories are for. I think that if either my wife or I were to be diagnosed with dengue, I should certainly try the papaya leaf juice treatment in the hope of establishing, to my own satisfaction, its efficacy, (or otherwise). Could it further harm us? I think not.

I don't believe this to be 'quackery', but rather more curiosity about the potential of alternatives.

I believe Wilcopop was responding to a poster's presentation of it as a "proven cure" and the possibility that this might lead people to delay seeking medical care. (Both posts have since been deleted, as claiming papaya leaf to be a proven cure is indeed factually incorrect).

There has been exactly one published report in a scientific journal regarding use of papaya leaf extract in dengue and it described the case of only one patient and concluded that more research was needed. The hypothesized mechanism of action pertains to blood clotting and thus, if true, would be of utility only in reducing hemorrhagic effects, it would not be of use in the more common simple form of dengue nor would it "cure" the infection. Best case scenario (and as yet unproven) is that it might mitigate or reverse drops in the platlet count in people with hemorrhagic complications. The dengue infection itself would still have to run its (comparatively short) course.

[Sheryl]

Multiple off topic posts have been removed. Please stay focused on the dengue outbreak and do not veer off into debates about "alternative" vs. "mainstream" medicine.

One of the Health Forum specific rules is to avoid aggressively advocated for or against on that score, and the rule is based on experience: it doesn't lead anywhere productive.

[bentarm44]

Wot u said Sheryl, I've got mega horror story about my chemo treatment here for cancer; which is quiet definitely another story.

However, regarding the mosquito situation; I can say this.

Two or three times a year a couple of local women go round the village I live in, checking people are covering water jars etc outside.

I live in rural Korat, near Phimai, where there are THOUSANDS OF RAI OF RICE PADDY.

Head scratching, or head banging, time for me; 'cas it's a WASTE OF TIME bothering with domestic still water, isn't it????

[wilcopops]

Wot u said Sheryl, I've got mega horror story about my chemo treatment here for cancer; which is quiet definitely another story.

However, regarding the mosquito situation; I can say this.

Two or three times a year a couple of local women go round the village I live in, checking people are covering water jars etc outside.

I live in rural Korat, near Phimai, where there are THOUSANDS OF RAI OF RICE PADDY.

Head scratching, or head banging, time for me; 'cas it's a WASTE OF TIME bothering with domestic still water, isn't it????

possibly not. The Aedes mosquito only flies a few hundred meters during its lifespan. the female only feeds once or twice a day and lives for a few days. it has to bite an infected person and then carry that infection to another person. So people need to be close to the breeding pot and close to each other.

(I'm also not sure how good a paddy field is for breeding Aedes either as the water is disturbed a lot and has mozzie predators i it.)

Anyhoo, if you can reduce the amount of water where these animals can breed in very close proximity to humans, then you are reducing - if not eliminating - the chances of contracting the fever. you are also continually keeping people aware of the presence of Dengue.

[bentarm44]

fair enuf, if u say so.

I have paddy bordering 2 sides of the land my house is on.

I actually experience more nuisance from the flies (and smell) that come from the small pig farm operation over the road.

I have proper windows, and screens, so my response is simple.

The filthy pig farm is owned by the "doctor" who "works" in the village "health centre".

How we laugh.

[Sheryl]

As wilcopops said, the mosquito vector has an extremely small flight span. Most infections are acquired a very, very short distance from the breeding place. Water jars are a prime source.

[DCLinBKK]

I don't think I saw this posted, but its a recent article posted in the Asian Pacific Journal of Tropical Disease, entitled "Repellent activity of herbal essential oils against aedes aegypti and Culex quinquefasciatus"... I think those are the 2 mosquito female types largely responsible for transmitting diseases like Dengue Fever.

Anyways, I bring this article to everyone's attention because I was trying to find a solution for my 2 kids. They both were getting eaten alive at school, parks... etc. apparently big breeding grounds according to all the reports I read. I read the attached article and my wife and I found a new repellent on the market which seems to work and is safe for kids. My kids get bitten much less often. Check it out, its called KIRI's mosquito patch... www.facebook.com/KIRIThailand. My wife got them because they are DEET-free, citronella based, and all natural. I even use it now when jogging and working out in the park... and my wife laughs when I use them watching tv along with my mosquito zapper in hand. The little pests are like ninjas. Anyways, protect the little ones... for those adults that have gotten dengue fever, you know what I am talking about.

Article: http://www.apjtcm.com/zz/20134/4.pdf

[jrtmedic]

DCLinBKK

Thank you

Good to see research undertaken in Thailand being published, in English via a peer reviewed journal.

[francescoassisi]

I don't think I saw this posted, but its a recent article posted in the Asian Pacific Journal of Tropical Disease, entitled "Repellent activity of herbal essential oils against aedes aegypti and Culex quinquefasciatus"... I think those are the 2 mosquito female types largely responsible for transmitting diseases like Dengue Fever.

Anyways, I bring this article to everyone's attention because I was trying to find a solution for my 2 kids. They both were getting eaten alive at school, parks... etc. apparently big breeding grounds according to all the reports I read. I read the attached article and my wife and I found a new repellent on the market which seems to work and is safe for kids. My kids get bitten much less often. Check it out, its called KIRI's mosquito patch... www.facebook.com/KIRIThailand. My wife got them because they are DEET-free, citronella based, and all natural. I even use it now when jogging and working out in the park... and my wife laughs when I use them watching tv along with my mosquito zapper in hand. The little pests are like ninjas. Anyways, protect the little ones... for those adults that have gotten dengue fever, you know what I am talking about.

Article: http://www.apjtcm.com/zz/20134/4.pdf

[francescoassisi]

I don't think I saw this posted, but its a recent article posted in the Asian Pacific Journal of Tropical Disease, entitled "Repellent activity of herbal essential oils against aedes aegypti and Culex quinquefasciatus"... I think those are the 2 mosquito female types largely responsible for transmitting diseases like Dengue Fever.

Anyways, I bring this article to everyone's attention because I was trying to find a solution for my 2 kids. They both were getting eaten alive at school, parks... etc. apparently big breeding grounds according to all the reports I read. I read the attached article and my wife and I found a new repellent on the market which seems to work and is safe for kids. My kids get bitten much less often. Check it out, its called KIRI's mosquito patch... www.facebook.com/KIRIThailand. My wife got them because they are DEET-free, citronella based, and all natural. I even use it now when jogging and working out in the park... and my wife laughs when I use them watching tv along with my mosquito zapper in hand. The little pests are like ninjas. Anyways, protect the little ones... for those adults that have gotten dengue fever, you know what I am talking about.

Article: http://www.apjtcm.com/zz/20134/4.pdf

This post appears to be spam

It has appeared on several sites and is promoting a single brand of mozzie repellent.

The report alluded to doesn't mention the product and appears to restate what is already known - it doesn't offer any new info and the peer review is of minimal value.

It would seem that they are trying to promote the product by association with this report.

Be aware that so called "natural" repellents last nowhere near as long as DEET.

Edited July 25, 2013 by francescoassisi

[wpcoe]

This would be a nice breakthrough if it really works as expected: The Kite Patch makes you invisible to mosquitoes for up to 48 hours

[AnotherOneAmerican]

Was visiting NakornPing government Hospital (near ChiangMai) last week.

Children's ward completely full to overflowing with some on collapsible beds at the end of the ward.

Must have been nearly 50 kids in the ward most with suspected Dengue Fever (kai luat awk).

Most on saline/dextrose drips and given paracetamol as medication, parents wiping them down with damp cloths to keep them cooler.

Totally unbelievable.

Edited July 25, 2013 by AnotherOneAmerican

[Sheryl]

The number of new cases has declined significantly in the past 2 weeks so it seems the peak of the epidemic may have finally passed in most locations (but not, as yet, CM/CR)

http://www.boe.moph.go.th/ (click on dengue to pull up map and graph)

[wilcopops]

I'm hesitant to use a figure of speech or idiom on this site as they seem to be misunderstood..... but "Don't count your chickens" comes to mind - we have a lot of wet to get through still and I don't see any dramatic action by the government, at least on a national scale - so whilst some regions may be in recession, it is known that dengue will travel outwards from a source in waves like ripples on a pond.........

[sudyod]

Gotta love all the talk about "war rooms" and "dengue corners" put out by the Ministry of Health

My experience with this disease. After having every symptom possible for dengue I went to the private hospital in Loei. I was tested at day four and results were negative. But a simple google search shows the test is basically useless until day five and later. So on day six I went back to be tested. The doctor said basically "why you want to be tested. You were tested and were negative". I said just test me for dengue...dont sell me drugs or anything else, just test me for dengue.

Results came back positive.

I write this because many people are tested before their immune system has mounted an adequate response to be verified by the test. Without knowing they are infected, dengue positive people are now infecting family and friends who reside in close proximity. The mosquito, once infected, remains infected for up to two months. Within this period, anybody can be infected by a bite from this mosquito.

The doctor had no response (of course) when I mentioned the ELISA test is not accurate during the initial onset of disease (day 1-4). And, unfortunately, the risk of infecting others is greatest between days 1-4.

There is a fairly rapid, DNA based test that can accurately test for dengue within the first day of infection. But would this test be part of the "war room" the Thai Ministry of Health has set up?

Edit: Also the private hospital here in Loei decided it would serve the needs of the community better by increasing the dengue test 50% from 700 baht to 1000 baht.

Edited July 30, 2013 by sudyod

[jrtmedic]

"And, unfortunately, the risk of infecting others is greatest between days 1-4"

Dengue is not a transmittable (infectious) disease which is spread form person to person.

http://www.hpb.gov.sg/HOPPortal/dandc-article/492

[sudyod]

Uh, yea. I think we can assume the vector is involved.

[wilcopops]

Gotta love all the talk about "war rooms" and "dengue corners" put out by the Ministry of Health

My experience with this disease. After having every symptom possible for dengue I went to the private hospital in Loei. I was tested at day four and results were negative. But a simple google search shows the test is basically useless until day five and later. So on day six I went back to be tested. The doctor said basically "why you want to be tested. You were tested and were negative". I said just test me for dengue...dont sell me drugs or anything else, just test me for dengue.

Results came back positive.

I write this because many people are tested before their immune system has mounted an adequate response to be verified by the test. Without knowing they are infected, dengue positive people are now infecting family and friends who reside in close proximity. The mosquito, once infected, remains infected for up to two months. Within this period, anybody can be infected by a bite from this mosquito.

The doctor had no response (of course) when I mentioned the ELISA test is not accurate during the initial onset of disease (day 1-4). And, unfortunately, the risk of infecting others is greatest between days 1-4.

There is a fairly rapid, DNA based test that can accurately test for dengue within the first day of infection. But would this test be part of the "war room" the Thai Ministry of Health has set up?

Edit: Also the private hospital here in Loei decided it would serve the needs of the community better by increasing the dengue test 50% from 700 baht to 1000 baht.

Firstly I think you illustrate well the sort of incompetence that surrounds Dengue diagnosis here in Thailand - even though some will claim Thai doctors have a "vast wealth of experience" with Dengue....yet they still make elementary mistakes like that.

Secondly - trasmission - yes people close together help the mosquito to transmit the disease, but they can't directly infect friends or family - which could be inferred from your post -

Furthermore as I understand it, the person must be viremial for the disease to be passed ito a mozzie - this can be symptomless in the carrier for up to 5 days - so it is unlikely that it would be picked up by testing for a week or two, leaving that person free to cary the disease around for some time without realising it.

I also am reliably informed that once infected the mosquito will carry the disease within itself until it dies - normal life span seems to be 3 or 4 weeks

[jrtmedic]

I have posted this previously -----however , here it is again

All anyone could wish to know about Dengue

http://whqlibdoc.who.int/publications/2009/9789241547871_eng.pdf

[dogpoo]

Getting to know about it first Hand, Daughter has it, now I am feeling the same but worse!!

[Chicog]

As wilcopops said, the mosquito vector has an extremely small flight span. Most infections are acquired a very, very short distance from the breeding place. Water jars are a prime source.

As I understand, the mossie involved also does not like laying eggs in dirty water or water that has other mossies in it, it likes it clean and fresh.

Which is the paddy fields aren't the issue but chronic rain is.

[dogpoo]

If I have Dengue what medicine do I need, I'm worried they will give me loads of I necessary pills!

[jrtmedic]

Just paracetamol