Dengue fever

[watgate]

What are the chances of getting dengue fever while primarily staying in Chiang Mai? I imagine the majority of long-stay expats are generally safely ensconsced in their homes in the evenings and much less susceptible to being bitten by the mozzies. What about individuals who like to roam around chiang mai during the evening and are occasionally being bit by the mozzies. Would this significantly increase the chances of coming down with dengue fever? Would continuous useage of mosquito repellant, especially at night, be recommended or is the danger of contracting dengue fever much less prevalent in chiang mai. I know individuals have come down with dengue fever in chiang mai and I am wondering if they were bit in chiang mai or in other parts of Thailand? Lastly, what times of the year are the most dangerous for potentially getting dengue fever?

[cloudhopper]

Hi AFAIK the mosquitos that vector dengue are most active in the middle of the day and in the rainy season, and in more densely populated areas. If I go into town in the rainy season I use repellant. Haven't heard any news of recent outbreaks.

[ClutchClark]

Hi AFAIK the mosquitos that vector dengue are most active in the middle of the day and in the rainy season, and in more densely populated areas. If I go into town in the rainy season I use repellant. Haven't heard any news of recent outbreaks.

Actually they are active a couple hours after sunrise and before sunset.

Not so much midday.

But valid point.

[naboo]

This year has been OK, last year there were a lot of cases in the Chiang Mai area. July to September is the most dangerous time.

I don't get bitten much and rarely use repellant. Walking around you'll rarely get bitten. When sat down make sure there's a fan on you (and your ankles especially).

[Goshawk]

Haven't heard any news of recent outbreaks.

a young girl (13yrs) from Mrs G's village was unbelievably misdiagnosed with something else! by a quack at Hang Dong Hospital a couple of weeks ago. She was sent home, then her sickness got steadily worse. She passed away at Suan Dok a few days ago with multiple organ failure . . . cause - Dengue.

[chiang mai]

It's less of a problem in cities where traffic pollution keeps the number of mozzies lower, still a risk however. Feeding time, early morning early evening are the riskier times.

[Seligne2]

I live in CM and was diagnosed with dengue at CM Ram Hospital, but it was after a trip I took to Doi In, Mae Sariang, Pai, Mae Hong Son, and points north. This was ~April 2013. I know a great many people in CM and have never heard of anyone who lives here and stays here contracting it. Maybe the most important measure you can take is wearing long sleeves and trousers at and after dusk. BTW, for me dengue was akin to having the flu for a week, not worse.

[freedomnow]

I got it 2.5 months ago ended up in Sripat Hospital....I was mis-diagosed at Maharaj 2 days earlier.....those ER 'docs" are the worst...moronic students doing some work experience.....dire service in that hospital.

Lucky I had medical insurance...it racks up fast in the "developing world"

Time slows down and you go a bit mad at the peak of the infection depending on severity.

My g/f had to go and get a visa extension on my behalf..god bless her, she is a lifesaver. Went and queued from 7am.

It is a daytime female tiger striped mosquito. If you get bit by the other 4 strains it can be fatal next time, you don't build an immunity to the other strains.

There is a vaccine coming next 2 years. It is a rapidly increasing problem globally.

Edited October 2, 2014 by freedomnow

[masuk]

Dengue mozzies sleep at night, active by day, and as noted, also dawn and dusk.. However, there are plenty of others ready from fresh farang blood, and I spray from knees down before venturing out in the evenings. I believe the range of a breeding dengue mozzie is around 150 metres, so if folk around you have it, check out why and where.

The common name in many countries is 'break bone fever'. Aptly named I'm told.

Local people here are not proactive about dengue breeding sites, and there's always water in bowls, old tyres, pot plants.

The bright side is there does not appear to be much malaria around here. It's not nice to have!

[ClutchClark]

Dengue mozzies sleep at night, active by day, and as noted, also dawn and dusk.. However, there are plenty of others ready from fresh farang blood, and I spray from knees down before venturing out in the evenings. I believe the range of a breeding dengue mozzie is around 150 metres, so if folk around you have it, check out why and where.

The common name in many countries is 'break bone fever'. Aptly named I'm told.

Local people here are not proactive about dengue breeding sites, and there's always water in bowls, old tyres, pot plants.

The bright side is there does not appear to be much malaria around here. It's not nice to have!

Yes, aptly named.

Caught it twice.

Second time is a real <delete>.

Edited October 2, 2014 by ClutchClark

[SoloFlyer]

Had it twice also. I thought that if you had one strain once, thats it. And just 4 strains. Not so?

[searcher22]

I seem to get bitten more when I'm indoors than when I am outdoors. Venues such as lobbies, cinemas, and shopping mall restaurants have mosquitoes lurking under tables and chairs. There's often one in my car too. Since I don't normally wear protective clothing and put on mosquito repellent when I am in these places, it makes me more vulnerable to an "attack."

[chiang mai]

Had it twice also. I thought that if you had one strain once, thats it. And just 4 strains. Not so?

I believe you get immunity from the strain you caught but only for a matter of months.

[beau thai]

I have had it but I think the chances are quite low and you can lower them by covering up as other posters have suggested and by spraying.

I play golf on courses with plenty of water so more risk than many-although I think I caught it at a coffee place by the Ping River, but cant be sure obviously.

My experience was like a bad dose of the flu combined with seasickness and it lasted about 2-3 weeks and left me weak for another few weeks.

I too thought there were 5 strains but if managed effectively (rest,liquids, take something to reduce fever), I believe only one is a real killer and that's haemeophilic I think.

Check out the WHO website on dengue for more...

[naboo]

Re. strains

There are four strains, and this explains why the first infection is usually not as bad as the subsequent infections:

The Dengue virus has been shown to have 4 subtypes. These 4 subtypes are different strains of dengue virus that have 60-80% homology between each other. The major difference for humans lies in subtle differences in the surface proteins of the different dengue subtypes. After a person is infected with dengue, they develop an immune response to that dengue subtype. The immune response produced specific antibodies to that subtype's surface proteins that prevents the virus from binding to macrophage cells (the target cell that dengue viruses infect) and gaining entry. However, if another subtype of dengue virus infects the individual, the virus will activate the immune system to attack it as if it was the first subtype. The immune system is tricked because the 4 subtypes have very similar surface antigens. The antibodies bind to the surface proteins but do not inactivate the virus. The immune response attracts numerous macrophages, which the virus proceeds to infect because it has not been inactivated. This situation is referred to as Antibody-Dependent Enhancement (ADE) of a viral infection. This makes the viral infection much more acute. The body releases cytokines that cause the endothelial tissue to become permeable which results in hemorrhagic fever and fluid loss from the blood vessels.

Ref: http://web.stanford.edu/group/virus/flavi/2000/dengue.htm

[Chicog]

One would hope the Thai medical authorities would be watching this closely, but my spidey senses tell me that they have probably never even heard about it, and if they ever do, they'll claim they invented it themselves.

http://www.bbc.co.uk/news/world-latin-america-29356232

Dengue re-emerged in Brazil in 1981 after an absence of more than 20 years.

Over the next 30 years, seven million cases were reported.

Brazil leads the world in the number of dengue cases, with 3.2 million cases and 800 deaths reported in the 2009-14 period.

Edited October 2, 2014 by Chicog

[ClutchClark]

Had it twice also. I thought that if you had one strain once, thats it. And just 4 strains. Not so?

I had thought four strains. There is atleast one unique to the Americas that is not found in Asia, but don't quote me.

[wilcopops]

The question itself is not answerable

What you have to ask is what can i do to protect myself against dengue.

[Sheryl]

It is a day time biting mosquito and quite possible to get in CM. Incidence is greatest in and immediately after the rainy season as the vector breeds in stagnant water.

Precautions = avoid getting bitten to the extent you can, and try not to have stagnant water around where you live. (Water jars are a common breeding site along with any standing puddles).

Wet markets are a particularly risky area.

[Tywais]

A year ago dengue fever was the worse in 20 years in Thailand. 10,000 known cases reported in Chiang Mai and 8 deaths in August last year, no telling how many not reported. Source

Have not heard of the same level this year though and the rainy season is wrapping up.

[Robert24]

The risk is high as in most countries with tropical climate. Even Singapore has a high amount of dengue cases. The more densely an area is populated, the higher the risk as it is transmitted from human-mosquito-human and mosquitos not travel far. I think Sheryl's advise is spot on, avoid getting bitten by mosquitos, wear long trousers, use mosquito repellent, mount dengue slide doors and windows at your home, use mosquito lamps etc etc. And if you do get flu like symptoms, do assume it's dengue and get appropriate help asap. Hydration extremely important in such a case.

[chiang mai]

The risk is high as in most countries with tropical climate. Even Singapore has a high amount of dengue cases. The more densely an area is populated, the higher the risk as it is transmitted from human-mosquito-human and mosquitos not travel far. I think Sheryl's advise is spot on, avoid getting bitten by mosquitos, wear long trousers, use mosquito repellent, mount dengue slide doors and windows at your home, use mosquito lamps etc etc. And if you do get flu like symptoms, do assume it's dengue and get appropriate help asap. Hydration extremely important in such a case.

Singapore has had a very proactive anti-Dengue campaign in place for several years, large banners hanging from apartment blocks in many places around the island.

[angelbat]

FWIW: While living in Chiang Mai for 13 months I had dengue once (a moderate case) in spite of always taking precautions like wearing long pants and long sleeves, using insect repellent, and being careful to keep mosquitoes out of my house. Several expats I know in Chiang Mai have had dengue at one time or another. As others have already said, just protect yourself as best as you can, and be prepared for the possibility that you might get dengue.

Angela

[Dante99]

The risk is high as in most countries with tropical climate. Even Singapore has a high amount of dengue cases. The more densely an area is populated, the higher the risk as it is transmitted from human-mosquito-human and mosquitos not travel far. I think Sheryl's advise is spot on, avoid getting bitten by mosquitos, wear long trousers, use mosquito repellent, mount dengue slide doors and windows at your home, use mosquito lamps etc etc. And if you do get flu like symptoms, do assume it's dengue and get appropriate help asap. Hydration extremely important in such a case.

Singapore has had a very proactive anti-Dengue campaign in place for several years, large banners hanging from apartment blocks in many places around the island.

They are doing a lot more than putting up signs--spraying, inspections, fines ....

[T_Dog]

When I had Dengue there were six houses in our moo bann that were affected. It is definitely a social disease and it needs humans to keep going. My doctor warned me that a subsequent bout would likely be more severe than the first. Was never weaker in my life and full recovery took well over six months.

[Chicog]

When I had Dengue there were six houses in our moo bann that were affected. It is definitely a social disease and it needs humans to keep going. My doctor warned me that a subsequent bout would likely be more severe than the first. Was never weaker in my life and full recovery took well over six months.

So you are saying that particular mosquito only feasts on humans? Or is that just an assumption?

[beau thai]

When I had Dengue there were six houses in our moo bann that were affected. It is definitely a social disease and it needs humans to keep going. My doctor warned me that a subsequent bout would likely be more severe than the first. Was never weaker in my life and full recovery took well over six months.

So you are saying that particular mosquito only feasts on humans? Or is that just an assumption?

Dont know about that, but apparently if a non-dengue mozzie bites a dengue sufferer within the first 3-4 days, their next bite will infect that person with Dengue too.

Not sure what the odds are though, that if you get Dengue, any old mozzie will infect your significant other after biting you first. May be when it is satiated it will fly off some place else??

[watgate]

Does a big city like Bangkok have a significant reduction in dengue fever cases due to it being a large metropolitan area? Also, for those unfortunate folks who have gotten dengue fever, what was the average stay in the hospital?

[Seligne2]

My dengue affliction was like a mild flu, nothing more.

[beau thai]

No hospitalization either