Opinion: Once bitten: The dengue dilemma

The Phuket News

PHUKET: -- The annual southwest monsoon winds have arrived in Phuket and brought with them the usual thunderstorms and heavy rain – and ensuing bouts of influenza and dengue.

While it is not uncommon for patients to be admitted for dengue this time of year, the question remains whether local health authorities are taking enough measures to help stop the spread of the disease, which affects thousands of people on the island each year.

Many campaigns are held each year to raise awareness about dengue among Thais, but is enough being done to warn foreigners? Just weeks ago the Phuket Provincial Health Office (PPHO) and local authorities launched campaigns, but the campaigns are in Thai.

The recent bout of wet weather over Phuket has left puddles of fresh water strewn all over the island, the perfect breeding grounds for mosquitoes that carry the potentially lethal dengue virus. But the PPHO recently reported that the number of dengue cases so far this year is “no more than normal”.

Thailand as a country saw its worst year of dengue fever in 1987 when some 174,000 people were infected with more than 1,000 deaths. The World Health Organisation (WHO) currently estimates there may be 50 to 100 million dengue infections worldwide every year.

In our latest online poll, we asked our readers if the government does enough to warn foreigners about dengue fever. According to the results, a staggering 69 per cent of foreigners living in Phuket or visiting the island receive little to no warning about the dangers of dengue and how the disease is transmitted.

Testament to how little warning foreigners in Phuket receive about dengue, only 2pc of respondents to the poll said “Yes, foreigners are given ample warning about dengue” – and all those respondents were Thai.

Compare that with the 10pc of respondents who said: “Dengue? What’s dengue?” And of that 10pc of respondents to the poll, 12pc were “Foreign visitors to Phuket”, better known simply as tourists.
Only 4pc of people who voted in the poll said “Yes, but there is room for improvement” in the efforts to warn foreigners about dengue; 17pc said: “Not really, I see some effort to warn foreigners, but not enough.”

With the number of expats rising on the island, it’s crucial that foreigners are warned of the disease and its dangers.

And despite it being common this time of year, that doesn’t mean it should simply be ignored – the government should be doing more to inform foreigners.

Source: http://www.thephuketnews.com/opinion-once-bitten-the-dengue-dilemma-53250.php

-- Phuket News 2015-07-19

In a severe drought year mixed with the passion for large cement vats filled with rainwater. Plus open drain systems. Its a no win situation.

Perhaps foreigners should spend a few minutes on the net (taking a break from the girly bar searches) to check out the dangers of the region before they get on the plane.

Unfortunately that poll did not give the option : I am not being warned but do find that my own responsibility and not important'.

Well that was disappointing to say the least. When I saw the headline "Opinion: Once bitten: The dengue dilemma" and the accompanying picture of various (pharmaceuticals ?) I thought it would be about how to deal with the disease after you've contracted it (or at least a description of the symptoms commonly associated with Dengue fever and the possible treatment options).

I don't think I've seen a single warning of any kind (in Pattaya) regarding Dengue either. I recall that every once in a blue moon (or three) the city fogs the sewers (once). Probably does the job for a couple of days (except in the klongs, swamps, cisterns and other areas of "standing or still" water that skeeters like to breed in). Amazing how many cockroaches are in those sewers as well, they come out in biblical hordes every time the city fogs them !

Dilemma? Def: "A dilemma is a problem offering two possibilities, neither of which is practically acceptable." So is one of the possibilities happen to be informing the farangs, starting some education regarding reality? That is not practically acceptable? I would guess most expats living here know about Dengue, so maybe worried about scarring off the tourists? If we tell them about this, maybe they will want to know other truths?

I've been twice bitten with Dengue, for what that's worth....

The most important warning about mosquitos that cause dengue fever is that they are active during the day. Most people are wary of mosquitos in the evening but these little blighters will get you early morning and afternoon. They are distinctive with their back and white banded legs.

Visitors to any new tropical location in particular should have the sense to do a little research.....dengue would be a high feature result ....maybe more than malaria. But dengue infection is increasing globally into regions nevr before considered risk areas.

Sadly Thailand has a poor record for diagnosing let alone even reporting incidences of either dengue or malaria possibly to not detract from tourism.

To the extent that manyThai sufferrers are neither diagnosed or treated accordingly! Instead they are given "treatment" for much less significant illness which does not require reporting or are less significant to the WHO.

The impact of this is that significant lifetime health deterioration and death rates accordingly go unheeded.

Dengue has no vaccine for any of the variants.Avoidance of the risk is the only option.

Malaria can be treated and minimized if similar avoidance fails.

Warn your visiting friends.

Why are they warning tourists of dengue fever?

There's big money in having a farang with dengue, who is insured, in a Thai hospital, for weeks and weeks.

Visitors to any new tropical location in particular should have the sense to do a little research.....dengue would be a high feature result ....maybe more than malaria. But dengue infection is increasing globally into regions nevr before considered risk areas.

Sadly Thailand has a poor record for diagnosing let alone even reporting incidences of either dengue or malaria possibly to not detract from tourism.

To the extent that manyThai sufferrers are neither diagnosed or treated accordingly! Instead they are given "treatment" for much less significant illness which does not require reporting or are less significant to the WHO.

The impact of this is that significant lifetime health deterioration and death rates accordingly go unheeded.

Dengue has no vaccine for any of the variants.Avoidance of the risk is the only option.

Malaria can be treated and minimized if similar avoidance fails.

Warn your visiting friends.

"Sadly Thailand has a poor record for diagnosing let alone even reporting" - but a great record for medical billing.

It all boils down to common sense, use mosquito repellant, don't wear perfume, be aware of your surroundings.

It it the luck of the bite, so short of living in a mosquito net don't let it ruin your stay in The Kingdom.

It seems the government is being blamed because tourists get sick, bull shit they know just like they know about the RED flags on the beaches, they chose to put them selves in Harms Way!

How do you know if you have a tough mosquito?
You slap him and he slaps you back!

What is the most religious insect?
A mosque-ito!

What has 6 legs, bits and talks in code?
A morese-quito!

What is the difference between a mosquito and a fly?
Try sewing buttons on a mosquito!

What do you get if you cross the Lone Ranger with an insect?
The Masked-quito!

What has antlers and sucks blood?
A moose-quito!

What is a mosquito's favorite sport?
Skin-diving!

What's the difference between a lawyer and a mosquito?
A mosquito drops off you when you die!

Why are mosquitos religious?
They prey on you!

Why did the mosquito go to the dentist?
To improve his bite!

Considering that Phuket is a very low risk zone for Dengue, I think this report is not very accurate.

"which affects thousands of people on the island each year." This is probably not factual. The total number of cases so far this year in the country of Thailand (January to July) is 18,890 cases reported. The regions affected worst by numbers is: Trad, Rayong, Angthong, Petchaburi, Ratchaburi.

Phuket is in the "very few cases" category, hardly the thousands of cases discussed in the report.

Interesting to note also that most of the regions most affected borders to Myanmar and Cambodia.....

Edited July 20, 201510 yr by AlQaholic

Excuse my ignorance but is dengue simalar to malaria?

Excuse my ignorance but is dengue simalar to malaria?

Dengue is a virus transmitted by Mosquitoes. It has no vaccine or cure, Only way to recover is plenty of care and rest, for weeks.

Malaria is a parasite also transmitted by mosquitoes, and must be treated by medication or patient will probably die.

Edited July 20, 201510 yr by AlQaholic

Excuse my ignorance but is dengue simalar to malaria?

Dengue is a virus transmitted by Mosquitoes. It has no vaccine or cure, Only way to recover is plenty of care and rest, for weeks.

Malaria is a parasite also transmitted by mosquitoes, and must be treated by medication or patient will probably die.

With Dengue fever the severity of it seems to vary somewhat, from the terrible pain in the joints and the fever, to those symptoms which are more easily bearable, albeit very uncomfortable.

The joint/bone aches for me were painful but bearable, however the vice-like headache was the biggest downside and of course feeling like sh1t, with a fever of course. Bed rest, fluids and paracetamol are about all that can be administered although sometimes the hospitals will try to keep you in for a few days to ensure that you don't develop haemorrhagic fever with it, which very often can be fatal especially for the young and the old or the immune impaired.

For the record, I am convinced that a milder version of this fever re-occurs over the years because I still have bouts of severe tiredness for many days on end. Normal research on the Internet didn't turn up anything, however having spent a lot longer doing some research, I did come across some articles which suggested that it was likely that this could happen.

Excuse my ignorance but is dengue simalar to malaria?

Dengue is a virus transmitted by Mosquitoes. It has no vaccine or cure, Only way to recover is plenty of care and rest, for weeks.

Malaria is a parasite also transmitted by mosquitoes, and must be treated by medication or patient will probably die.

With Dengue fever the severity of it seems to vary somewhat, from the terrible pain in the joints and the fever, to those symptoms which are more easily bearable, albeit very uncomfortable.

The joint/bone aches for me were painful but bearable, however the vice-like headache was the biggest downside and of course feeling like sh1t, with a fever of course. Bed rest, fluids and paracetamol are about all that can be administered although sometimes the hospitals will try to keep you in for a few days to ensure that you don't develop haemorrhagic fever with it, which very often can be fatal especially for the young and the old or the immune impaired.

For the record, I am convinced that a milder version of this fever re-occurs over the years because I still have bouts of severe tiredness for many days on end. Normal research on the Internet didn't turn up anything, however having spent a lot longer doing some research, I did come across some articles which suggested that it was likely that this could happen.

The response to an initial infection of the dengue virus varies from individual to individual. Mild to severe.

So does the time for the sysytem to develop suppression which is the reason for lingering symptoms such as night fevers.

Haemorrhagic fever is sometimes the response to ensuing infection with the same virus due to the immune system reacting mistakenly due to the presence of antibodies from the initial infection. And with delayed care it can be rapidly fatal !

Statistically this is more likely to occur in younger people. But the advise is as many have said.....avoid mosquito bites as much as possible.

Dengue and malaria may feature as primary risk illnesses but there are others out there just as bad and more insidious.

How many are aware of the micro filaria risk from insect bites for one? Is not uncommon and the treatment is often long and uncomfortable.

An off topic post has been removed

Excuse my ignorance but is dengue simalar to malaria?

Dengue is a virus transmitted by Mosquitoes. It has no vaccine or cure, Only way to recover is plenty of care and rest, for weeks.

Malaria is a parasite also transmitted by mosquitoes, and must be treated by medication or patient will probably die.

snip>

For the record, I am convinced that a milder version of this fever re-occurs over the years because I still have bouts of severe tiredness for many days on end. Normal research on the Internet didn't turn up anything, however having spent a lot longer doing some research, I did come across some articles which suggested that it was likely that this could happen. <

I agree. I had dengue about 6 years ago and twice since then had same symptoms. The one that sets it apart from anything else I've every had is the eye pressure/pain. The first relapse lasted 3 days, the last about 2. Not nearly as bad as the original case which was 5-6 days. I read similar articles (concerning relapse) from a health organization in India. That was 6 years ago, so don't have link.

Edited July 22, 201510 yr by Shot

I had dengue in February this year, within two months of moving to Phuket.

Lucky, huh?

What was lucky, however, was that I had a mild bout. I was a bit concerned by having a temperature of 41C but, other than that, I just felt a bit lethargic and not very hungry.

After much nagging from my concerned wife I went to the doctor who monitored my platelets over the next five days or so. It's a haemorrhagic fever which means that your blood platelets reduce in number. They help blood to clot so, without them, you can bleed internally, which can be fatal.

If your platelet numbers drop below a certain level you need to be in hospital to have infusions of platelets until your body is making more of its own again.

Anyway, I'm sure you all know this.

The main thing I understood from my experience is that it doesn't recur, but you can get it again and again.

So, as has been said, the only way to avoid it again is by not being bitten.