Understanding Dengue (fearful for baby)

[mommysboy]

I have a 14 month old daughter. Lately she's been picking up a few mosquito bites which is confounding us as we are quite vigilant when outside and keep the bedroom free of mozzies at night. We live in a row house in a small estate in Surat Thani.There has been a small outbreak of dengue in our road, and the council have fumigated the area twice this week. I am just checking my understanding is right:

1. There is no real preventative measure such as vaccine and lotions have a limited effect.

2. 3/4 of infected people suffer only a minor illness or show no symptoms at all.

3. Under 1% of people who suffer the definitive illness go on to suffer the really dangerous hemorrhagic illness.

4. The mosquitos that carry the disease tend to be active during the day.

5. Small children and babies tend to have milder symptoms.

6. There are few real treatment options if someone is suffering dengue fever.

Ideally I would like to prevent my baby being bitten at all, but this seems something difficult to obtain in practice. Does anyone have any practicable hints and tips?

Edited April 2, 2016 by mommysboy

[Sheryl]

There is a vaccine,newly developed, but not yet available in Thailand.

The overwhelming majority of infections -- far more than 75%, more like 90-95% are what is called "simple dengue" i.e. not life threatening, no serious complications. But it would be rare to be asymptomatic. Usually a fever, muscle aches, headache. Severity varies greatly.

Have you tried applying a natural insecticide (citronella - many Thai brands around)?

It is a daytime mosquito, yes.

[johnatong]

Dengvaxia(dengue vaccine) is available in the Philippines but I do not know if it is available yet in the private health care sector.

[phetphet]

You don't say if you are using one... but how about a mosquito net?

[mommysboy]

You don't say if you are using one... but how about a mosquito

Initially we had a few bites inside the house at night mainly, and we are now quite diligent inside. We got a cot with a mosquito net but baby really hated it, and in any case a mosquito still got inside, so we stopped using it.

As I now understand it it's not about preventing bites completely only the ones during the day. It's not as simple as it sounds and requires great vigilance but at least daylight is on our side. I can do this but I am doubtful about the Thais. On the whole though, she is well protected. For some reason the problem only cropped up recently which caught us napping. Up until that point I thought it well contained.

I'll use sprays in the house, and the shock-bat even more than we do, and try to eradicate all mosquitos.

Thank's for the insightful replies: helps me to get clear in my mind at least.

[bark]

Big problem is education. You and your wife pay attention, but what about other members of her family. Until everyone thinks like you, it only takes one bite.

[laochef]

Anyone heard of Papaya Leaf Extract to cure Dengue ? Below are a couple of articles... I do not know if it works or not, but it can certainly not do you harm. You can find a lot of info. Google 'Papaya Leaf Juice (or extract) and also take a look at:

Melia dubia (Malai Vembu in Tamil) - medicinal plant used to cure dengue fever. Belongs to the Neem family.

http://www.thehealthsite.com/diseases-conditions/can-papaya-leaves-help-cure-dengue/

http://timesofindia.indiatimes.com/city/delhi/Doctors-unsure-but-papaya-a-hit-for-dengue-treatment/articleshow/48977419.cms

[stoneyboy]

Another issue to consider is standing water,things like having a tub for showering Thai style,open drains from the house for example as well as neighbours habits regarding water usage.

Areas such as this are a breeding ground for Mozzies and should be avoided if possible,also you can use the various insecticides which are placed in these areas such as the water tubs etc.

Edited April 4, 2016 by stoneyboy

[patyh]

Was once infected by Dengue, so here's me trying to answer your questions:

1. There is no definitive cure to Dengue like most "retro viral virus". When a person is diagnosed with dengue, all the doctor can do is put said person on drip, and give medication for the various symptoms like fever. The doctor would then monitor if the person starts bleeding or showing blood in his/her stools etc. Lotions that repel mozzie do work to prevent the mozzie from biting.

2. Not so sure about this, but high fever that comes and go will be the very first to show. Followed by rashes. If it gets serious, joint pain, easy bleeding and stuff will come. For your baby, once she has a high fever of 38.5, just bring her to the doctor. Do not DELAY for whatever reason even if your wife insists your baby will get over it.. Don't risk it. The earlier your baby gets to the doctor, the better it will be.

3. It depends on a lot of factor. But if a person has gotten a subtype of dengue before (I think there are 4), if he/she catches another subtype, the symptoms will be worst than the first and will be more deadly. (He/she will be immune from the sub-type he/she gets the first time round though)

4. Yes. Ades mozzie tends to be more active during the day time and evening.. just before the sun sets.

5. Symptoms depends from person to person..

6. Refer to point 1. Is it very important to bring her to the doctor if she's having fever especially in places with an outbreak.

The thing with baby is, there is few insect repellent that are safe for use near babies. Consult your doctor on what he/she recommends. But it is very important to make sure that there is no standing water in or near your house. That will help reduce the risk of breeding ades.

[Catoni]

Dengvaxia by Sanofi-Pasteur is now approved for use in four tropical countries in which Dengue is present. Philippines, Brazil, Mexico.... and I'm not sure what the fourth country is... but more countries are going to be approving it. It's very effective against all four sero-types.

But I think it requires a series of three shots given spaced out over a year. So if you were to take your child to the Philippines for the shots... you'd need to make three trips over the year.

Another problem is... .she may be younger than the age range they will give the shots to. But if there is no risk for younger kids.... you may be able to convince the doc to give her the shots..

Another very effective vaccine is close to being approved.. .and may need only one shot. But we have to wait another year or two for that one...

Another one is TetraVax-DV. It's a tetravalent admixture of monovalent vaccines that were tested separately for safety and immunogenicity. The vaccine passed phase I trials and is being tested in phase II studies in Thailand and Brazil. In Brazil, the studies are being done in collaboration with the Instituto Butantan.

Edited April 4, 2016 by Catoni

[Robert24]

Best to put all measures in place in order not to get bitten by mosquitoes, I.e.

1. Do you have screens on all windows and doors in you house?

2. Use a mosquito lamp at night time to kill mosquitos

3. Eliminate any breeding spots around your house

4. Wear protective clothing when outside.

Hope this helps. And if you do have signs of dengue, make sure a hospital checks if is is and treat it accordingly.

[Sheryl]

Was once infected by Dengue, so here's me trying to answer your questions:

1. There is no definitive cure to Dengue like most "retro viral virus". When a person is diagnosed with dengue, all the doctor can do is put said person on drip, and give medication for the various symptoms like fever. The doctor would then monitor if the person starts bleeding or showing blood in his/her stools etc. Lotions that repel mozzie do work to prevent the mozzie from biting.

2. Not so sure about this, but high fever that comes and go will be the very first to show. Followed by rashes. If it gets serious, joint pain, easy bleeding and stuff will come. For your baby, once she has a high fever of 38.5, just bring her to the doctor. Do not DELAY for whatever reason even if your wife insists your baby will get over it.. Don't risk it. The earlier your baby gets to the doctor, the better it will be.

3. It depends on a lot of factor. But if a person has gotten a subtype of dengue before (I think there are 4), if he/she catches another subtype, the symptoms will be worst than the first and will be more deadly. (He/she will be immune from the sub-type he/she gets the first time round though)

4. Yes. Ades mozzie tends to be more active during the day time and evening.. just before the sun sets.

5. Symptoms depends from person to person..

6. Refer to point 1. Is it very important to bring her to the doctor if she's having fever especially in places with an outbreak.

The thing with baby is, there is few insect repellent that are safe for use near babies. Consult your doctor on what he/she recommends. But it is very important to make sure that there is no standing water in or near your house. That will help reduce the risk of breeding ades.

Accurate except #3.

Most of the time, repeat infections will be milder than the first as there is some, but not total, cross-immunity.

The severe form of the disease is though to be due to the immune system being over-active in attacking the virus and thus more likely in people who have been previously infected, but still the majority of people with a repeat infection do not get the severe form, and there are also now known cases of people with no prior infection who got the severe form (though very rare).

I've had it 3 times myself. First time was terrible, flat on my back in hospital for 2 weeks, next two were pretty mild, in fact so mild that diagnosis unclear until the rash broke.

In a baby or small child the only initial sign you will see is high fever, which of course children get for many other reasons as well so don't panic, but indeed should consult pediatrician if fever over say 38 C.

Index of suspicion is higher during dengue "season" (rainy season and immediately afterwards) and in children from locations experiencing an outbreak.

[Pdavies99]

You don't say if you are using one... but how about a mosquito

Initially we had a few bites inside the house at night mainly, and we are now quite diligent inside. We got a cot with a mosquito net but baby really hated it, and in any case a mosquito still got inside, so we stopped using it.

As I now understand it it's not about preventing bites completely only the ones during the day. It's not as simple as it sounds and requires great vigilance but at least daylight is on our side. I can do this but I am doubtful about the Thais. On the whole though, she is well protected. For some reason the problem only cropped up recently which caught us napping. Up until that point I thought it well contained.

I'll use sprays in the house, and the shock-bat even more than we do, and try to eradicate all mosquitos.

Thank's for the insightful replies: helps me to get clear in my mind at least.

Edited April 4, 2016 by Pdavies99

[Pdavies99]

Sorry, but the baby hates a mosquito net ???? How idiotic can you be?

Use a net, do you want your baby to grow up with scarred skin like you often see for many reasons, one being having parents who never used a net!

[mommysboy]

Sorry, but the baby hates a mosquito net ???? How idiotic can you be?

Use a net, do you want your baby to grow up with scarred skin like you often see for many reasons, one being having parents who never used a net!

Idiotic!!

The problem is not inside the house, not at night, and in any case bites at night (well after dusk) do not seem to pose a threat for dengue. Our bedroom is well protected.

I don't think mosquito bites cause long term scarring. Where we are the mozzies are small. Yes I have seen Thais with what appears to be scarring/discolouration on legs especially, but I think this is more likely from untreated infected wounds, boils, tick bites, etc.

Baby seems not to be scarred at all.

Edited April 4, 2016 by mommysboy

[Sheryl]

Please keep it civil.

MB, when outside the house if the baby is sleeping or sitting in one place, there are these small folding umbrella-like nets you can get and put over where the baby is lying, very helpful.

And as others said, do be mindful of trying to stay far from any stagnant water. Right now is not the peak season for dengue, it is possible to get but less likely than it will be when the rains come.

As you are a new father (and also as I know, prone to health worries!) I should warn you to be prepared for the fact that babies and young children get sick a lot and run high fevers easily, even with a common cold. Especially starting at about 6-9 months of age and then until around age 6or so (with a spike after starting school). Most of the time these fevers and illnesses are nothing serious. It is part of the natural process of developing immunity. Even a temp of 40 C is commonplace in babies and young kids and usually will not be dengue or anything else serious. Should still definitely see a doctor of course, and it's worth spending some time finding a good pediatrician you are comfortable with (preferrably one that does not over prescribe if possible).

I mention this as I don't want you to suffer undue emotional stress each time the baby is sick as starting soon that will be a common occurrence. You usually get a reprieve until age 6-9 months because the baby still has circulating antibodies from the mother but those levels wane and then the child starts to catch every common bug there is and gradually build up their own immunity.

So be prepared and don't panic.

[mommysboy]

Please keep it civil.

MB, when outside the house if the baby is sleeping or sitting in one place, there are these small folding umbrella-like nets you can get and put over where the baby is lying, very helpful.

And as others said, do be mindful of trying to stay far from any stagnant water. Right now is not the peak season for dengue, it is possible to get but less likely than it will be when the rains come.

As you are a new father (and also as I know, prone to health worries!) I should warn you to be prepared for the fact that babies and young children get sick a lot and run high fevers easily, even with a common cold. Especially starting at about 6-9 months of age and then until around age 6or so (with a spike after starting school). Most of the time these fevers and illnesses are nothing serious. It is part of the natural process of developing immunity. Even a temp of 40 C is commonplace in babies and young kids and usually will not be dengue or anything else serious. Should still definitely see a doctor of course, and it's worth spending some time finding a good pediatrician you are comfortable with (preferrably one that does not over prescribe if possible).

I mention this as I don't want you to suffer undue emotional stress each time the baby is sick as starting soon that will be a common occurrence. You usually get a reprieve until age 6-9 months because the baby still has circulating antibodies from the mother but those levels wane and then the child starts to catch every common bug there is and gradually build up their own immunity.

So be prepared and don't panic.

Thank you Sheryl. We have been very lucky so far. Hardly a day's illness beyond the odd cold. And yes I am mindful of my own foibles.: I understand panicky, over controlling Dads are not helpful.

I've got a reasonably good health policy for her, and a clinic we can use if needed. The local health facilities are pretty good. When my nephew succumbed, the sprayers were down here straight away and they treated him well even though it was a mild case.

We live close to a river and the neighbours also have these little ornamental pots full of water, but I will be vigilant around our bathroom which has a big water tub.

[Jimbo1964]

You might also want to buy some natural 100% tea tree oil. Put in a spray bottle mixed with water and spray that on yourself and child, keeping away from eyes of course. This will keep away mosquitoes, ticks, sand flies etc and it is not harmful to health as its not a harmful chemical.

You can spray this mixture on dogs and cats too if they have ticks or fleas. Tea tree oil is a natural antiseptic, use for thousands of years by Australian Aboriginals and will help heal previous bites too.

[khunPer]

I have had dengue fever twice in Thailand – it's quite unpleasant.

There are 4 types of virus, of which 2 are harmless – meaning not fatal – but can make the infected extremely exhausted for quite some time. The other 2, that seem not to be so common, can be fatal; however fairly low rate (I've heard 4% and 7%). WHO states that 50 million are annually infected by dengue, and there are 22,000 fatal cases.

It's said, that if you have have been infected with one of the four virusses, your immune-system should make you immune for further infections by that virus – the other virusses are just that different, so your immunity don't work for infection with another type. The Nation (Thai newspaper) wrote in 2014, that a vaccine is on it's way, and the preliminary studies shows more than 50 percent prevention (56% the article said).

My first infection, some 7-8 years back, was quite mild, but lasted about a month with extreme fatigue. The second, last year, was worse – presumable another of the 2 mild virusses – and when I thought my time was up, it was time to be checked at the local government hospital; blood test showed I had dengue, but they could only give some painkiller (?! they always give/sell paracetamol) and some "energy-powder" to mix in drinking water. However, it did only last about a week-and-a-half, and I was almost Okay when finally had power enough to visit a hospital – but I did have a few quite bad days before – seem like drinking enough water is important.

The to my knowledge, the only know cure that have shown positive result, is pressed raw papaya leafs. There are some few smaller scientific studies that prove good results, this one is from Malaysia in 2013 with 228 patients. And here is a scientific article about Potential anti-dengue medicinal plants.

Lemongras (or citronella) is said to be a good natural mosquito protection.

[BritManToo]

Go on holiday for a month.

Dengue outbreaks are seasonal, temporary and very localized.

It'll be over when you get back.

[mommysboy]

Actually I have been thinking about our care in general, so may I raise another issue that may be of reasonable concern:

As I mentioned baby sleeping in the cot has been a non starter, so she sleeps with us. We have one of those very big mattresses. We did away with the base for obvious reasons. We created a sort of well in the middle. As she's got bigger, she seems to spin around at night and wecan end up just about anywhere usdually at the foot of the mattress.

I'll talk with my wife right now about possibly having my daughter on an improvised bed beside the mattress.

Other things regarding the sleeping area where we spend a lot of time:

Hard floor has been covered up with these alphabet squares, similar to the material in a yoga mat.

Electric cables on tv not left dangling, and tv on stable base and on a high chest of drawers out of reach.

One big stand up fan, rotators currently out of reach.

I slip the catch on the door at nights.

[BritManToo]

I'll talk with my wife right now about possibly having my daughter on an improvised bed beside the mattress.

That ain't gonna happen.

Baby shouldn't be between you though, you easy to squish, and too hot.

Have baby beside mum, away from you, with a small mattress on the floor in case baby falls off.

[SamuiRes]

Anyone heard of Papaya Leaf Extract to cure Dengue ? Below are a couple of articles... I do not know if it works or not, but it can certainly not do you harm. You can find a lot of info. Google 'Papaya Leaf Juice (or extract) and also take a look at:

Melia dubia (Malai Vembu in Tamil) - medicinal plant used to cure dengue fever. Belongs to the Neem family.

http://www.thehealthsite.com/diseases-conditions/can-papaya-leaves-help-cure-dengue/

http://timesofindia.indiatimes.com/city/delhi/Doctors-unsure-but-papaya-a-hit-for-dengue-treatment/articleshow/48977419.cms

Yes - my wife's mother (living in Issan) suggested it and my wife created the drink. Tastes absolutely foul - almost the cure being worse than the complaint. My Dengue was not that serious so I did not persevere but it is an "old folks" traditional remedy from the days before health care became more widespread in Thailand.

[mommysboy]

Please keep it civil.

MB, when outside the house if the baby is sleeping or sitting in one place, there are these small folding umbrella-like nets you can get and put over where the baby is lying, very helpful.

And as others said, do be mindful of trying to stay far from any stagnant water. Right now is not the peak season for dengue, it is possible to get but less likely than it will be when the rains come.

As you are a new father (and also as I know, prone to health worries!) I should warn you to be prepared for the fact that babies and young children get sick a lot and run high fevers easily, even with a common cold. Especially starting at about 6-9 months of age and then until around age 6or so (with a spike after starting school). Most of the time these fevers and illnesses are nothing serious. It is part of the natural process of developing immunity. Even a temp of 40 C is commonplace in babies and young kids and usually will not be dengue or anything else serious. Should still definitely see a doctor of course, and it's worth spending some time finding a good pediatrician you are comfortable with (preferrably one that does not over prescribe if possible).

I mention this as I don't want you to suffer undue emotional stress each time the baby is sick as starting soon that will be a common occurrence. You usually get a reprieve until age 6-9 months because the baby still has circulating antibodies from the mother but those levels wane and then the child starts to catch every common bug there is and gradually build up their own immunity.

So be prepared and don't panic.

Spot on again Sheryl. I found a small pool of water just outside the front door hidden behind some bins. I sit our baby in the pram just at the door arch because its cool and she loves to watch kids play and the neighbours like it too. The mosquitos were here.

[Sheryl]

They can't breed without water so if you have thoroughly removed it should soon vanish.

[lemonjelly]

I've my first baby on the way, I'm concerned about the zika as well as the dengue virus. I'm using one of the electrically vaporised liquid repellents at the moment, does anyone know if they're safe for babies?

Edited April 11, 2016 by lemonjelly

[Sheryl]

No idea. But probably best nto to have your wife inhale it.

Suggest your wife use a natural insect repellent (citronella- many brands on the market).

This is not season for a lot of mosquitoes. If you nonetheless have them, search for stagnant water as there must be some where they breed.