Heat, hassle, constant staring and culture shock, just another day in India. Until something that up until that point I assumed would never happen did. I caught dengue fever, and it knocked me on my arse so hard I didn’t know what had hit me.
Agra was one of the many highlights of my time in India, it was where I finally fulfilled my ambition to see the famous Taj Mahal. It was something I had been looking forward to since I stepped off the plane in Mumbai, well, long before that if truth be told. I fulfilled my ambition in the end, but it took me longer than I had initially planned for, and took me through a journey through hell and back to get there.
By the time I reached Agra I had been in India just long enough to start to acclimatise. I had gotten over the initial mental beating that is politely referred to as culture shock, I had started to get used to the heat, the crowds and the sensual overload, and I had even started to get my head round the intricacies of the infamous Indian head wobble. I was starting to relax enough to look past the heat and the hassle and see the real beauty that India has to offer those who take the time to look deep enough.
Getting off the train at the Agra Cantonment station, I ran the usual gauntlet of touts without to much difficulty, but I wasn’t feeling at my best. I had a mild headache and I could have sworn my body temperature was rising too quickly, but I dismissed it at first. I just assumed I was tired. I hadn’t really slept well the night before, and I just wanted to get a room and relax. A quick taxi to the outskirts of the Taj Ganj area – where traffic had been banned from entering in a half hearted attempt at gentrification and protection of the UNESCO world heritage site – allowed me to slowly walk through the streets and explore in my own time.
Spoilt with a smorgasbord of cheap budget hotels and hostels, all without fail displaying the ubiquitous ‘endorsed by Lonely Planet’ signs whether they had been that decade or not, it wasn’t difficult to find a room. I chose a private room instead of a dorm, I figured I needed a little rest and having a private bathroom was a luxury I suddenly couldn’t do without. By now my headache was starting to get seriously distracting and I was sweating far more than I should have been in the heat outside. Assuming it was a mixture of tiredness, dehydration and the heat I bought a couple of bottles of water and headed up to my private room for a nap.
When I awoke, it hit me, and it hit me hard.
I was feverish, dog tired, my entire body ached and I felt like hell. I could hardly move. I’m a big guy and to be honest nothing much ever really touches me, but this felled me like a tree. I fell back on the bed and stayed there for god knows how long.
Dengue fever is a viral infection transmitted by the bite of an infected Aedes aegypti or more rarely the Aedes albopictus mosquito. Any mosquito that bites during the daylight hours has a chance of carrying the disease. It is becoming increasingly problematic throughout the tropical and sub tropical world from South America to Asia, and has become a major international public health concern. Serious intermittent outbreaks occur frequently right across South and Central America, Africa and Asia.
There is no vaccine or cure for dengue fever and there is no treatment, but it is not fatal and will usually resolve itself. Dengue hemorrhagic fever (DHF) however is a more severe strain of dengue and can sometimes – rarely – be fatal if not recognised and medically managed by physicians and nurses quickly enough.
My initial thought from these flu like symptoms was more than a little alarming. This was malaria. It had to be. I had passed through malarial areas on the way up to Delhi and then Agra. But how could I have Malaria? I hadn’t been in India that long! I was careful with my preventative measures, I was liberal with the DEET spray, I was even taking antimalarials damnit!
I remember clearly falling back asleep, hoping it would pass. It didn’t.
When I awoke it had gotten even worse. The flu like symptoms just kept getting more intense, I was running a high fever, could barely think, it felt like every joint in my body was breaking and my head felt like it had a dozen hobnail booted dwarves kicking hell out of it from the inside. I just kept thinking malaria over and over, my increasingly fevered mind causing me to think the worst.
I was a nurse, why couldn’t I diagnose it? Why couldn’t I even think straight? It took a little while, but the rational part of my brain fought through the fog and forced me to think. It couldn’t be malaria. It certainly wasn’t the flu. Then it hit me. This was dengue. It had to be.
The telltale final sign was a small rash that developed on my arms and hands, maybe I had one on other areas too, but I specifically remember them there.
Along with the other symptoms, this was the definitive sign of dengue.
Symptoms usually develop between 3 – 7 days after being bitten by an infected mosquito, but can take up to 14 days. Symptoms include:
- Severe headache, especially behind the eyes.
- Severe aching in bones and joints.
- Severe muscle pain.
- Skin rash.
- Abnormal bleeding, nosebleeds, bleeding gums and blood in stools or urine.
Not all of these symptoms will be present in every case to the same degree. Symptoms usually pass in a week on average, but can take up to two weeks, and it is not uncommon to feel tired or drained for a little while afterwards.
I had dengue. Damn it! Some damn mosquito had – despite all my preventative measures – still managed to get me. I spent the next half hour after realising what my symptoms were laying on my bed in agony and swearing every Celtic expletive and imaginative curse on every damn mosquito that I could think of.
But at least now I knew what it was, and that meant I knew what to do too. Sort of.
Up until this point I had only ever heard of dengue in the classroom, or as part of an anecdotal tale on the tropical disease unit and the emergency division where I had undertaken part of my nurse training. I’d never personally come across it in a patient, and certainly never been the victim of it.
Clinician, heal thyself. Yeah, right.
I tried to dredge up from the back of my mind all the information I had about dengue, which I admit at the time wasn’t much more than the basics. But it was enough to calm myself down and to get myself thinking rationally.
The problem with dengue fever is that there is no treatment. No cure. No magic pill you can take. You just have to fight through it. Just knowing that vital piece of information was ridiculously reassuring to me at the time. I don’t know why exactly but just knowing that it would be fine if I just battled through it helped.
I knew there was no point in seeking medical attention, as bad as they felt at the time I knew my symptoms were relatively mild and I had no other serious complications. There was no excessive blood or bleeding and the bathroom situation was – lets just say manageable. I knew there was little any medical facility could do for me that I couldn’t do for myself and frankly I couldn’t be bothered leaving my room. The treatment of dengue was all about the management of the symptoms. Stay hydrated, stay rested, let it pass.
So that’s what I did. I took some paracetamol for the pain and waited it out, gaining a whole new understanding why dengue is nicknamed breakbone fever. I stayed as hydrated as possible and became extremely grateful to the guys who worked at the guesthouse I was staying in who – once they became aware of my situation – kept me supplied with large bottles of water and fruit. To this day I am extremely thankful to them for looking out for me. And I rested. A lot.
For three whole days I confined myself to bed in a self imposed form of solitary confinement. I put all my travel plans on hold and just waited until I felt better.
The whole experience felt like some sort of horrible, feverish dream filled with pain and intermittent bouts of consciousness. Time lost any and all meaning.
I did finally feel a lot better on the third day, still rough, but well enough to emerge from my room and get some fresh air. I still wasn’t up to full strength though and I decided to just hang back another couple of days and rest some more. I didn’t really have an itinerary as such because I was travelling indefinitely, so I could easily afford to put plans on hold, but this is one of the reasons I always recommend that long term travellers factor in rest time in their travels, so they can rest up when needed without missing out.
Another couple of days saw me fit and strong enough to start getting back to normal. I even did some light morning exercise which I hadn’t done since the dengue knocked on my backside. I felt a lot better. I was over it. I had contracted dengue but I had beaten it! I wished I could have personified the disease so I could have had the physical satisfaction of punching it in the face!
Now that I felt better I could get on with my trip and do what I came to Agra to do. I spent the next day visiting the Taj Mahal, one of the most magnificent and memorable sites in India and something I had now waited the better part of the week to do!
It was worth the wait!
Remember, there is no vaccine or cure for dengue at the moment, so if you get it all you can do is try to relieve your symptoms.
- Use paracetamol to relieve pain. Do not use any other painkiller – especially aspirin or ibuprofen – as they can have serious side effects with dengue.
- Important note: Paracetamol (a British standard analgesic medication) is known in the U.S.A as acetaminophen, but there are also dozens of brand names such as Tylenol, Aceta, Dapacin or Panadol for example.
- Drink plenty of fluids to prevent dehydration.
- Antibiotics won’t help you, don’t take them.
- Eat fruit to replenish essential vitamins.
- Most importantly, stop travelling and rest! You may continue to feel tired for a little while even after the symptoms have stopped. This is normal, but if you are worried seek out further medical attention.
The best and in fact only way to prevent contracting dengue in the first place is by taking preventative measures to stop yourself from getting bitten by the mosquitoes that carry the disease.
I was lucky in the sense that I am a trained nurse, so when the worst happened I knew how to diagnose and treat myself without the need to find and get to the nearest medical facility – which is the first thing I would recommend for anyone not trained – and more importantly I had enough information to remain calm instead of panicking. I hope this article gives you at least a little of the knowledge you need to prepare yourself and helps to increase awareness about this disease. Remember though, if you don’t have training or aren’t confident about what you have, then go and get advice from your nearest medical facility as soon as possible. It seems like such an obvious thing being able to tell what is wrong with you, but if your first thought after developing symptoms is malaria then believe me no amount of Delhi Belly can compare to that feeling. I was grateful what little knowledge I did have at the time allowed me to think clearly and realise what it was. If you are travelling through any area that dengue is present in, not just India, then it is really important you arm yourself with the same information. Unless you are trained then you should still seek medical attention as soon as possible after contracting the symptoms, but a little bit of knowledge will stop you from worrying and let you know what to do.
What about you? Have you ever suffered from dengue? Are you plagued with mosquitoes on your travels or do you have any particular mosquito prevention techniques? Did you just enjoy this article? I would love to hear your thoughts in the comments section below or on my Facebook or Twitter pages and please feel free to share it with any or all of the social media buttons. If you want to get more great backpacking tips, advice and inspiration, please subscribe to updates via email in the box to your right.