Even a background in travel medicine couldn’t prepare me for how miserable dengue would make me feel. This is my experience of catching it in India.
Editor’s Note: This editorial draws on more than 25 years of independent travel, first-hand experience and publicly documented evidence and regulatory changes. Many of these editorials were written years before the issues became mainstream, and have been updated to reflect current developments while remaining true to their original arguments.
Heat, hassle, constant staring and culture shock. Just another day in India. But somewhere along the way, something had shifted. The culture shock that had flattened me in my first few days was losing its edge, and I was growing more comfortable with the chaos, the noise and the sheer relentlessness of it all. I was even starting to enjoy it. The stares had become smiles, the hassle had become part of the rhythm of the day, and for the first time I felt like I was travelling with India instead of just surviving it. Then something happened that I had always assumed would happen to other people. I caught dengue fever, and it flattened me so completely that I never saw it coming.
Agra was meant to be the crown jewel of my journey. For weeks, if I’m honest for years, I had carried a picture in my head of the Taj Mahal rising pale and perfect from the morning mist. It was the image that pulled me across the world to India in the first place, and the one I’d been chasing since the moment I stepped off the plane in Mumbai. Agra, the city of emperors, was where I would finally see it for myself.
But things didn’t go to plan. Before I could see it for myself, I was knocked on my arse so hard it felt like I had been hit by a freight train.
By the time I reached Agra, India had begun to loosen its grip on me. I had made peace with the heat, the crowds and the relentless assault on the senses. I had started to decode the Indian head wobble, and even survived the logistical and physical ordeal of buying a train ticket. For the first time I was relaxed enough to look past the hassle and see what India gives to anyone willing to look a little deeper.
So when the train pulled into Agra Cantonment, I felt something close to triumph. Somewhere beyond the touts and the smoke and the heat shimmer lay the monument I had crossed a continent to see, and a city that had once been the seat of the Mughal Empire. I stepped onto the platform with the quiet thrill of a pilgrim nearing the end of a long road.
I had no idea what was waiting for me.
Pulling my old, familiar bergen onto my back, I ran the usual gauntlet of touts without too much trouble, but I wasn’t feeling at my best. I had a dull headache and felt flushed and overheated, even by the standards of an Indian afternoon. I dismissed it. I hadn’t slept well the night before thanks to a less than peaceful hostel, so I put it down to tiredness.
A quick taxi took me to the edge of Taj Ganj, where traffic is banned in a half-hearted attempt to protect the UNESCO World Heritage Site. After Delhi’s relentless traffic, the empty lanes and the occasional cow blocking my path were a pleasant surprise. I wandered past restaurants, artisan shops and the odd internet café, but I wasn’t tempted by any of them yet. I needed a room first.
There was a smorgasbord of budget hotels and hostels, every one of them displaying a faded ‘endorsed by Lonely Planet’ sign outside, whether it actually had been that decade or not was irrelevant. Of course the signs never displayed what decade that recommendation was made. But at least finding a room was easy. Because I wasn’t feeling right, I chose a private room over a dorm. It was basic, dirt cheap, clean and, crucially, had its own bathroom. Little did I know it would be my self-imposed cell for the next few days.
By now the headache had turned from a nuisance into a serious distraction, and I was sweating far more than the heat warranted. I put it down to dehydration and fatigue, bought a couple of large bottles of water and went up for a nap.
Breakbone In Agra
I have no idea how long I slept. It could have been an hour or it could have been four. The light through the shutters had changed, the ceiling fan was still turning lazily overhead, and the sheets underneath me were soaked through. The nap had been a short reprieve, and whatever had been creeping up on me all afternoon had arrived in full while I was out.
I was feverish and wrung out, burning up one minute and shivering the next. Behind my eyes was a deep, drilling ache like the entire seven bloody dwarves were hammering away inside, and every muscle in my body was sore, as if I’d been hit by a bus. My body was used to getting a beating. I was used to pain, and had a high tolerance for it. But this was more than I had ever felt during training or after a big competition. Worse than coming off a tactical march. I tried to sit up and made it about halfway before I gave up. Even reaching for the water bottle by the bed felt like a major effort.
I’m a big guy, and I rarely get ill. When I do, I shake it off in a day and carry on. Colds, dodgy stomachs, none of it has ever really touched me. This felled me like a tree.
Whatever this was, it wasn’t a bug. It was something more.
Not Malaria
My first thought was the one every traveller dreads. Malaria. The word kept looping through my head like an alarm.
But it didn’t fit. Agra is low risk, as is most of India, and I hadn’t reached Chhattisgarh or Jharkhand, the only part of my route that was high risk and the reason I was taking antimalarials at all. I’d been religious with the DEET and the tablets. Unlikely, then, but not excluded.
And not all the symptoms fit. I started to get angry with myself, force myself to think logically.
High fever. Headache. Both general malaria symptoms. But crushing bone and joint pain wasn’t, not to this level. A mosquito-rich city and a negligible malaria risk. There was only one suspect left. Dengue.
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 worked as a nurse. I’d never up until this point personally come across it in a patient, and certainly never been the victim of it. That meant I had to rely on theory, and a memory that at this point was less than stellar.
But I had no tests, no bloods and no confirmation, and I knew that symptoms alone can’t prove dengue. Other tropical fevers can look the same. All I had was a conviction, and a sudden realisation of why it was nicknamed breakbone fever.
I spent the rest of the night laying on my bed in agony and cursing every bastard mosquito on the planet with every Gaelic expletive and imaginative curse I could think of.
But at least now I knew what it was, and that meant I knew what to do too. Sort of.
There is no specific antiviral for dengue, no magic pill. Treatment is supportive: fluids, rest, paracetamol, definitely no ibuprofen or aspirin and close watching for the more serious symptoms few who go on to develop severe disease. Luckily I wasn’t showing any of those, no abdominal pain, no vomiting or bleeding, no tachypnoea. Strangely, that was reassuring. It meant the job was simply to get through it, and at least that gave me something I could actively fight.
But I was alone in my room, no phone at the time and no one to help. Every movement was agony. Even rolling over made me wince. There was nothing more I could do that night.
I fell asleep.
The next morning, I knew what I had to do.
Clinician, Heal Thyself. Yeah, Right
I couldn’t diagnose myself from a hotel bed, and I couldn’t sit out a presumptive diagnosis alone in a strange city. I needed a blood test, a confirmation and a baseline platelet count in case things took a turn for the worse. I also wanted malaria properly ruled out. So I got up.
Every step felt like walking on a broken bone. I made it down the stairs one painful stride at a time, and the taxi ride to the clinic was a blur of potholes, horns and gritted teeth. I gripped the seat and tried not to think about the next bump.
The clinic was beyond helpful. They took bloods for a full blood count, a dengue test and a malaria screen, and started IV fluids while I waited. There was nothing they could treat me with, because there is nothing to treat dengue with, but the tests were what I’d come for. The results took hours, which I spent half asleep on a trolley, watching the fluids tick down.
When they came back, it was dengue, and mild. My platelets were low, as I’d expected, but not dangerously so, and the malaria test was negative. I couldn’t have been more relieved. They were happy for me to go back to my room to recover on one condition: if anything got worse, I came straight back. Severe abdominal pain. Persistent vomiting. Bleeding from the gums, nose or other less savoury areas no one needs to hear about, or becoming unusually drowsy. I knew the list. It was strange hearing it from the other side, but also strangely reassuring.
So that’s what I did. I went back to my room, drank as much water as I could manage, and took paracetamol only when I absolutely had to. I’ve never liked painkillers, so I held off for as long as I could bear. Then I slept.
Three Days in the Cell
For three days I confined myself to bed, a self-imposed solitary confinement with a ceiling fan for company. My travel plans went on hold. The only job I had was to get through it.
Breakbone fever, I discovered, is not an exaggeration. Every joint ached with a deep, grinding pain, and the fever came in waves that left me soaked and shaking. Time lost all meaning. The days dissolved into a feverish dream of pain, water and snatches of sleep, and I surfaced only now and then to drink, take paracetamol when I couldn’t bear it any longer, and drift off again.
The guys at the guesthouse were wonderful. Once they realised I was ill, they kept me stocked with big bottles of water and fruit, and they kept gently trying to persuade me to see a doctor. I’d already been, but I never found the energy to explain. I’m thankful to them to this day. Strangers looking out for a sick backpacker is the kind of kindness I’ll always associate with India.
Eventually the fever broke, the headaches receded, and the pain began to ease. I knew better than to trust it. As a nurse I’d learned that the point where a patient starts to feel better is exactly when you keep watching them closely, so I kept drinking, kept resting and kept checking myself against the list I’d been given. Thankfully I stayed on the right side of it.
By the third day I felt a lot better, though still rough, and well enough to take a few steps out into the fresh air. I wasn’t anywhere near full strength, so I decided to hang back another couple of days. I was travelling indefinitely, with no real itinerary, so I could afford to. It’s one of the reasons I always tell long-term travellers to build rest time into their plans. When the unexpected hits, you can stop and recover without missing out.
Two days later I was back on my feet, and I did some gentle exercise for the first time since the dengue had flattened me. I felt like myself again. I had caught dengue, and I had beaten it. I only wished I could have personified the disease so I could have had the satisfaction of punching it squarely in the face.
Now I could do what I’d come to Agra to do in the first place. The next morning I finally went to see the Taj Mahal, a full week later than planned, and after everything it had taken to get there, it was worth every minute of the wait.
Michael Huxley
Michael Huxley is the founder of Bemused Backpacker, a travel writer, published author, international speaker and former nurse who has spent more than twenty-five years travelling independently through over 150 countries. He helps readers travel with more confidence, safety and perspective.
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67 responses to “My Battle With Dengue Fever In India”
Oh dear!! Sounds awful!! You poor thing! Glad that it resolved and that you were able to fulfil your dream! Great post 🙂
Should probably say… “informative” post instead of great because it is not great that you got dengue fever…
Haha! Thank you! It was pretty bad at the time. Hopefully others will get some useful information out of my experience. Thank you for the comment. 🙂
Eurgh that sounds awful. Bloody mosquitoes. Thanks for all the tips, very informative
It was! Thanks for the comment. 🙂
Dengue really is awful! I suffered from it too last year. I didn’t get a very bad case of it myself, but I was still out cold for almost 2 weeks! Although, I will add that it is extremely important to seek medical attention even if you feel you are equipped to handle dengue. One essential fact is that your platelet count keeps falling when you have dengue. That’s what results in the weakness in the first place. And you need to monitor the count with blood tests at least once every two days to make sure it doesn’t fall too low. Dangerously low platelet counts can be fatal, no matter how rested and hydrated you are. So I would advise everyone to go to the doc as soon as possible!
There is a difference between dengue and the rarer dengue haemorrhagic fever and dengue shock syndrome, which various medical councils including the WHO have suggested reclassifying into two simple classes, dengue and severe dengue. For most people who would not know the difference medical advice is essential I agree, as I said in the article. It is awful though, I felt a lot better within a week, but I still got tired easily the week after too.
Good thing you had a private room to recover!! A dorm would have been misery with all the lights and noise. The migraine might have been the worst part. Great tips though too!
Thank you. 🙂 The headache was bad at first but then it was the joint pain that became the worst part for me! The private room was an absolute life saver. I don’t know how you managed getting through dengue without one!
I remember dengue. It’s not something I wish to revisit… Ever.
Me neither!
I agree with wisemonkey, informative and interesting post, in that you are like a patient case study 😉 Sorry you had to get it at all but it will be helpful for many others!
Thank you. It was a bad experience but hopefully people will find it useful. 🙂
I had a friend who had dengue before…it took her one week in hospital before she got well enough to be discharged and she wasn’t even at full recovery yet. My dad works to hunt down these mosquitos here…because we’ve had some pretty bad clusters with deaths from dengue fever so all I can say is…very fortunate you were able get through it…:)
It’s awful. I was lucky mine was only the milder strain. Thankfully the more lethal strains are relatively rare! I wish your dad luck!
Yeah but it has been going around here in Singapore routinely too. So you should watch out when you are next here too, wouldn’t want to get it again in Singapore of all places…:)
Don’t worry I’m always a stickler with my prevention, I just happened to get unlucky that time that’s all. Dengue is pandemic throughout most of South and South East Asia, and flare ups are happening all the time. That is why it always pays to be careful. I think a lot of travellers drop their guard in Singapore particularly because it has a low risk of malaria and is generally considered safe. Hopefully by spreading the word more people will protect themselves. 🙂
Oh dear, that really sounds like hell! Thanks for this educational post, it’s really more ‘convincing’ and informative then a wiki explaining the symptoms. I will carry this information with me on my next trips. Thanks 🙂
Thanks! It wasn’t nice but I’m glad you and others might be getting some important info from the experience. That was the plan! 🙂
Very informative post! We will certainly be sharing this. It is always helpful for our readers and others to hear about dengue infection and how it can be avoided from a first-person perspective. At Break Dengue, we are all too aware of the burden of dengue in India, and we are doing what we can to stop dengue in its tracks.
Thank you, I appreciate the shares. I totally agree, everyone always asks about malaria but dengue is relatively unknown and ignored in comparison. The more the word is spread the better!
That sounds nasty – glad you recovered OK. I sympathise, because when I went to Agra I was suffering from a worse than usual case of Delhi Belly, but that was nothing compared with what you had.
Thanks, I was just unlucky really. These things happen from time to time though, at least we can recover and carry on with our travels. 🙂
There’s something in that smile that says, “I Just Kicked Dengue’s Butt!” Maybe you should get a t-shirt. 🙂 Being sick on the road is awful, but it does leave you with a host of stories. I contracted cholera during a road trip through Central America in 1992, and hepatitis A in South America in 2013. No regrets.
Haha thanks Bob! I think there is more an ‘I’m exhausted and lost half my body weight’ statement in that smile, but I do like the T Shirt idea!
Cholera and Hep A are bad news though mate, glad you got through okay.
I totally agree on the no regrets thing too, anyone can get sick anytime, it isn’t an experience I’d like to repeat but I certainly wouldn’t change a thing even if I could. The bad experiences are as much part of the adventure as the good ones!
Thanks for the comment. 🙂
Very informative and educational post! I will keep all that in mind for sure when I go to India and not only. And Im sorry you got it!
Thanks Elena, hope it is of use to you. 🙂
How… character building!
I am so glad I have not been so unlucky to get this but I have heard the stories of people who have (yourself included!) and am really happy I have been lucky enough to not get this… UGH.
Thank you for sharing though – simple advice for how to treat it but someone might read this and then when it happens to them go, “Wait… I read about this once…”
That’s the aim Stacey, hopefully anyway! I don’t mind using myself as a case study if it makes a few people consider mosquito prevention. 🙂 Thanks for the comment.
Wow, that’s some heavy disease by the looks of it. Main reason why I won’t travel anywhere really tropical with our little girl yet. She’s 4 and I find her way to little to have the risk to catch something bad like this…
It is pretty unpleasant but the general risk of contracting it is pretty low if you take precautions against mosquito bites, I was just unlucky. I certainly wouldn’t let the risk stop you from travelling with children. Just take my advice (and incidentally the advice of the CDC and WHO too) on the bite prevention methods above.
I’m really worried about dengue, I always always always get bitten by mosquitos. If there’s one in a town, I’ll be the first to be bitten. This post is really useful thanks 😀
Thanks Laura, glad you found it useful. There really is no need to be overly worried about dengue provided you have the right information (the reason for this post) and take the right precautions (see above). It is all about minimizing the risk to you and knowing what to do. Yes there is a small chance you may get it, but there is a larger chance you won’t, especially if you guard yourself against bites. Be prepared, don’t be worried. 🙂
For once I feel your pain. Quite literally. I came back from Burma having traveled taking no malaria precautions. 1 day after we arrived home I began to lose my appetite and I felt more tired than normal but I put it down to 24 hours of travelling the days before. When i woke the next day i felt terrible and throughout the day my symptoms became increasingly worse to the point where I could not move, walk or breathe without being in some serious pain. I honestly thought I was going to die or Malaria and to make things worse I live in a country where neither I or my partner speak English.
To cut a long story straight I was left in a Czech hospital with no attention, water or pain relief for over 11 hours. I discharged myself which is highly dangerous if you have Dengue and suffered at home for over 2 months with unbearable muscle and bone pain. Guess its not called break bone fever for nothing! I am glad you are feeling better! I know how horrible it is and I only hope neither of us catch it again! But I did have the scare of my life so I will never travel without Malaria tablets again!
Thanks for the comment Shussey, sounds like a horrible experience! Just to be clear though antimalarials will not protect you from dengue. Malaria and dengue fever are two very different diseases, even though they are both transmitted by mosquito bites. There is no vaccine for dengue at all at the moment, and the only way to protect yourself is by preventative mosquito measures.
No no that I know….I meant I was so scared I had malaria that I will never travel without taking antimalarial! I know there is no vaccine for Dengue unfortunately and I covered up for the entire holiday and still managed to get it 🙁
Ah, I misunderstood! I know what you mean though, I always recommend everyone take antimalarials for that exact reason, the risk just isn’t worth it. I guess we were both just unlucky! We got through it though! It’s all part of the experience, right? 🙂
Indeed its all part of the experience! Fingers crossed I never get it again 🙂
Wow. I’m so so sorry you had to go through that. Like you said, Dengue is very rarely fatal, but the first two people I knew who contracted it, died. So my family is terrified of the disease. Of course, we know many more who (relatively) sailed through it. Thanks for the tips. Hopefully I won’t get terrified next time someone I know had to go through it (I hope NEVER!!!).
And glad the Taj Mahal was still worth your while 🙂
Thank you Surya, it really was worth it! It is important to distinguish between dengue and the more severe strains of dengue that can be fatal without treatment. Having the right information really does help with fear of a disease too, so I hope I have helped in some way toward that. 🙂
You definitely have! Thanks a lot!!
Sounds like you had a tough time but here to tell the tail which is great. I’m there in 2 weeks so thank you so much for this information, i’m sure i’ll read this post a few times to try and make sure i’m covered or to know what to look for. What malarial tablets did you go for? As still deciding that one. Thank you.
Thanks Brad, I am! ;D I hope you find the info here useful for your trip. Personally I took Doxycycline as an antimalarial, but that doesn’t mean it will be right for you. Visit your travel clinic or GP as soon as possible. Make sure you look in my travel health section and the India destination guide for more specific information. 🙂
Whoa – what an intense illness for your travels! I was ill in Egypt but not to this extent! How great it was that you could ensure you took as much time as you needed to recover and didn`t feel pressure to rush and sight see!
Exactly Alli, that is why I always factor in ‘rest time’ in any of my trips so I can spend a few extra days on a beach, waste a day or so in transit, see a whole new place I hadn’t planned on before I arrived, just hole up and rest if I get sick or whatever else it may be without worrying about it too much. The benefits of travelling slowly. ;D
That should be your next blog post, if you haven’t done it already! (Benefits of Slow Travel)
Already written a little about it (search for travel slowly in the search bar), but I’m always open for suggestions on what to write about or what people want to read, so keep an eye out! ;D
Oh my goodness Mike, I’m so happy you’re ok now. dengue sounds terrible. Many of my friends in SEA have had it and said how important it is to keep yourself hydrated and get plenty of rest. Lucky it was the mild strain and you’re up travelling again!
Thank you Margherita, I appreciate that. It would have had to kill me to stop me travelling though! ;D
I am so glad you’re okay and you survived that ordeal! It is a good thing you are a trained nurse and you recognized the symptoms, I think many people would be unsure. Thanks to your post I now know all about it too, Thank you for that!
Thank guys, that’s the whole aim. If I can raise a little awareness then it’s all good!
Excellent post. We hear about these diseases but brush it off, thinking that it won’t affect us. But it always hits home when it’s someone you know. You covered it well, I’m prepared!
Frank.
Thanks Frank, I agree, so many people just dismiss the risks thinking it won’t happen to them. Odds are it won’t, but there is still no harm in reducing the risks even more!
I really feel for you. I’ve been lucky with my travels so far and have never contracted anything serious. It just goes to show how important insurance is!
I totally agree, insurance is as essential as your plane ticket! I never actually used it this time as I didn’t need treatment, but it could have easily been necessary.
I feel your pain. I visited Bali in November 2014 and upon returning fell very ill and discovered I had contracted Dengue fever! I recovered in a few weeks but even to this day I feel like it flares up every now and then, especially if I get a cold or the flu, some of my symptoms remind me of Dengue fever. I just wonder if the symptoms of it can actually keep continuing to flare up. have you experienced this at all?
Sorry you went through that Marie. No, unless you are in a dengue risk area it seems you may just be getting regular flu viruses, the initial symptoms can be very similar but don’t worry.
I’m so sorry you had to go through that, but thanks for the serious and important information.
You are more than welcome, it’s an important subject that deserves attention. 🙂
Thank you for writing this, I’m sorry you went through that but reading it has been very informative and helpful. Thank you. 🙂 (I’m glad you got better btw!)
Thank you so much, me too! And I’m really glad you found it useful. 🙂
Omg I have no idea how you managed to stay rational like that, Id be freaking out! I’m actually a little worried now because I’m going in the summer and had no idea about any of this until I saw this post.
Don’t worry Kelly, honestly. The risk of you catching it is relatively low , especially if you take all the steps above to stop getting bitten in the first place. One of the best weapons you have for not panicking and being able to deal with situations is knowledge, and that is hopefully what you can get from reading this post. 🙂
Oh no that sounds like a horrible experience! Glad you got through it ok.
Thanks Lucy, it was horrible, but if other travellers are more aware of dengue and use more bite prevention measures as a result it is worth it!
Dengue is scary! Thanks for sharing your story on this it is really good to get some actual real life information.
You’re very welcome, and thanks for the comment.