Dengue fever is a nasty viral infection spread by mosquitos in a similar way to malaria and is an increasing public health concern. It is a global threat with around half the worlds population at risk according to recent reports by the World Health Organisation, yet it is a disease that is often completely under reported, ignored or misunderstood by so many travellers who set off on their round the world adventures. After contracting a nasty case of it myself in India, and in my professional capacity as a qualified nurse, I would say worry may be too strong a word with the right preparation but it is definitely something you should be aware of.
Dengue is not malaria. It seems obvious but there is actually a lot of confusion on this issue. Even though it is often spoken of in the same context, is transmitted via a mosquito bite and has similar initial symptoms, it is a completely separate infection. Dengue fever is a viral infection transmitted by the bite of an infected Aedes aegypti or more rarely the Aedes albopictus mosquito. These mosquitoes – unlike malaria carrying breeds that bite in the evening or at night – bite during the daylight hours and any of them have a chance of carrying the disease.
It is becoming increasingly problematic throughout the tropical and sub tropical world from South America to Asia, especially in urban and semi urban areas, 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 any of the four distinct strains of dengue fever and there is no treatment, but it is not fatal and will usually resolve itself within 2 – 7 days.
Once you have caught one strain of dengue (known as a serotype), you will become immune to that strain after recovery. However, this immunity does not apply to the other serotypes, and further infections from one or more serotypes of dengue increase your risk of getting severe dengue.
Severe dengue, also known as dengue hemorrhagic fever (DHF) however, is a more severe strain of dengue, characterised by severe shock and sometimes bleeding, and can sometimes – very rarely – be fatal if not recognised and medically managed by physicians and nurses quickly enough. It is still very rare in travellers however, and prompt treatment can bring the death rate down from an average of 20% to 1%. It is something to be aware of so you can take precautions if necessary, but not something to be paranoid about.
Symptoms usually develop between 3 – 7 days after being bitten by an infected mosquito, but can take up to 14 days. Symptoms are flu like in nature and can include:
- Severe headache, especially behind the eyes.
- Severe aching in bones and joints.
- Severe muscle pain.
- Nausea and vomiting.
- Swollen glands.
- Skin rash.
If the infection develops into severe dengue, then further symptoms to watch out for include:
- Abnormal bleeding, nosebleeds, bleeding gums and blood in stools or urine.
- Severe abdominal pain.
- Persistent vomiting.
- Rapid breathing.
Not all of these symptoms will be present in every case or to the same degree. Symptoms usually pass in two days to a week on average, but can in relatively rare cases take up to two weeks. It is not uncommon to feel tired or drained for a little while afterwards either.
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. Vaccines are being developed at the moment but they won’t be widely available for some time yet.
The only way to prevent getting dengue, is to protect yourself from the mosquitoes and avoid getting bitten in the first place.
That means using plenty of DEET spray of 40 – 50% strength and reapplying it regularly onto any exposed skin. If you are using sun protection, then put that on first and then use the DEET spray.
Clothing is also important to consider. Light, breathable clothing that covers up more skin such as long trousers and a T Shirt are best. You can also get mosquito repellant clothing which are impregnated with permethrin, the same chemical that is used on mosquito nets. It isn’t necessary to use these, but they don’t do any harm either, especially if you are heading to areas where mosquitoes are much more active.
Remember, dengue mosquitoes bite during the day, especially in the morning and before sundown, which is when they are most active. They like dark, damp areas and can often be found in dark rooms or in dark crevices.
Before you travel, you should always check for recent outbreaks in areas you want to travel to and plan accordingly, and get yourself to the nearest medical professional if you develop any of the above symptoms on your trip. It is always better to be safe than sorry, because believe me, Dengue is not something you want to suffer through!
The information provided here is for general travel health advice and information only. It is provided by a qualified nurse but is not a replacement for a personal consultation with a travel nurse specialist, your GP or a doctor specialising in travel medicine who can tailor advice to your individual medical history and needs.
Have you read all the information but still need a little more specific advice? Is there a travel health issue that you are worried about and need a little reassurance on? Need some information on malaria, or which vaccinations you will need? Is there a travel health issue you would like to ask about in complete confidence?
Well I am here to help.
Apart from being an experienced backpacker with over 10 years travel experience, I am also a qualified nurse with an interest in emergency nursing and travel medicine and practical experience volunteering as an expedition medic.
The Bemused Backpacker Travel Clinic is an indispensable online resource for you to gain a one on one consultation with a medical professional giving you personal reassurance, expert information and qualified advice for any and all of your travel health related questions. To head into the Travel Clinic, click here.
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