Don’t take dengue fever lightly Posted on July 20, 2014, Sunday
Aedes mosquito having its fill of blood.
A YOUNG housewife was not bothered about mosquitoes until she came down with dengue fever about four years ago.
It started as a mild headache before morphing into a burning fever.There was a rash of tiny red spots over her arms, chest and back.
“The fever was awful but the headache was the worst — like being tortured,” recalled the 35-year-old from a suburban village accessible by all vehicles.
Taking paracetamol did not prove very effective and it was worse when she tried to sleep.
“The headache — it was horrible,” she said on condition of anonymity.
She suffered for two days and one night before seeking medical help.
“I was first examined by a medical assistant from one of the rural clinics. He immediately referred me to the Sarawak General Hospital.
“I was too weak to go to the hospital — and thank goodness, my husband was there to help me,” she said.
At first, the hospital was unable to confirm the dengue virus but because there was an outbreak in Kuching back then, they put me in the ward.
“I was prescribed paracetamol but on my first night in hospital, I just felt awful. The next day, my blood test confirmed it was dengue. Luckily, I did not have any serious complications,” she added.
The housewife started feeling a lot better after the first day in hospital with the doctors monitoring her condition.
On the second day, she was informed the fever had peaked and the worst was over. She stayed in hospital for two nights and three days.
She said the illness made her “incredibly weak” for a week after she was discharged and it took a while for her to fully recover.
The mother of four said she would never again be casual about protection against mosquitoes.
“I don’t ever want to go through the same ordeal. I have learnt my lesson and will always make sure mosquitoes have no place in our home,” she said.
The life cycle of Aedes mosquito.
Chills and headaches
A general worker in his mid-40s had also struggled with Dengue fever about a year ago. It started with fever, chills and headaches.
“When I first got it, my days were spent under the blanket in my bedroom. It was horrible and I didn’t know I had Dengue fever until the doctor told me,”said the man who also preferred not to be identified.
He first felt something was wrong when he woke up one Sunday morning with “one of my worst hangovers ever.”
The night before, while clubbing, he had a few cans of beer but the morning after, he felt as though he had downed a whole bottle of whisky.
He had pounding headaches all day, chills even when the weather was hot and muscle aches all
over. Miraculously, the next day, his fever subsided — the headaches were gone and he felt better.
“In fact, I felt so good I decided to return to work. As I got started, the pain came back — my feet were really sore and my fingertips hurt.
“I felt something was wrong when I could not move my fingers — the pain was so bad. Red dots started appearing all over my hands and feet. So I asked my friend to drive me to a private clinic.”
He claimed at first the doctor seemed doubtful it was Dengue because most patients suffered a lot more than he did. Nevertheless, he was referred to the Sarawak General Hospital where he was given a blood test.
About an hour later, the results confirmed he was infected by Dengue fever. His platelets count was low but not so low as to require hospitalisation.
Severe cases of Dengue are called hemorrhagic fever and can result in internal bleeding, low blood pressure and death.
The man said the doctor told him he must have a very strong immune system to suffer fever for only one day. Normally, victims are out for a week — or require hospitalisation.
He was also told there is no real medical treatment for Dengue fever other than rest, hydration and removal of mosquito breeding grounds.
He made sure he heeded the doctor’s advice to get plenty of rest and drink a lot of water over the week.
“My brush with Dengue was a mild one — I was lucky,” he said.
The two above narratives should serve as an eye-opener to all that Dengue fever is a painful affliction.
Dengue fever is caused by a tropical virus and spread by mosquitoes. It is a serious disease that can leave sufferers bed-ridden for weeks — and also kills tens of thousands people worldwide every year.
Dengue has been in the news in Malaysia everyday for weeks now.
The state of Dengue has, in fact, reached endemic level as reported cases continue to rise. As such, the government has set a two-month target to reduce Dengue fever cases, especially in the 492 localities where the disease is active.
Deputy Prime Minister Tan Sri Muhyiddin Yassin announced this on July 14 after chairing the inaugural meeting of the National Committee on Dengue in Putrajaya.
He said the Committee would endeavour to achieve the target by initiating “optimum measures” to control the disease.
“We hope to see a positive impact over the next two months. Dengue fever cases and deaths are reportedly rising — and this is alarming,” he was quoted as saying by Bernama.
According to media reports, Selangor has the highest number of localities where the disease is active at 264, followed by Kelantan (66), Kuala Lumpur and Putrajaya (45), Negeri Sembilan (41), Johor (28) and Sarawak (14).
Between January and July this year, 48,845 cases of Dengue fever have been reported — up 34,719 (246 per cent) over 14,126 for the corresponding period last year. Ninety-two deaths were also reported.
State Health Department director Datu Dr Zulkifli Jantan said as of June this year, Sarawak recorded 674 cases of Dengue fever with three reported deaths. However, overall, cases in the state this year were down 14.2 per cent compared to 786 cases in the corresponding period last year.
Even so, the public cannot be complacent but must continue taking measures to curb the spread of the disease by destroying the breeding grounds of Aedes mosquitoes in their compounds.
The community’s participation is the key to Dengue prevention.
Facts on dengue
The habitats of Aedes
Dengue fever — severe dengue
Dengue is a vector-borne disease transmitted by the bite of an infected mosquito. There are four serotypes of the virus that causes dengue and are known as DEN-1, DEN-2, DEN-3, DEN-4.
Severe Dengue is a potentially lethal complication which can develop from dengue infections.
It is estimated there are over 50-100 million cases of Dengue worldwide each year and three billion people living in dengue endemic countries.
Where does the disease occur?
Dengue is mainly transmitted by a mosquito (Aedes aegypti) and distributed across all tropical countries. Travellers already infected with the virus also spread the disease when they get bitten by the local Aedes mosquito population.
Dengue outbreaks can occur anytime — as long as the mosquitoes are still active. However, in general, high humidity and temperature are conditions that favour mosquito survival, increasing the likelihood of transmission.
Dengue fever skin rashes.
Dengue fever causes flu-like symptoms and lasts for two to seven days. It usually occurs after an incubation period of four to 10 days after the bite of the infected mosquito.
High fever (40°C/104°F) is usually accompanied by at least two of the following symptoms:
Headaches, pain behind eyes, nausea, vomiting, swollen glands, joint, bone or muscle pains and rash.
In severe Dengue, the critical phase takes place around three to seven days after the first signs of illness. Temperature will decrease although this does NOT mean the person is necessarily recovering. Special attention needs to be given to these warning signs as it could lead to severe dengue: Severe abdominal pain, persistent vomiting, bleeding gums, vomiting blood, rapid breathing and fatigue/restlessness.
When severe Dengue is suspected, the sick person should be rushed to the emergency room or to the closest health care provider.
There is no vaccine or specific medication for Dengue fever.
Patients should seek medical advice, rest and drink plenty of fluids. Paracetamol can be taken to bring down fever and reduce joint pains. However, aspirin or ibuprofen should not be taken since they can increase the risk of bleeding.
Patients can transmit the infection via Aedes mosquitoes after the first symptoms appear (within four to five days — maximum 12 days). As a precautionary approach, patients can adopt measures to reduce transmission by sleeping under a treated net, especially during the period of illness with fever.
Infection with one strain will provide life-time protection only against that particular strain. However, it’s still possible to become infected by other strains and develop into severe dengue.
When warning signs (listed above) of severe dengue are present, it’s imperative to consult a doctor and seek hospitalisation to manage the disease. With proper medical care and early recognition, case-fatality rates are below one per cent. However, the overall experience remains very discomforting and unpleasant.
Dengue fever skin rashes.
What should I do?
If you suspect you have Dengue, you need to see a doctor immediately.
Who spreads the disease?
Dengue is spread through the bite of the female mosquito (Aedes aegypti). The mosquito becomes infected when it takes the blood of a person infected with the virus. After about one week, the mosquito can then transmit the virus while biting a healthy person. The mosquito can fly up to 400 metres looking for water-filled containers to lay its eggs but usually remains close to the human habitation.
Aedes aegypti is a daytime feeder: The peak biting periods are early in the morning and in the evening before dusk.
Dengue cannot be spread directly from person to person. However, a person infected and suffering from Dengue fever can infect other mosquitoes. Humans are known to carry the infection from one country to another or from one area to another during the stage when the virus circulates and reproduces in the blood system.
The mosquitoes thrive in areas close to human population (urban areas).
The Aedes mosquito lays its eggs in water-filled containers inside the house and surrounding areas of dwellings. The eggs hatch when in contact with water. Eggs can withstand very dry conditions and survive for months. Female mosquitoes lay dozens of eggs up to five times during their lifetime. Adult mosquitoes “usually” rest indoors in dark areas (closets, under beds, behind curtains).
Reducing the risk
The best preventive measure for areas infested with Aedes mosquito is to eliminate the egg-laying sites – called source reduction. Lowering the number of eggs, larvae and pupae will reduce the number of emerging adult mosquitoes and the transmission of the disease.
Examples of breeding habitats: Indoor, ant traps, flower vases and saucers, water storage tank (domestic drinking water, bathrooms), plastic containers, bottles, outdoor, discarded bottles and tins, discarded tyres, artificial containers, tree holes, potholes, construction sites, drums for collecting rainwater, shells, husks, pods from trees, leaf axils of various plants, boats and equipment.
Items that collect rainwater or are used to store water should be covered or properly discarded. The remaining essential containers should be emptied and cleaned and scrubbed (to remove eggs) at least once a week. This will prevent adult mosquitoes from emerging from the egg-larva-pupa stage.
Outdoor breeding grounds of dengue-spreading Aedes mosquitoes are destroyed through fogging.
Reduce exposed skin to mosquitoes bites. Long-sleeved clothing and mosquito repellents are the most viable options.
Window and door screens, air-conditioning reduces the risk of mosquitoes coming into contact with the household members. Mosquito nets (and/or insecticide-treated nets) will also provide additional protection to people sleeping during the day or protect against other mosquitoes which can bite at night (such as Anopheles (malaria).
Household insecticides, aerosols, mosquito coils or other insecticide vaporisers maybe also reduce biting activity.
Generally, breeding grounds in the environment are destroyed through periodical fogging.