One of the risks of being a global nomad is exposure to illnesses not common at home. I’ve been to 73 countries now in my life, and managed to avoid malaria and other serious tropical illnesses–until recently.
I am in recovery from an episode of dengue fever now. One of my readers asked that I chronicle my experience with it, so here goes.
From WebMD: “Dengue fever is a painful, debilitating mosquito-borne disease caused by any one of four closely related dengue viruses. These viruses are related to the viruses that cause West Nile infection and yellow fever.
An estimated 390 million dengue infections occur worldwide each year, with about 96 million resulting in illness. Most cases occur in tropical areas of the world, with the greatest risk occurring in:
The Indian subcontinent
The Pacific Islands
The Caribbean (except Cuba and the Cayman Islands)
Central and South America (except Chile, Paraguay, and Argentina)
Most cases in the United States occur in people who contracted the infection while traveling abroad. But the risk is increasing for people living along the Texas-Mexico border and in other parts of the southern United States. In 2009, an outbreak of dengue fever was identified in Key West, Fla. There have been outbreaks in Hawai’i.
Dengue fever is transmitted by the bite of an Aedes mosquito infected with a dengue virus. The mosquito becomes infected when it bites a person with dengue virus in their blood. It can’t be spread directly from one person to another person.
Symptoms, which usually begin four to six days after infection and last for up to 10 days, may include
Sudden, high fever
Pain behind the eyes
Severe joint and muscle pain
Skin rash, which appears two to five days after the onset of fever
Mild bleeding (such a nose bleed, bleeding gums, or easy bruising)
Sometimes, symptoms are mild and can be mistaken for those of the flu or another viral infection. Younger children and people who have never had the infection before tend to have milder cases than older children and adults.”
For me, the onset was a severe headache, accompanied by chills and sweats, and body aches. The headache was pretty bad for one day, but then abated. My skin became mildly painful to the touch, and my muscles and back ached. I was very tired, and my appetite was low. There was indeed pain behind the eyes. I did have a bit of mild nausea, but not much. I had a little rash, but not much, or for long. No bleeding in this case.
Tylenol helped a little with the pain. I would normally use Advil, but it can contribute to bleeding, so the doctor advised against it.
I figured out what it was myself. No flu symptoms, plus knowing I was in a dengue area, and the distinctive symptoms made me pretty sure. As there is no treatment for it, I was just going to wait it out.
After discussions with the advise nurse at home in Washington (and friends here) I decided after a week to be tested so I could be certain it was not some other malady. There is an international quality hospital here in Bangkok that caters to ‘medical tourism’ (having care done here at a fraction of the cost in many other countries). I walked in, and within 3 hours had been seen, and a blood sample taken. By that evening, the result confirmed that I had dengue fever. My white blood cell and platelet counts were low, and I tested positive for dengue antigens and antibodies.
The doctor recommended that I come in at the end of the week and be tested again. Today, 8 days after my first symptoms, I did so. I could tell already that my aches were easing overnight, and the blood test confirmed that my counts are on the way back up, as is the normal course. I had a relatively light case, fortunately. That said, it has not been pleasant, and I do not recommend it. I think I rested and half-slept 18 hours a day. I’m not quite out of the woods yet, either.
(later note: after about 10 days, I was back to normal, as expected)
Fortunately, I was settled in to a nice apartment in Bangkok, and rested up there. It would have been difficult to go through while traveling. There are four strains of dengue fever. I will now be immune to one strain, but could get any of the others, so I do need to take care.
The lesson: when traveling, do all you can to avoid mosquito bites. Usually, I wear long sleeve shirts and pants, but the weather was hot, and I exposed my arms and ankles with shorts and short sleeve shirts.