What is Dengue fever? What is Dengue hemorrhagic fever?
Dengue fever is a flu-like illness spread by the bite of an infected mosquito.
Dengue hemorrhagic fever is a severe, often fatal, complication of Dengue fever.
What is the infectious agent that causes Dengue?
Dengue and Dengue hemorrhagic fever are caused by any of the Dengue family of viruses. Infection with one virus does not protect a person against infection with another.
How is Dengue spread?
Dengue is spread by the bite of an Aedes mosquito. The mosquito transmits the disease by biting an infected person and then biting someone else.
Where is Dengue found?
Dengue viruses occur in most tropical areas of the world. Dengue is common in Africa, Asia, the Pacific, Australia, and the Americas. It is widespread in the Caribbean basin. Dengue is most common in cities but can be found in rural areas. It is rarely found in mountainous areas above 4,000 feet.
The mosquitoes that transmit Dengue live among humans and breed in discarded tires, flower pots, old oil drums, and water storage containers close to human dwellings. Unlike the mosquitoes that cause malaria, Dengue mosquitoes bite during the day.
What are the signs and symptoms of Dengue fever and dengue hemorrhagic fever?
Dengue fever usually starts suddenly with a high fever, rash, severe headache, pain behind the eyes, and muscle and joint pain. The severity of the joint pain has given dengue the name "breakbone fever." Nausea, vomiting, and loss of appetite are common. A rash usually appears 3 to 4 days after the start of the fever. The illness can last up to 10 days, but complete recovery can take as long as a month. Older children and adults are usually sicker than young children.
Most Dengue infections result in relatively mild illness, but some can progress to Dengue hemorrhagic fever. With Dengue hemorrhagic fever, the blood vessels start to leak and cause bleeding from the nose, mouth, and gums. Bruising can be a sign of bleeding inside the body. Without prompt treatment, the blood vessels can collapse, causing shock (Dengue shock syndrome). Dengue hemorrhagic fever is fatal in about 5 percent of cases, mostly among children and young adults.
How soon after exposure do symptoms appear?
The time between the bite of a mosquito carrying Dengue virus and the start of symptoms averages 4 to 6 days, with a range of 3 to 14 days. An infected person cannot spread the infection to other persons but can be a source of Dengue virus for mosquitoes for about 6 days.
How is Dengue diagnosed?
Dengue is diagnosed by a blood test.
Who is at risk for Dengue?
Anyone who is bitten by an infected mosquito can get Dengue fever. Risk factors for Dengue hemorrhagic fever include a person's age and immune status, as well as the type of infecting virus. Persons who were previously infected with one or more types of Dengue virus are thought to be at greater risk for developing Dengue hemorrhagic fever if infected again.
What is the treatment for Dengue and Dengue hemorrhagic fever?
There is no specific treatment for Dengue. Persons with Dengue fever should rest and drink plenty of fluids. They should be kept away from mosquitoes for the protection of others. Dengue hemorrhagic fever is treated by replacing lost fluids. Some patients need transfusions to control bleeding.
How common is Dengue?
In tropical countries around the world, Dengue is one of the most common viral diseases spread to humans by mosquitoes. Tens of millions of cases of Dengue fever and up to hundreds of thousands of cases of Dengue hemorrhagic fever occur each year.
In the United States, approximately 100 cases of Dengue are reported each year in travelers returning from tropical areas. Many more cases probably go unreported. A few persons have become infected with Dengue while living in the United States. Aedes mosquitoes are found in Texas, Florida, and other southern states, and locally acquired dengue has been reported three times since 1980 in southern Texas.
Is Dengue an emerging infectious disease?
Yes. All types of Dengue virus are re-emerging worldwide and causing larger and more frequent epidemics, especially in cities in the tropics. The emergence of Dengue as a major public health problem has been most dramatic in the western hemisphere. Dengue fever has reached epidemic levels in Central America and is threatening the United States.
Several factors are contributing to the resurgence of Dengue fever:
- No effective mosquito control efforts are underway in most countries with Dengue.
- Public health systems to detect and control epidemics are deteriorating around the world.
- Rapid growth of cities in tropical countries has led to overcrowding, urban decay, and substandard sanitation, allowing more mosquitoes to live closer to more people.
- The increase in non-biodegradable plastic packaging and discarded tires is creating new breeding sites for mosquitoes.
- Increased jet air travel is helping people infected with Dengue viruses to move easily from city to city.
Dengue hemorrhagic fever is also on the rise. Persons who have been infected with one or more forms of Dengue virus are at greater risk for the more severe disease. With the increase in all types of virus, the occurrence of Dengue hemorrhagic fever becomes more likely.
There is no vaccine to prevent Dengue, the following may be of some interest, however:
For those of you that may be familiar withthe Wanderling and his interactions with the shaman man of spells called Obeahman high in the mountains of Jamaica you may recall that when a young girl from the village was hit by a car, the parents, who could not afford a regular medical doctor, opted to have their daughter taken to the Obeah. The Wanderling and another village member carried the girl in a sling-like hammock slung between two long wooden poles up the hazardous mountain trail to the Obeahman's abode. During that several hour period, although breathing, the girl never regained consciousness. The Wanderling was not allowed to go into the Obeah's hut bcause he was white, nor were any of the rituals performed observed, that is, if any at all were performed. The next morning the Wanderling ended up clear down the mountain and didn't exactly see what happened to the girl. About two weeks later she was seen to be playing with other village childern as though nothing had ever happened. No marks, scars, scraches, casts or anything else. Many months later the Wanderling contracted Dengue Fever and laid in his bed sweating in pools of water, delirious with a high fever, not eating, and basically unable to move. A villager happened by and reported how sick he was to a village elder. He inturn passed word to the Obeah. Under NO circumstances had the Obeah ever been known to leave his mountain lair, everyone in need of his services ALWAYS had to go to him no matter how serious the situation. However, much to the suprise of everyone in the village and others for miles and miles around, within a few hours of hearing of the Wanderling's condition he showed up on the veranda. He would not enter his house, again because the Wanderling was a white man, but he did remove spiritual items and herbs from his Medicine Bag called an Oanga Bag and perform a set of rituals that included spreading sand and ashes in a circle, casting bones into the circle, sitting Buddha-like doing some chanting and using smoke that waifted throughout the house. The next day the Wanderling was up and around, sore, and except for a substantial loss of weight and weak from having not eaten, OK. The Obeah was gone. (source)
The day after the Obeah departed and following a night of heavy wind and rain, the Wanderling, conscious but racked with pain, for the first time in days was able to move and hobbled himself out onto the veranda. Barely able to stay upright he stood before the shaman's circle, and despite the severity of the storm of the night before, the circle was still in place just as it had been left by the man of spells. An ever so slight breeze came up and spread across the veranda floor twisting itself into a small dust-devil-like Vortex encompassing the Wanderling's bare feet and legs with the ash and sand of the circle. As the twisting breeze climbed his body the pain dissipated eventually disappearing altogether along with the wind.
In an incredibly interesting conincidence, almost paralleling the Wanderling's experience as described above, Enlightened Zen master Hsu Yun (1840-1959), had the following striking similar incident:
Later he(Hsu Yun) caught malaria and dysentery and was dying in a deserted temple on the top of a mountain when the beggar appeared again to give him the hot water and medicine that saved him. The begger, who had given his name as Wen Chi, asked several questions which Hsu Yun did not understand and could not answer because he was still unenlightened and did not understand the living meaning of Ch'an dialogue. Although he was told by the beggar that the latter was known in every monastery on the Five-Peaked Mountain, when Hsu Yun arrived there and asked the monks about Wen Chi no one knew him. Later he mentioned the incident to an elderly abbot who brought his palms together and said: "That beggar was the transformation body of Manjusri Bodhisattva." Only then did the master realize that he had actually met the Bodhisattva who had saved him twice on the long journey.
Although he was told by the beggar that the latter was known in every monastery on the Five-Peaked Mountain, when Hsu Yun arrived there and asked the monks about Wen Chi no one had ever heard of him. Similarly, several days after the initial episode of carrying the young girl up the mountains to the Obeah's hut the Wanderling returned to seek him out. The following is what the Wanderling wrote about that incident:
As for me, I just wanted to know for sure. A couple of days later when I was able to walk and was much less sore I hiked back up the winding mountain trail to the Obeah's place. When I got to the clearing where his hut should have been, and had been a few nights before, nothing was there. No hut, no fire pit, no nothing. Not only that, to me, it looked as though nothing had ever been there.
TALON AND SCRATCH MARKS OF THE GIANT BIRD
PEACE CORPS ZEN
POWER OF THE SHAMAN: WHERE DOES IT COME FROM, HOW DOES IT WORK?
MEDITATION ALONG METEOR CRATER RIM
SHAMANS AND SHAMANISM
SEVEN AFRICAN POWERS
THE SUN DAGGER
THE WANDERLING'S JOURNEY
ZEN, THE BUDDHA, AND SHAMANISM
With thanks to: ASTDHPPHE