The Viral Illness That Packs Quite a Sting

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August 16, 2011

Natasha Whymms has just come through the worst sickness of her life.  It was one she thought she would die from, and says she wouldn't wish that experience on her worst enemy.It starts off sneakily.  Initially you feel a bit under the weather, the next thing you know you are suffering from aches and pains so intense it feels like your entire body is under attack.  Coupled with a fever and the fact that you don't want to eat anything, it could feel like you are in your final days.  After a few days of suffering, taking painkillers to combat the full body pain and keeping your body hydrated with fluids, it vanishes like a mist in the sun.  This is what it has been like for a number of people over the last few weeks as the health care system battles with the onslaught of dengue fever, the viral disease that has shaken up the community.  This outbreak has been the worst instance of the illness to occur in The Bahamas in recent history.

For most people, dengue fever comes and goes without too much of a fuss, but for others it is a debilitating experience that they wouldn't wish upon their worst enemy.  Contracting it was an experience that 28-year-old Natasha Whymms hopes she never has again."It felt like a regular cold in the beginning ... I didn't even think twice about it being something serious at first," says Whymms.  "I went to work normally just feeling a bit under the weather, but by that afternoon I was in terrible shape.  I was aching in places I didn't know I had ... behind my eyes were so painful I was sure my eyes were going to pop out.  By the time I got home trying to get out of the car was debilitatingly painful.  It was terrible.  I couldn't drink much or even eat.  It was just horrible."By the next day she says her symptoms were worse.  Whymms was so weak she could barely pick up the phone to call a doctor.  She was informed by a medical physician that she exhibited dengue fever symptoms and assured that as long as she hydrated, took painkillers and rested for a few days, it would pass.  As the disease ran its course, what she remembers most besides the pain is that even though her air-conditioning was on, she felt like she was "boiling" and freezing at the same time."That was the worst sickness I have ever had," said Whymms.  "I literally thought I would die.  It was so bad I wouldn't even wish it on my worst enemy."

With an average of 100 reported dengue fever cases per day over the past week, and more than 2,000 clinical cases reported, Dr. Delon Brennen, deputy chief medical officer at the Ministry of Health and pediatric emergency medicine specialist says dengue fever, although alarming in its symptoms and the numbers of people being affected, is not a highly dangerous or deadly disease for most people. Treatment can often be administered at home with the patient simply keeping themselves well hydrated throughout the illness and taking Panadol, Tylenol or Calpol for their pain.  It is not advised to take aspirins or ibuprofen painkillers such as Advil, Bayer or Motrin as these pills while good for heart attacks, prevent clotting of the blood which is not good since your platelet  (the part of your blood that assists in clotting) count is very low due to the illness and can cause unnecessary complications in your recovery.


"It is not highly contagious in the sense that it is airborne and simply breathing the air of someone with it will infect you," says Dr. Brennen.  "Dengue is in fact a viral illness much like influenza, another viral disease.  The only difference is that unlike influenza, dengue isn't transmitted person to person, but via vector or carrier.  In this case the Aedes aegypti mosquito."The doctor says dengue fever is different from the typical cold or influenza through its intensity and the fact that there is no real treatment for it. Symptoms of this illness include a fever, joint pain, back pain, retro orbital discomfort, muscle aches, rash and sometimes even pain that seems to emanate from the bones.  In relatively healthy people the illness should persist for about a week to two weeks.  In persons with compromised immune systems or chronic conditions like diabetes, sickle cell anemia or HIV it can last longer and in-patient treatment may be required."


Complications a person can experience due to dengue fever are dengue shock syndrome (DSS)  and dengue haemorrhagic fever (DHF), says the health professional.

A person will suffer with dengue shock syndrome if he does not keep himself hydrated, which tends to happen the doctor says, because the patient will not feel very well and often cannot keep down foods or even water, so they will just not try.  By not trying to stay hydrated, the person afflicted with dengue fever is prolonging his own recovery, and putting stress on his organs.The medical professional says patients that do not adhere to medical advise can also end up with a capillary leak due to small blood vessels becoming too permeable and all the products their body produces like glucose and salts are not flowing properly due to insufficient fluids to help them circulate around the body.  As a result, the organs become deprived and don't function the way they should, which leads to organs starting to shut down, which is when a person suffering with dengue fever needs to be admitted to a hospital.Dengue haemorrhagic fever is another complication that is equally dangerous, and comes about as a result of the natural course of the illness says the physician.

Even in healthy people it starts off the same, with the platelet count then the white blood cell count becoming greatly reduced as the disease sets in.  He says everyone who has dengue experiences this, but most people tolerate it well and don't notice any differences.  The problem arises when your platelet count drops too low because you become susceptible to hemorrhaging or bleeding out which happens to people who start out with a low count to begin with more often.

"The first places you notice haemorrhaging are mucosal surfaces like in the nose which means you will start to see nose bleeds or gum bleeds when you brush your teeth.  If the bleeding worsens you can start to hemorrhage internally as well in which bleeding can go anywhere in the body such as into the lungs or in your gastro-intestinal tract.  This becomes very serious because you can lose large volumes of blood long before you really notice it," says the doctor.


Although thousands of cases have been reported, Dr. Brennen says dengue fever is not endemic or native to The Bahamas, but is an outbreak that occurs and vanishes.  The last serious bouts with the illness occurred in 1998 and 2003.The reason dengue outbreaks occur locally is due in combination to the tropical climate, rainy season and the abundance of mosquitoes native to our environment says the doctor."There is no definite origins of the current outbreak, but it is clear that we have the right environment for it to thrive due to our climate and presence of mosquitoes.  This illnesses is likely brought in by visitors or locals from areas where dengue is endemic.  Unlike a similarly transmitted disease -- yellow fever -- dengue has no vaccine or cure, so we cannot have persons entering the country vaccinated against it."


While the illness is something that can be easily treated, it can be controlled by people being vigilant of their environment and taking steps to protect themselves.  Since mosquitoes need water to lay their eggs, ensuring that your yard is devoid of containers that can collect water is important.  If you live in a marshy area, or one that easily floods it is essential to spray the water with larvicides.  Doing personal insect spraying daily inside the home is also recommended.  To effectively do this you should close the windows in the selected area and then thoroughly spray the room and allow it to settle for 10 to 15 minutes prior to reentering and opening the windows. Repeat the steps in a different area until the entire home has been fumigated.  Taking these precautions should allow your home to be mosquito free, significantly reducing your chances of encountering a disease-carrying mosquito in your domestic environment."Since we cannot confine ourselves to our homes, it is essential for people to know how to protect their bodies from mosquitoes," says the doctor.  "This can be done by applying a trusted insect repellent prior to leaving the home.  And although it is summer, wearing long clothing is also a great help.  If you can wear lighter colored clothing it is good since mosquitoes tend to be a little more attracted to darker colors.

Dengue fever does not have to be a major problem for us for too long, especially if more people can just take more precautions at the end of the day for their own benefit and those of others."


Use aerosol buy spray.
Read and follow the directions ont he label.
Close windows.
Spray until the room is full with the spray, then leave the room and close the door.
Keep room closed for 10 to 15 minutes
Open windows and let fresh air in before you stay in the room again.


Tightly cover water and septic tanks.
Ensure that all garbage (cans, unused bottles, empty plant pots, drums, old tires, soakaways, tree stumps, bottle cap covers) is stored in a covered trash can.
Turn containers face down when not in use.
Fill all water puddles with sand or quarry (fill).
Completely screen all windows and doors to keep mosquitoes out of the house.
Burn mosquito coils or coconut bark.  The smoke stops mosquitoes from coming around.
Wear long-sleeved clothing and long pants.
Apply mosquito repellant to the skin

Click here to read more at The Nassau Guardian

News date : 08/16/2011    Category : Environment, Health, Nassau Guardian Stories

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