Dengue

Ah, this lovely "little" sign is hanging in our neighborhood.  It's notice is written in English, Chinese, Malay, and Hindi.  Government officials have been going from house to house (not just yard to yard).  They are looking for places that the mosquitoes breed (i.e., standing water, leaky faucet areas, etc.)  For an American, this is a little intrusive because they want to see all sink and toilet areas.  They were handing out little bottles of "Off!" spray.  Singapore is what Jeremy always refers to as a "quasi-democratic society."  While Singapore is very much a city, and heavily populated, it is still a city within a jungle.  A tropical, humid one.

Dengue fever is caused by a virus which is transmitted by an infected Aedes mosquito - Aedes aegypti and Aedes albopictus.

Mosquitoes become infected when they bite infected humans, and later transmit infection to other people they bite.

The disease usually is self-limiting but in some people can present with life-threatening complications such as Dengue Haemorrhagic Fever and Dengue Shock Syndrome.

Symptoms

The symptoms usually develop within 4-7 days after being bitten by an infected mosquito. Symptoms of classic dengue include:

• High fever (up to 40.6 C)
• Severe headache with retro-orbital (behind the eye) pain
• Severe joint and muscle pain
• Nausea and vomiting
• Body rash which appears on day 3 or 4

Dengue Hemorrhagic Fever is a severe form of dengue fever which can result in death and is characterized by:

• Severe bleeding from the nose, gums, or under the skin causing purplish bruises

Dengue Shock Syndrome is the most severe form which usually occurs in children having a re-infection and is sometimes fatal. It often presents with:

• Massive bleeding
• Shock (very low blood pressure)

Treatment

There is no specific treatment for dengue fever and most people recover within 2 weeks. To help with recovery, general measures include:

• Getting plenty of bed rest
• Drinking lots of fluids
• Taking medicine to reduce fever. Avoid aspirin but paracetamol is considered safe

For severe dengue symptoms including shock and coma, hospitalisation and aggressive emergency treatment with fluid and electrolyte replacement may be necessary to save lives.

Complications

Most people with dengue fever recover completely within 2 weeks. The more clinically severe dengue hemorrhagic fever and dengue shock syndromes can result in vascular (blood vessel) and liver damage, and can be life-threatening.

Prevention

The best way to prevent dengue fever is by taking precautions to avoid being bitten by mosquitoes which include:

• Using a mosquito repellent containing DEET, or oil of lemon eucalyptus
• Dressing in protective clothing during the day-long-sleeved shirts, long pants, socks, and shoes especially in early morning hours before day break and in late afternoon after dark.
• Keeping unscreened windows and doors closed
• Getting rid of areas where mosquitoes breed, such as standing water in flower pots, containers, and bamboo poles.