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With the rains coming back watch out for Dengue


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Dafey

 

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Coronavirus overshadows another dangerous viral outbreak

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SINGAPORE — The first of Yuli Irma’s children to fall ill with a fever was her 6-year-old girl. The next day it was her 13-year-old daughter, followed by her 12-year-old son.

Living on the outskirts of the Indonesian capital of Jakarta, Irma feared her children were stricken with the coronavirus. But blood tests revealed they had dengue fever, another viral disease that’s in the throes of an outbreak but has been overshadowed by COVID-19.

After a record number of cases last year, the illness is relentlessly spreading across Southeast Asia, a hot zone where the mosquitoes that transmit the virus flourish. The painful disease kills thousands each year and infects hundreds of millions within a band of tropical territory spanning the globe.

While the overwhelming majority of people infected never present symptoms, severe cases can result in bleeding, respiratory distress and organ failure. More common symptoms — a few that mirror the coronavirus — include high fevers, severe headaches and excruciating joint pain deserving of dengue’s sobriquet, “breakbone fever.”

The rise in dengue fever cases is further straining medical resources in countries such as Indonesia at a time when health care facilities are dealing with the crushing demands of a pandemic — a stark reminder of how the coronavirus’ impact on health is rippling far beyond just those it sickens.

People worldwide are delaying elective surgery. Noncoronavirus patients are competing for diminishing supplies of ventilators, antiviral drugs and sedatives. And countries with chronically low numbers of medical staff are being pushed to the brink.

It took days for Irma to find treatment for her children. A doctor drew blood samples at home because Irma feared exposing the youngsters to the coronavirus at a hospital. When the tests revealed dengue, it took several more days to find a facility that wasn’t designated for COVID-19 patients.

“The children were very weak and dizzy by then,” said Irma, 42, whose children were hospitalized for four days in April.

Dengue’s early flulike symptoms can be confused for the coronavirus. Some patients have been found to have both, exponentially worsening their chances of recovery. The first person with COVID-19 to die in Thailand was also infected by dengue (pronounced deng-ee). In February, two Singaporeans with COVID-19 were misdiagnosed as having dengue.

Like the coronavirus, there is no cure for the disease, though researchers have been trying for decades to develop a vaccine — a sobering prospect for those expecting a COVID-19 vaccine to be ready in less than two years.

Development has been complicated by the fact the dengue virus appears in four different forms, known as serotypes. Patients who recover from one serotype can develop an immunity, but they face severe illness if they’re later infected by another serotyope. A successful vaccine would have to target all four serotypes.

One promising vaccine ended up being marred by controversy. In 2016, the Philippines stopped a vaccination drive that used a drug sold by French pharmaceutical manufacturer Sanofi Pasteur after children began dying.

Sanofi Pasteur subsequently disclosed its vaccine was making children ill who had never had dengue. The World Health Organization now recommends the drug only for those who have had dengue in the past. The scandal resulted in indictments of government officials and medical researchers in the Philippines, and a public mistrust of inoculations that contributed to a major recurrence of measles last year.

“It’s sort of a cautionary tale while we’re searching for a COVID-19 vaccine,” said Dr. Leong Hoe Nam, an infectious diseases expert at Mount Elizabeth Novena Hospital in Singapore. “Vaccines don’t always behave the way we want them to.”

While dengue is also found in Africa and countries south of the United States, 70% of its occurrence is in Asia. Before 1970, only nine countries had severe dengue epidemics, according to the World Health Organization.

Since then, mass urbanization, explosive growth in travel and warming weather has propelled the spread of the disease, making it endemic in 128 countries. Dengue is considered a “neglected tropical disease,” a title given by health officials to describe illnesses that occur in mostly poorer countries that receive inadequate attention.

The World Health Organization last year named dengue one of the top 10 public health threats and urged countries to improve surveillance of female Aedes mosquitoes, the pests most responsible for spreading the disease.

Experts are unsure what impact social restrictions and widespread lockdowns will have on the spread of the disease. Aedes mosquito bites most commonly occur inside homes, which is where people are now confined.

The likelihood of infection “is probably increased with everyone staying at home, but the lack of mobility may limit its spread,” said Duane Gubler, founding director of the Emerging Infectious Diseases Signature Research Programme at Duke-NUS Medical School in Singapore. “We’re going to have to wait and see.”

Dengue outbreaks tend to come in waves lasting several years. The duration of outbreaks depend on populations developing herd immunity to strains of the virus before a new one can gain momentum.

Countries such as Singapore have learned to live with the disease by promoting what amounts to social distancing with mosquitoes.

Citizens here are regularly reminded by inspectors to eliminate sources of stagnant water. Construction sites, prime places for puddles, must include on-site pest control officers charged with eliminating larvae. And residential neighborhoods are periodically doused with plumes of organic insecticides, a practice known as fogging.

Earlier this month, the country’s National Environment Agency expanded a program releasing male mosquitoes loaded with bacterium designed to prevent eggs from hatching after mating.

Despite increased vigilance, however, dengue cases, including a senior member of parliament, have doubled compared with the same period last year, to 6,900 — all while the country’s health network has had to treat nearly 25,000 coronavirus patients.

“We are all susceptible to dengue and it’s a war we can’t fight alone. We need each other, more than ever before,” Low Yen Ling, a member of parliament since 2015, wrote on her Facebook page.

Guo Xian has been vigilant since he saw public health banners up in his central Singapore neighborhood warning of a local dengue outbreak. The radio producer contracted the disease three years ago and had to be hospitalized with a high fever and a rash. To reduce his chances of getting dengue again — and facing an even worse episode — he has reduced his morning jogs and begun applying mosquito repellent liberally, even indoors.

“Ever since I got discharged, I’ve been paranoid,” said Guo, 46, who feels dengue sapped him of some of his energy. “You’ve always got to be careful, especially now because of dengue and COVID-19.”

https://www.msn.com/en-ph/news/world/coronavirus-overshadows-another-dangerous-viral-outbreak/ar-BB141NUn?ocid=spartandhp

 

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Salty Dog

My SIL and her son in Sorsogon City both have Dengue. To make things worse, they are in the path of Typhoon Ambo...

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Headshot
58 minutes ago, Salty Dog said:

My SIL and her son in Sorsogon City both have Dengue. To make things worse, they are in the path of Typhoon Ambo...

They have my empathy. I had a stroke right when Typhoon Yolanda went through in 2013. It was not a good scenario. Dengue waited until 2015 to hit me, but I know all about that too. Make sure that your SIL and nephew both get to the hospital to get checked out. Dengue can be a lot more serious than a lot of people think.

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Dafey

@Headshot, I know you have a wealth of knowledge for avoiding Dengue, perhaps you could share with us again?

I know one thing we do is to make sure there is no standing water around our homes. i.e. buckets, cans and puddles where water has collected.

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RogerDuMond

Aedes Mosquitoes

Can any type of mosquito carry dengue? The dengue virus is carried and spread by mosquitoes in the genus Aedes, which includes a number of mosquito species. Of these species, the primary vector of the dengue virus is the species Aedes aegypti. It is the principal dengue vector responsible for dengue transmission and dengue epidemics. Other mosquito species in the genus Aedes — including Aedes albopictus, Aedes polynesiensis, and Aedes scutellaris — have a limited ability to serve as dengue vectors.

Aedes aegypti is a small, dark mosquito that can be identified by the white bands on its legs and a silver-white pattern of scales on its body that looks like an ancient Greek musical instrument called a lyre (Figure 1). Where are these mosquitoes found? Aedes aegypti dwell in tropical and subtropical regions all over the world, mainly between the latitudes of 35°N and 35°S where the winter temperature is no colder than 10°C. Although some mosquitoes may travel farther north or south of these latitudes, they are unable to survive cold winters. Because Aedes aegypti require a warm climate, they typically do not live at altitudes above 1000 m, where the temperature is colder. These mosquitoes are associated with the living spaces of humans. They generally spend their entire lives in and around the houses where their eggs hatched.

dengue.jpg.f42733619a404b0f1ad73409e0763dd3.jpg

https://www.nature.com/scitable/topicpage/dengue-transmission-22399758/

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Ozepete

As a kid my father had us put oil on any stagnant water to slow the mosquito numbers. The 'skin' of oil floating on the water stopped the mosquito larvae from being able to breathe.  

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Headshot
3 hours ago, Dafey said:

@Headshot, I know you have a wealth of knowledge for avoiding Dengue, perhaps you could share with us again?

I know one thing we do is to make sure there is no standing water around our homes. i.e. buckets, cans and puddles where water has collected.

Keeping standing water away from your home is a good thing, but mosquitoes can fly further than that. The standing water they hatched in may be blocks away from your home. Just a slight breeze might bring them to you. They don't like to fly in high winds. I rarely see mosquitoes at my home even though we live next to two ponds with lots of stagnant water. Of course, it helps that we live very close to the Lion-Tiger plant where they manufacture mosquito coils. For some reason, mosquitoes just don't like to hang out in the area. We also have thousands of bats flying around in the evening (presumably eating many mosquitoes).

Unfortunately, I was bit while I was in the Mandaue City Police Station (after a lady ran into my car with hers). There were lots of tiny mosquitoes in the office. I hadn't applied repellent that day, and I got bit. I never felt the bite because the mosquitoes that carry Dengue are tiny, and you will likely not feel them bite. That is one thing people should know about these mosquitoes. Unless you see the mosquito on you, it is unlikely you will know you were bitten.

The mosquitoes that carry Dengue typically only fly for a couple of hours around sunset, and they rarely fly more than a foot off the ground. That does not mean they can't make it to the 23rd floor of a building though. I once killed a Dengue mosquito in the elevator of Chong Hua Hospital when we were going to visit a friend who had Dengue. I guess the mosquito was on its way up to get infected. So, without flying more than a foot off the ground, mosquitoes can make it to any floor. They also have no problem flying at any time of the day or night inside buildings. What they don't like is bright sunlight or darkness. An artificially lit area (regardless of time) is an invitation to them.

Because they fly so close to the ground, it is most important to apply mosquito repellent from your knees to your feet (especially if you wear sandals). However, it is probably be advisable to apply it to any exposed skin if you have the time. Since I got Dengue, we always have a supply of Off lotion on our kitchen counter and in the console of our car for easy access. My wife makes sure that everybody uses it.

There are four strains of Dengue Fever. Getting one will confer immunity to that strain, but actually makes you more susceptible to the other three strains. The first infection will likely make you very sick. A second or third infection will likely kill you. Even the first infection can be serious. My heart muscle was damaged when I got Dengue, which is why I now have a heart device implanted in my chest that keeps my heart beating regularly (85 bpm) and keeps me from having heart failure (among other things). Otherwise, my ventricle chambers wouldn't beat on their own and my atrial chambers would be overworked carrying the whole load. The doctors don't talk about that much as a possible effect of contracting Dengue (mostly because it isn't what kills most Dengue patients). Massive internal bleeding is the greatest danger from Dengue Fever.

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yingy52
8 hours ago, Ozepete said:

As a kid my father had us put oil on any stagnant water to slow the mosquito numbers. The 'skin' of oil floating on the water stopped the mosquito larvae from being able to breathe.  

Those poor mosquitoes.

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Irenicus
On 5/15/2020 at 7:51 AM, RogerDuMond said:

Can any type of mosquito carry dengue?

Yeah, it's the little bastards that get ya below the knees.  Don't often feel the bite as they are so small but they itch like hell.

I got Dengue back in December.  No bleeding but my count went down to 30.  Took lots of paracetamol, drank jugs of tawa-tawa, lost 15 pounds and slept for about a week.  You only feel half-dead for that week, but it takes about a month to get back to 100 percent.

And yeah, I use the off and wear long, VC pajama bottoms when outside at dusk and dawn.

Dengue ain't no frikken joke. 

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Dafey
Posted (edited)
31 minutes ago, Irenicus said:

Yeah, it's the little bastards that get ya below the knees

Is that true? I hate those guys. They sneak up on you!

Glad you recovered

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