DOWN WITH DENGUE

October 3, 2017

My experience of going down with dengue fever following a trip to africa

 

Travelling to exotic locales is not without its hazards. In fact, the dangers can be part of the mystery and adventure that make such journeys worthwhile; preparing for them is all part of the fun, too. Reading guide books, plotting routes and packing supplies primes the mind and excites the senses in anticipation of the trip. Even those of us who have travelled extensively as part of our work still enjoy ‘gearing up’. Less enjoyable is the procession of vaccinations needed to move safely in equatorial areas. Still, temporarily being a pin-cushion is preferable to the alternative.

 

But what about the diseases that don’t yet have a reliable vaccination?

Well, we can only do so much. The most feared tropical diseases are spread by one particular species of mosquito: Aedes Aegypti. This humble creature, barely strong enough to fly against a slight breeze, poses not just a local threat… but feasibly threatens the stability of mankind on a global scale.

Precautions can be taken: wearing long sleeves, clearing areas of standing water, and the use of mosquito nets all help. Still, the sheer numbers alone make mosquito-borne illness a consistent issue.

 

I was to discover this personally in 2015, on my return to the UK after a two-week stint in Djibouti, a multi-ethnic nation of strategic importance to shipping in the Horn of Africa. I was flying with Ethiopian Airlines from bustling Addis Ababa when I started to feel headaches the like of which I had never felt before. Behind my eyes was a strong, striking pain which was driving me to distraction. I complained to the air hostess, who could do little but offer me a glass of water. It was welcome but didn’t do much for the pain! The call went out on the aircraft’s tannoy… ”Are there any medical professionals on board?”

It’s never a good sign when the captain asks that! Worse yet, there were no doctors to be found. Things were getting worse, too: a rash around my neck had made itself known and as I stood up to go to the toilet and splash my face with cold water, my knees felt weak. All in all, my body was telling me something was drastically awry. But what could I do at 30,000 feet? I decided it was time for a bit of mind over matter, man up and get a grip.

 

It was about this point I started doing that thing we all do when we start to feel unwell: I started trying to remember the exact point something didn’t feel “quite right”. The last few days at sea I had been feeling under the weather. My colleague and I, who had been flying together, had been escorting an HBO film crew as they covered the situation between pirates and private contractors in the region. Much to my colleague’s amusement, he kept telling me that I was seasick. I knew I wasn’t; I had been on choppy seas on hundreds of occasions as a maritime security advisor, so surely my sea legs were steady by now! In any case, it kept him entertained.

 

On arrival at London Heathrow I made it to the baggage carousel. I was doing well until my knees buckled beneath me. I had collapsed and briefly blacked out before quickly regaining consciousness. I headed to the taxi rank against the advice of medical staff at the airport. I had made the decision to get home; I needed to get back and see my daughter, as I was taking care of her that evening.

 

In the taxi back to Hampshire I asked the rather accommodating driver to pull over as I felt sick. My system, it seems, had endured enough and decided to take the reins. I awoke in unfamiliar and clinical surroundings which turned out to be the quarantine ward of Winchester Hospital. If you remember, at that time an Ebola epidemic was sweeping through West Africa and the staff were taking no chances. Five days I spent recovering my energy while blood tests were taken. The doctor came to me with the conclusive results… Dengue Fever.

 

In terms of who catches it, Dengue fever is an indiscriminate disease. If there are conditions useful to mosquitos it can reach young and old, and local populations and travellers alike. The World Health Organisation notes that there are around 390 million Dengue virus infections each year, and that figure is likely to rise with rapid urbanisation in sub-tropical countries. Before 1970 there were only nine countries affected by Dengue epidemics. Now, unfortunately, the disease is endemic in more than 100 countries.

In terms of epidemiology, the disease is new; there are no ancient manuscripts charting its outbreaks like there are for leprosy or polio. In fact, it only started cropping up in the late 1700’s. It’s likely that the virus mutated from one that was harmless to humans and started spreading with the opening up of trade in the Americas. We know that in 1780 the disease had spread as far as Philadelphia, and at that point a famous physician by the name of Dr Benjamin Rush named it “breakbone fever” after listening to a description one of his patients gave about terrible pain he was feeling in his joints.

 

Dengue fever can be fatal, especially if Dengue hemorrhagic fever, also known as ‘severe Dengue’, develops. This is where problems in capillary permeability occur and blood can be seen to pool under the skin and bleed from the nose and gums. The best defence against Dengue is to prevent contact with mosquitos where possible; staying indoors where there is good air conditioning is ideal, but not always practical. Powerful mosquito repellent will limit the chances of infection while you are on the move.

 

The indigenous communities that sometimes have to deal with Dengue with limited access to medical care swear by certain folk remedies. They will place plants such as citronella and feverfew around their homes as these naturally repel mosquitos. Malaysians swear by drinking the juice of crushed papaya leaves, which they say increases the platelet count in blood and relieves the aches and chills of Dengue.

 

Once contracted, it is early diagnosis and quick hospital treatment that saves lives. Look out for all the symptoms I described happening to me, especially the tell-tale red rash. Also, be aware that blood pressure tends to drop quickly when it’s not staying in your arteries like it’s supposed to… I suppose that explains the fainting. So, no point trying to tough it out, get to a hospital right away!

 

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