Dengue is a mosquito-borne infection that in recent years has become a major international public health concern. Dengue is found in tropical and sub-tropical regions around the world, predominantly in urban and semi-urban areas; more recently, dengue incidence has increased in Central and South America. Outbreaks of dengue fever have been reported annually in Costa Rica since 1993. In 2006 dengue cases declined from previous years in Costa Rica. So far this year, it appears that the number of cases are on the rise.
Dengue fever and dengue hemorrhagic fever (DHF) are viral diseases transmitted from person to person by the Aedes mosquitoes.
There are four distinct, but closely related viruses that cause dengue. Immunity to the infectious strain is long lasting, whereas broader immunity to other strains lasts only 2 to 12 months. There is good evidence that further infection increases the risk of the more serious DHF.
Classic Dengue Fever is very similar to having a severe flu virus. The symptoms start about 4-7 days after being bitten, and are characterized by sudden onset of a high fever, severe headache, pain behind the eyes and severe joint and muscle pain. Many people also experience nausea, vomiting, and a rash. Mild cases usually start improving after 3 days but generalised weakness and fatigue can last several weeks. Full recovery is normal.
Dengue hemorrhagic fever (DHF) is a potentially deadly complication. This version CAN be fatal, so if you are suffering the symptoms described above, see a doctor ASAP, even if you have returned to your home country. Do not ignore these symptoms.
This is based mainly on symptoms, a blood test can show low Platelets which is indicative of Dengue. A more specific blood test is available in specialised centres.
There is no specific treatment for dengue fever and antibiotics should not be used. Acetinomephin (Paracetamol or Tylenol) is used for reducing the fever, and for relieving the muscle aches and headache. Under NO circumstances should Aspirin or any other type of NSAID such as Ibuprofen (Advil, Motrin) be given. Oral fluids are to be encouraged.
DHF will require hospitalization and intensive support therapy with intravenous fluids.
It is hoped that within the next several years a vaccine will be available against all 4 strains of Dengue.
Prevention and control
Since there is currently no vaccine for dengue, prevention relies on avoiding mosquito bites and eliminating breeding sites.
To avoid mosquito bites, insect repellent should be used in the early to mid-morning hours, as well as in the late afternoon and early evening. These are the times that the aedes mosquito bites. Wear long sleeves and pants for added protection.
The aedes mosquito likes to breed in standing water. The mosquito can use as little as a teaspoon of water on the bottom of a coffee cup. Removal of all standing water helps prevent further breeding of the mosquito. Plastic containers, old tires, house plants, old oil drums, anywhere that water can collect and stay is an ideal breeding ground for mosquitos and should be discarded. Change the water in pet dishes and bird baths regularly.
When someone is infected with dengue fever, they spread the disease to mosquitos that bite them. When they no longer have a fever, they are not transmitting the virus to mosquitos. During the febrile period, an infected person should rest under a mosquito net and dilingently use insect repellent to avoid getting bitten for the protection of others.
We can work together to prevent dengue by keeping alert for breeding areas, eliminating them and avoid getting bitten.
Insect repellents which contain DEET, Picaridin or oil of lemon eucalyptus are recommended. Adults can use products containing up to 30% DEET. Products with 15%-30% DEET will protect for 5-8 hours. Products with 15% DEET will protect for 1-5 hours. Children should use products containing no more than 10% DEET or Picaridin. DEET or picaridin should not be used on children under 2 months of age and oil of lemon eucalyptus should not be used on children under 3 years of age.
On behalf of our community Mel would like to thank the following people for their incredible generosity that has enabled the community to have some vital life saving equipment including a defibrillator, ECG and pulse oximetry machine, vacuum air mattress and splints and breathing equipment.
We managed to raise 12,000 USD:
Our sincere thanks go to: Flor Blanca Hotel, Anna Wachtmeister, Brett & Mary, Anne, Carlotta, Daniella, Hidden Coast Realty, Lenny, Macasnes Family, Malpais Surf Camp, Man Leon & Family, Maramar, Nazca Pacifica, Tropico Latino Hotel, Tropisphere, Valley Hermosa School.
For Further Information: Mel 8685251
One person has commented on this article.
I had forgotten a lot of this info practicing as an ophthalmologist in the US, but this was perfect and relevant given my recent travels to Costa Rica. I was there 15 years ago in Chirripo an Corcovados and was eaten alive my mosquitoes, fortunately nothing came of this and hope for the same again.