The Indonesian health authorities have been adequately challenged in these past few weeks with no less than 3 epidemics (and potential endemics) throughout the archipelago. An outbreak of polio in West Java with over 220 cases and rising by the day; Avian “Bird flu” claiming the lives of 3 in one family, and Dengue fever which has caught all authorities off guard with it’s unseasonable appearance. There have been 3 deaths in Bali alone, and Jakarta has declared the disease an epidemic.
What Is Dengue Fever?
Dengue fever is a serious viral illness, transmitted by the Aedes Aegypti (Tiger) Mosquito. Dengue occurs in two forms, Dengue Fever, and the more severe Dengue Hemorrhagic Fever (DHF). Dengue fever is a severe flu like illness that causes fever mostly in older children and adults, but rarely causes death. DHF is a second more severe form of the disease causing bleeding and shock. Severe cases may be fatal, particularly in children.
How does Dengue Fever present?
The symptoms of dengue fever may vary according to the age, and condition of the patient. Should you or your child present with any of the following signs a doctor should be consulted immediately to confirm diagnosis.
Dengue fever:
-Abrupt onset of high fever (>39 c or 102 f).
-Headache.
-Pain behind the eyes. Muscle & joint pain.
-Rash.
-Loss of appetite. Nausea / vomiting.
D.H.F:
-All or any of the above symptoms.
-Severe stomach pains.
-Pale, cold or clammy skin.
-Bleeding from the nose mouth or gums. Bruising, or “blotchiness” under the skin.
-Vomiting, with or without blood. (N.B. Vomited blood may be red or dark brown / black in appearance).
-Black stools (Digested blood).
-Change in level of consciousness (Drowsy, fainting).
-Restlessness. Inconsolable crying in children / babies.
-Excessive thirst. Rapid, weak pulse.
-Difficulty in breathing.
PERSONS EXHIBITING ANY OF THESE SYMPTOMS MUST SEEK MEDICAL ATTENTION IMMEDIATELY.
Treatment
Firstly, there is no curative treatment for Dengue, (i.e. No magic pill, injection etc. that will cure it). Dengue is treated symptomatically by reducing the fever, analgesics for headache (Aspirin or any other NSAID painkillers must never be given for Dengue, as it will increase the bleeding tendencies. Codiene, paracetamol or acetomenaphin are safe). Intravenous fluids are given to treat dehydration, and in severe cases of shock, blood transfusion may be required.
Prevention
While Dengue fever can occur at any time of year, it commonly occurs in epidemic proportions toward the end of the monsoons. This is when the Aedes (“tiger”) mosquito breeds rampantly in water catchments, puddles and ponds. It is a myth by the way, that this creature prefers murky, stagnant, or putrid water holes…it feels just at home bringing its young into this world in pristine waters as it does the murky ones! So why are we experiencing such an outbreak in the middle of the dry, windy season? And why does this years strain seem to be particularly nasty? Who knows!? More to the point would be how we can prevent further cases of the disease. Government fogging programs are obviously not doing the job. (I have not had a fogger in my street for more than 3 months). While this method will kill adult mosquitoes if they are up and about, it does not kill the larvae, nor does it solve the problem that these little blighters are breeding faster than we can control them. The answer must be in prevention by eliminating the mozzie “sex ponds”! ..those little soggy, wet areas where the Saturday night mozzie trippers get it together for a night of sordid romance. In Singapore “Dengue prevention officers” can issue on the spot fines for anyone who leaves water catchments “wet” during the dengue season. Here is what you can do to prevent the breeding cycle in your area.
-Make sure that your garden and surrounding area are free of water catchments, or that water containers are covered.
-Keep larvae eating fish, such as guppies, in ponds.
Use chemical larvicide’s in ponds, drains or other water catchments. The common pesticides used for larvae are Abate, Altosid and Bti. Abate is a species-specific organo-phosphate that breaks down in the environment within 36 hours.
-Remove garbage or unnecessary pots, bottles, cans etc from the garden area.
-Lush garden areas should be fogged regularly in the monsoon season.
…
and secondly, don’t get bitten!
-Mozzie coils, or vapor mats can be used indoors in the early mornings and late afternoons during the wet season.
-Mosquito nets and screens can be used in problem areas.
Babies and young children should always be protected by cot, or pram covers.
-Wear long sleeved, loose light colored clothing while walking in garden areas.
-Personal repellants may be used; however, they should be used with caution in the very young, or the elderly.
-People suffering from dengue should also be protected from the mosquitoes bite, so as the disease cannot be passed on.
Remember that if you have previously suffered from Dengue fever, you are not immune to the disease. In fact subsequent attacks may be much worse than your initial encounter.
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Kim Patra is a qualified Registered Nurse and Midwife that has been living and working in Bali for almost twenty years. She now runs her own private practice and medical referral service from her Kuta office. Kim is happy to discuss any health concerns with you and she may be contacted via e-mail at info@chcbali.com”.
