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Tuesday, June 14, 2005
Watch out for that killer bite!
By Henrylito D. Tacio
Health 101
IN THE summer of 2000, Mario went to Baguio City for a much-needed vacation. Unknowingly, he contracted dengue while roaming under the beautiful pine trees. That night, he experienced fever and severe headache.
His friends noticed that it was not just an ordinary headache and fever so they brought him to Manila. But it was already too late; Mario suffered hemorrhage in the liver and succumbed three weeks after being confined at the hospital. The doctor said he died of dengue.
Dengue viruses are transmitted to humans through the bite of infected Aedes aegypti mosquito. "Dengue is the world's most important viral disease transmitted by mosquitoes," reminds Dr. Duane Gubler, health administrator of the Atlanta-based U.S. Centers for Disease Control and Prevention.
The dengue-carrying mosquito is attracted to the odor and sweat of human beings and bites only during daytime. However, its peak biting time is after sunrise and at dusk--especially one hour before sunset. Like all other mosquitoes, only the female bites.
Health officials contend that the time between the bite of a mosquito carrying dengue virus and the start of symptoms averages four to six days, with a range of three to fourteen days.
Some 2,500 million people are now at risk from dengue, according to the Geneva-based World Health Organization (WHO). In Asia, dengue is now one of the leading causes of death, particularly among children.
"The number of recorded cases per year in the region is about 200,000 to 400,000, but this is just the tip of the iceberg," bared Dr. Allan Schapira, former epidemiologist at the WHO regional office. "The real number of infection is probably about 10 times as high, but many people get infected without falling sick."
The symptoms of dengue fever vary according to the age of the patient. Infants and young children may have an undifferentiated febrile disease with rash.
Older children and adults may have either a mild febrile syndrome or the classical incapacitating disease with abrupt onset and high fever, severe headache, pain behind the eyes, muscle and joint pains, and rash.
DHF is a potentially deadly complication that is characterized by high fever, hemorrhagic phenomena--often with enlargement of the liver--and in severe cases, circulatory failure.
The illness commonly starts with a sudden rise in temperature accompanied by facial flush and other nonspecific constitutional symptoms of dengue fever. The fever usually continues for 2-7 days and can be as high as 40-41 degrees Celsius, possibly with febrile convulsions and hemorrhagic phenomena.
Most of those who die from complications of dengue are in children under 15. "Dengue is a big problem among children because it is a major cause of illness and deaths," says Dr. Lulu Bravo, of the College of Medicine at the University of the Philippines.
Approximately 5 percent of all DHF cases are fatal. "Death is due to the body fluids leaving the blood vessels and accumulates in body cavities or spacing, thus causing shock," Dr. Bravo explains. "It may also be due to severe bleeding either internally into the intestines, in the brain, or in other organs of the body."
Dengue is caused by one of four dengue viruses. Recovery from infections ensures lifelong immunity against the particular virus involved, but not against the other three. Even worse, if subsequent infection with a different serotype occurs, it is believed to increase susceptibility to DHF.
Until now, there is still no specific treatment for dengue fever. "There is no antiviral or antibiotic that can directly fight off the dengue virus," says Dr. Garcia. "All that the physician can do is to give supportive treatment such as anti-fever pills (like paracetamol) and plenty of fluids (orally and intravenously)."
Aspirin should not be given to any patient with fever as a home remedy because it can further aggravate bleeding.
For patients with dengue fever, they may be brought to the hospital for admission or may stay at home. If not admitted, they should be given plenty of fluids (water or juices). Should any of the severe symptoms appear, they should be brought immediately to the hospital.
Although there is no effective dengue vaccine as yet, hope is on the horizon. As vaccine is still far from reality, the best measure against dengue fever and DHF is protection. To curtail dengue and its deadly complication, medical experts offer these timely tips.
The community should organize themselves to remove all possible breeding places of mosquitoes inside and outside of houses and/or offices.
"We can control dengue if we work together," says Dr. Schapira. "Every individual, building administrator, company owner, mayor, and barangay captain must ensure that there are no uncovered water containers or receptacles for mosquitoes to breed in. By doing just that, we can all save lives."
For Bisaya stories from Davao. Click here. (June 14, 2005 issue)
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