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Wednesday, September 18, 2019
CEBU

Literatus: Adult dengue, fatal risks

Breakthroughs

BECAUSE of the overwhelming number of children and adolescents among those with dengue infection, perhaps many will assume that adults are not vulnerable to dengue infection. That is far from the facts.

One key fact about dengue is that second dengue infections are far more fatal and life-threatening than the first infection. First dengue infections are either asymptomatic or are non-threatening as a “mild fever.”

Consequently, adults who were exposed to dengue infection when they were children will be at high risk for the hemorrhaging type of dengue fever. This type of fever is the killer dengue fever. They are the causes of more than 600 deaths noted in July alone. A study in Taiwan last year, shows that 17 of 39 (43.6 percent) adult patients with fatal dengue died within seven days from the start of illness. Thirteen of these 17 patients died within three days from onset of illness. In fact, Terapong Tantawichien of Chulalongkorn University (Bangkok, Thailand) affirmed that dengue infections in adults have a higher risk for death.

Let us be clear about this. Studies indicated that dengue vaccination of people without prior dengue infection could be fatal when these persons become infected with the dengue virus later on, reported Eunha Shim of Soongsil University (Korea) in February in the journal Mathematical Biosciences and Bioengineering. The dengue vaccine appears to replace the first dengue infection so that the first dengue infection after dengue vaccination causes a severe case of dengue.

Adults with fatal dengue infection are assumed to have an initial dengue infection while still children or adolescents. Thus, the best time to have a dengue vaccination is after the first infection disappears. The deadly times to receive dengue vaccinations are before the first infection and after surviving the second infection.

Therefore, scientific evidence recommends that parents must have their children tested for past dengue infection before making any decision to have their children vaccinated against dengue. If their children have had no previous dengue infection, dengue vaccination is not recommended. Parents must wait for first infection with dengue before letting their children receive dengue vaccination. If their children have had a previous dengue infection, dengue vaccination is recommended.

There had been no study yet on the safety or need for dengue vaccination after the child, adolescent, or adult survives a fatal second dengue infection.

Correction:

In last week’s entry “Dengue vaccination paralysis: Preventing ‘Killed, Killed, Killed,’” the correct sentence should have been: “The standard public management of dengue today consists of conducting a serological confirmation of past exposure with any dengue virus and the vaccination of those who have been exposed before.”


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