Dengue fever and dengue hemorrhagic fever are at epidemic levels in Costa Rica. Only malaria surpasses dengue as a worldwide tropical infectious disease. Citing the journal of Clinical Microbiology Reviews global statistics, approximately 100 million cases of dengue fever occur annually, with 500,000 cases of dengue hemorrhagic fever, and 25,000 deaths.
Dengue fever is a very old disease. Around 300 AD Chinese medical texts reported a dengue-like illness called ‘water poison’ that was related to flying insects associated with water. In the late 1700’s apparent dengue epidemics occurred in Asia, Africa and North America. The first known epidemic of dengue hemorrhagic fever (DHF) began in the Philippines in 1954. In 1981 the world’s largest epidemic of DHF occurred in Cuba.
The global pandemic of dengue has its roots in the ecologic disruption of Southeast Asia and the Pacific during and following World War II. Present day resurgence of dengue and DHF is thought to relate to unprecedented global population growth, unplanned and uncontrolled urbanization especially in tropical regions, insufficient home based environmental hygiene mosquito control (the only method shown to be effective), increased air travel and decay of public health infrastructures.
Dengue virus produces mild to severe flu-like symptoms and is spread by the bite of infected mosquitoes from one person to another. Symptoms may show with abrupt high fever, frontal headache, body aches, bone pain, rash, altered taste, mild sore throat, nausea, vomiting and loss of appetite. Dengue is also known as breakbone fever and the African ki denga pepo, a term found in English literature during the 1827-1828 Caribbean outbreak. Dengue fever is generally self limiting, but recovery may take weeks. Young children generally experience milder symptoms then older children and adults.
Dengue hemorrhagic fever can be a severe, potentially fatal, bleeding complication of dengue that may show with bruising of skin and bleeding of gums, nose and other orifices. People who have previously had a dengue infection are at more risk for DHF if it recurs. Fatalities due to DHF are more common in children and young adults. Risk factors for dengue hemorrhagic fever include a person's age, immune status and which one or combination of the four dengue virus strains a person contracts.
While found in rural areas, dengue is more common in city environments. The types of mosquitoes that transmit dengue are homebodies. They like to rest indoors, are unobtrusive, and prefer to feed on humans during daylight hours. To breed, any standing water in or near dwellings will do; plant containers, plastic bottles, old tires, buckets. Infected female mosquitoes transmit dengue when probing human skin for a blood meal. These somewhat skittish insects don’t have to draw blood to transmit the virus, probing alone will do.
There is no vaccine to prevent dengue. Prevention entails avoidance of mosquito bites where dengue occurs or might occur, and eliminating breeding sites; that’s any standing water for longer than one day. Oral supplementation of Vitamin B1 (Thiamine) 50-100 mg daily tends to repel mosquitoes, while many perfume products will attract mosquitoes.
Seek medical care immediately if you suspect you may have dengue fever. There is no specific treatment for the dengue virus, however there are supportive life saving medical interventions for DHF.
People with dengue fever need rest and plenty of fluid to prevent dehydration. Frequent small amounts are better then infrequent large amounts to avoid vomiting. Do not rely on soda or sport drinks if diarrhea is present because the high sugar content may worsen the condition. Liquid used to steam vegetables provides a good source of electrolytes, and any pharmacy should have electrolyte replacement drinks. This is especially important for children and infants if vomiting or diarrhea is present. Symptoms of inadequate fluid intake such as dry sticky mouth, low or no urine output, no tears, lethargy or sunken eyes require medical attention.
To protect others, infected individuals need to be kept away from mosquitoes for at least 6 days. Use acetaminophen, not aspirin for aches and pains. Aspirin may aggravate bleeding tendencies associated with DHF, and aspirin used during a viral illness may lead to Reye's Syndrome in children, a rare condition that can lead to brain and liver damage. Fever is an attempt of the body to kill virus, so a little temperature may be acceptable. Hypericum or St. John’s Wort posse’s anti-viral properties against the family of dengue virus and is an herb to consider for dengue treatment. Check with your doctor before using Hypericum if you are taking any prescription medications.
Avoid herbal and fungal (mushroom) immune system stimulants such as echinacea and shitake. They may exacerbate the immune irregularities of DHF.
Milkthistle, taken as directed from health food stores, helps protect the liver from possible dengue damage. If you haven’t lost your appetite artichoke, radish, and beets all aide in liver function. Ginger powder (1/4-1/2 tsp.) in hot water, is a safe time tested anti-nausea therapy taken as needed.
Don’t forget homeopathic medicine to ease the illness. In the absence of a qualified homeopathic practitioner, consider the following homeopathic preparations based on the dominant symptom profile from a homeopathic pharmacy or retailer: Belladonna if intense pain and high temperature, Baptisia or Gelsimium if confusion, Eupatorium per. if severe bone pain and Bryonia if feeling dry, thirsty, severe headache and aches that are worse with any movement.
Homeopathic remedies come in different strengths or potencies and have several numerical systems to quantify the strength. Strengths such as 12X, 24X or 30C are generally considered low dose and applicable for home use. Typically a sick person would take a few pellets of Belladonna for example, either 12X, 24X, or 30C depending on what's available, or a few drops in water if liquid homeopathic, and see if improvement occurs in the next 1-3 hours. If feeling better, give no more of the remedy unless relapse occurs. If no improvement, try a different remedy. I usually advise no more then 3 or 4 doses of a remedy without consulting a practitioner, or more then 3 different remedies during the course of an illness without professional guidance.
Weakness, exhaustion and a slow recovery may be mitigated with the following regimen for adults: Vitamin C to repair tissue and aide in immune status recovery, 500mg twice daily. Fish oil supplements to reduce inflammation about 1200mg twice daily (taken in the middle of your meal to avoid burping), and milkthistle as above to help remove toxic waste products accumulated during the fever.
In Health,
Jon Dunn, ND
Dr. Jon Dunn is a Naturopathic Physician. Comments and questions are welcome and can be sent to wonc2000@hotmail.com or www.drjondunn.com
