Dengue Fever

Dengue fever is a viral illness which is spread by mosquitoes. In its simplest form it consists of fever and chills, headache, eye pain, joint and muscle pains and a rash. The pains are so severe that it is often called "breakbone fever." In the more severe cases, especially with repeated exposure, it can result in generalized bleeding, severe kidney damage, shock and even death. Whichever type a patient gets is apt to result in a subsequent, prolonged emotional depression.

Unfortunately, there is still no prevention for dengue fever other than trying to ward off the mosquitoes that carry it. Work is being done on a vaccine, but none is available yet. The problem is that there are four types of dengue virus and it is infection with a second type which causes such severe illness after exposure to a first type. To be effective, a vaccine would have to immunize against all four types. The question then arises whether the vaccine would in fact cause the very problem it is trying to prevent. Or, if you vaccinated someone who had already had dengue fever (and therefore most needs the vaccine) would you cause more severe disease.

The disease occurs worldwide in the tropics, especially around major cities. The mosquitoes which transmit it, unlike those responsible for malaria, are day-biters and breed in small collections of water such as old tires and barrels. Its occurrence is definitely increasing in the Caribbean and in Central and South America. Most Americans who come down with it contract it in Puerto Rico or the Virgin Islands.

Treatment at this time consists of bed rest, intravenous fluids and pain medications. Plus hemodialysis if needed. It is best to avoid aspirin for pain or fever as this may cause worse bleeding.