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Dengue fever

Manchester, United...
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Dengue fever

Hi, we were in Bali for a week 12 yrs ago and when we got to next stop, Kuala Lumpur, my husband was diagnosed with Dengue Fever. We are going to Bali in February for a week - any suggestions on how to avoid daytime biting mosquitoes??

London
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1. Re: Dengue fever

I was also worried about the same and have got deet spray - it's the tropical maximum strength formula from boots and will apply regularly

We also have got deet wristbands and will get the hotel to put plug ins in the rooms and the coils

As long as you have deet on you should be ok and spray the hotel rooms with spray

Australia
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for Bali, Nusa Dua, Sanur, Tuban, Ubud
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2. Re: Dengue fever

Hi, we have a number of posts regarding dengue fever in Bali. This past year it has been worse.

You can search the forum and read all the other replies on this topic. Type "dengue fever" in the search bar.

Keep repellant on at all times especially during the day. Yes deet is good but it is also very strong and some people do not like using it. Even IF you don't use it use any other reliable repellant and be vigilant, re apply on a regular basis.

Spray your room, there are cheap cans of insect spray in the supermarkets and most hotels will have cans you can use. You can also use mosquito coils and or plug in devices for your room / patio. These are also sold in Bali. If you want also buy some wristbands.... prevention is your best form of defence.

It is advisable to be extremely cautious since your husband has already had dengue. Getting it a second time can be very dangerous. Speak to your doctor about this before you travel.

I have had dengue fever and became extremely ill.

Edited: 24 October 2012, 09:32
Newcastle, Australia
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3. Re: Dengue fever

If you have had dengue and get bitten again you will get dengue worse than before. I contracted dengue in June 2010, lost 16kgs, was extremely unwell for months. It took a long time to get over, and have been advised not to go to any countries that have dengue Mosquitos. I covered myself in repellant, but if you are at a water park or at the beach or the pool, your chances of being bitten are higher.

Lombok, Indonesia
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4. Re: Dengue fever

Mumo$ though there are risks of acquiring Dengue a second or subsequent time following a previous infection it is not an absolute as you have indicated.

Contact with the Dengue fever virus has no certain outcome of leading to Dengue Haemorrhagic Fever (DHF), nor does it even have any certainty of providing symptoms. Different people have different reactions.

As your statement is sounding a little alarmist you may possibly have received information that is a little misleading.

You sound most apprehensive to engage in further travel in sub-tropical areas.

If so I think you should reexamine your situation as you may be overly concerned.

Of course you must take adequate precautions and be wary of the situation but don't restrict your travel unnecessarily.

By all means avoid an area if there is a known serious outbreak, these do occur sometimes, but at other times just use a good repellant.

Perhaps seek the opinion of an immunologist and ask them to outline your risks, you may find it gives some re-assurance. Risks bear possibilities, but not certainties in this situation.

The development of Dengue Hemorrhagic Fever symptoms following an earlier viable infection is not the absolute it is often projected to be, it can happen, but that does not mean that it will.

In any case you have to encounter an infective mosquito of the correct genus and sex, they must successfully transmit a viable virus into your blood and you must then succumb to the infection and it must advance past the classic febrile stage before there is even the remotest chance of that occurring.

Dengue fever is transmitted by Aedes mosquito. It is the females that are problematic, but only if they are actually infected at the time you encounter them.

The males feed on fruit and are benign in regard to passing on an infection, they are of course required for breeding to occur.

The Aedes mosquitoes are active in the daytime and at dusk and dawn.

They may possibly also remain active in a locality if there is sufficient bright daylight temperature artificial lighting available.

They have a faily short life span and this generally assists in limiting the disease. if breeding conditions are ideal, and an infection is introduced to the potentially viable mosquito population then infection rates may rise.

Occasionally there are outbreaks. There is no outbreak at present but the weather patterns and lack of adequate breeding controls and mitigation has allowed the virus to remain active in Bali throughout the dry season. Fortunately this is uncommon.

The full adult life span can range from two weeks to a month depending on environmental conditions. The full life cycle of Aedes aegypti from egg to adult can be completed within one-and-a-half to three weeks. It looks like this... denguevirusnet.com/images/Aedes_aegypti_2.jpg and here cdc.gov/ncidod/dvbid/arbor/images/aedes.jpg

Edited: 26 October 2012, 17:35
Lombok, Indonesia
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5. Re: Dengue fever

The most widely accepted hypothesis put forward to explain the problem of a more complicated course of the Dengue infection sometimes being apparent in a second or subsequent infection is that of antibody-dependent enhancement (ADE).

What causes the ADE is unclear, it is thought it may arise from poor binding of non-neutralizing antibodies and delivery into the wrong compartment of white blood cells that have ingested the virus for destruction.

The effect of the previous infection is that the victims immune system reacts in a compromised manner and the outcome is worse than Dengue Fever, I have briefly outlined those potential outcomes below. Of the four different DENV serotypes the Dengue virus (DENV 1-4) seems to play an enhanced role in this potential outcome of Dengue Haemorrhagic Fever (DHF).

Normally Dengue may arise around 4-8 days from onset, but in limited cases it may develop 3-14 days subsequent to infection.

Following this period symptoms may become apparent to a varying degree. Some people are infected but suffer almost no symptoms, for them the outcomes are reasonably benign.

After incubation the Dengue infection normally runs it's course in about 4-7 days.

The recovery period may be quite drawn out requiring an extended period of convalescence. Fatigue may last for weeks afterwards.

After the incubation period symptoms such as fever, headache, pain behind the eyes and in the extremities may become evident.

The earlier stages Dengue is often mistaken for a common cold, gastroenteritis, or a 'flu' like viral infection. Vomiting and diarrhea may also occur. It also has similar symptoms to Chikungunya, that is trasmitted by the same mosquito but the outcomes are reasonably benign.

Red spots on the chest, back and limbs are common, first appearing as 'flushed' skin at day 1-2 and then developing into a rash of small red spots

Severe pain in the legs is a notorious symptom of a Dengue infection.

The febrile phase involves high fever, often over 40 °C, this usually lasts 2-7 days

Up to 80% of people infected with Dengue virus suffer no more than mild symptoms, many remain asymptomatic (free of symptoms) or have only have mild symptoms.

A dengue infection is diagnosed with a blood test seeking evidence of one of the 4 serotypes. If a patient suspected to have a Dengue infection and they are found to have reduced platelets or an increase in blood hematocrit (PCV), then they are normally considered to most probably have Dengue. (Platelets are cells that help to stop bleeding. Hematocrit indicates the thickness of blood)

Dengue normally has 3 distinct stages once the incubation period has passed:

1. Febrile phase (2-7 days) (DF)

2. Critical or leakage phase (24-48 hr)

3. Convalescence phase (2-7 days)

Normally at the end of the febrile (fever) phase a Dengue sufferer will begin to recover.

A more severe form of the disease is Dengue Haemorrhagic Fever (DHF), this involves a seriously lowered blood platelet level (Thrombocytopenia), and internal bleeding (Haemorrhagic), it is also is sometimes associated with the Dengue Shock Syndrome (DSS).

With Dengue Haemorrhagic Fever (DHF) the critical stage is reached after the fever subsides and medical intervention is by now essential. In more severe cases the disease progresses rapidly into Dengue Shock Syndrome (DSS).

Presentation of the standard symptoms is normally sufficient to indicate treatment and observation of the patient.

The application of the tourniquet test to a limb may be used to assist in understanding the development of the Dengue infection in a sufferer.

The test is applied to determine a patient's haemorrhagic tendency and may be used to identify thrombocytopenia.

If small red spots come and do not go away after the tourniquet is released then that patient should be admitted to a hospital for treatment and observation.

With Dengue medical intervention and monitoring is very important and best carried out in a clinical setting such as a hospital.

Edited: 26 October 2012, 17:44
Sydney
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6. Re: Dengue fever

My husband & I will also be in Seminyak, Bali at the end of March & I am now very concerned about the Dengue Fever situation. It was reported on last night's news that 3/4 of the ppl suffering from Dengue Fever in Australia have contracted it whilst in Bali. Whether that is an exaggeration I am not going to ponder but it has rung some serious 'alarm bells' as I am a 'mozzie magnet'. Does anyone know if Aeroguard (available in Oz) is strong enough a repellent? I welcome any advice.

Canberra
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7. Re: Dengue fever

Joolls. My 4yo is a mozzie magnet. I use either Off (Bali purchased) or Tropical Strength Aerogard (Aussie purchased) on him every day, re-applied every time we go outside. I usually use the spray, but also the lotion at dusk. In 4 trips to Bali he has been bitten approx 8 times, mostly after swimming and a few times when we were staying at a hotel which had a lot of mozzies congregating near the door of the room (Kumala Pantai). I put a long sleeve rash top and long board shorts on him for evening swimming, the rest of the time he wears normally tropical clothes. I'm in Bali at the moment and the mozzies are pretty minimal.

Perth
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8. Re: Dengue fever

Hi Jools

We are frequent travellers to Bali, & like you, I'm a magnet for Mosquitos.

I always use Rid taken from home. I spray my self straight after my morning shower, & reapply throughout the day, especially towards sunset.

We always give the room, including under the bed & wardrobes, a good spray with fly spray before we go out for dinner.

So far, so good. Heading over soon for our 30th trip, and I'll be taking a good supply of Rid!

Perth
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9. Re: Dengue fever

Forgot to add, I heard of someone who contracted Dengue fever after being bitten by a mosquito at check in at their hotel.

So now I apply Rid before we even leave home, as it is good hour or two before we get to unpack our stuff after arrival.

Oshawa
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10. Re: Dengue fever

Hi Wayvan,

I'm arriving from Toronto area Canada on Mar 2/13 and my sis is meeting up with me middle of April. She's asthmatic and cannot tolerate any spray with fragrance. Do you know if there are any fragrant free sprays available in Bali ? We have Off up here but I haven't heard of Areoguard or Rid. Im going to the travel clinic for innoculations on Friday and will certainly ask if they can do anything.