Sunset. Out comes the mosquito repellent, windows are closed and rooms checked for the tiny yet just visible black bodies of mosquitoes. We listen out for their miniscule whine. We swear if we have the misfortune to get bitten – we know we’ll feel the sting for a while. But basically, we know that here on Samui, they’re more of a night-time nuisance than anything else. During the day, we go about our business quite happily, mosquitoes all but forgotten. This is our playtime and we do as we please.
But unfortunately it’s also playtime for Aedes aegypti, another type of mosquito, and one that’s a lot more dangerous. We’ll probably not feel its sting, as it’s so mild – the creature merely sips, as it were, rather than does a full-scale bite. Then it moves on. It’s hard to see because its body is white and tends to be camouflaged against many surfaces. We can recognize it very easily, however, due to its unusual stripy legs. By night it’s all but gone, and we may never realise it was ever there at all. It portends nothing remotely good, of course – it’s the bearer of one of the world’s emergent diseases, dengue fever. An infected mosquito picks up the disease from someone who has it and passes it on. Dengue is therefore not a contagious disease, which is good news for us humans.
Many people are afraid of dengue, but often that fear is partly based on not knowing quite what it is or what to do about it. On Samui, dengue fever affects relatively few people in the population, but there are times when that number increases. As elsewhere in the tropical world, this usually happens after severe rain. It’s a disease that peaks every few years (no-one’s really sure quite why) but it’s quite likely that 2017 will be a bad year, given the amount of rain we had in January.
Fortunately there’s plenty of help at hand. At Bangkok Hospital Samui, as with the other hospitals on the island, the doctors are all used to prescribing treatment. They’re also very good at giving information about the disease and what to do. Follow their advice and you can usually protect yourself from it.
Hopefully, they say, you won’t get dengue but if you do, you’re likely to experience a high fever along with at least two of the following:
• Feeling of being exhausted
• Painful joints and muscles
• Severe pain behind the eyes
• Swollen glands
• Mild bleeding, for example, from nose or gums, or easy bruising
There is no actual cure for dengue fever, as it is a virus, but there are effective ways to combat its symptoms. It’s very important to have plenty of rest and enough fluids. Many dengue fever patients become dehydrated, and worsen their feeling of being sick. Tylenol with Codeine may be given for the joint and muscle pain. Fluid replacement is crucial to combat dehydration.
Aspirin and non-steroidal anti-inflammation drugs should only be taken following a doctor’s orders, as it is possible to have haemorrhaging problems. Also avoid Naproxen and drugs containing Ibuprofen.
If you think you have dengue fever, go to a hospital where you can be tested for its presence. The doctor will be able to give you advice on what to do and any precautions you may need to take. Go to hospital immediately if you have any of the following:
• Severe abdominal pain or persistent vomiting
• Red spots or patches on the skin
• Bleeding from nose or gums
• Vomiting blood
• Black, tarry stools
• Drowsiness or irritability
• Pale, cold, or clammy skin
• Difficulty breathing
Bangkok Hospital Samui, on the ring-road in Chaweng, provides professional treatment for patients with dengue, some of whom may simply be asked to visit several times as out-patients, while others may need to be admitted. Doctors make their decision largely on two factors: the level of dehydration the patient is experiencing and the blood test results.
Dehydration is a very common symptom. In order to be re-hydrated, a patient will need to drink three litres of water per day. This is quite often no problem, but for some, it’ll be impossible as they’re vomiting so much that they can’t keep the water down. In this case an intravenous drip is the only solution – it can only be administered as an in-patient.
Blood tests are important too. Platelet counts tend to go right down once dengue fever gets underway. It may be enough to come in as an out-patient a few times for a platelet test, but if levels are already alarmingly low, it’s best to stay in the hospital due to the risk of haemorrhaging. The patient can be easily monitored and if an acute situation arises a platelet infusion can be given.
There’s no reason for alarm with dengue fever. If you have it you’ll need to see a doctor, and once in proper hands, in 99% of cases there’ll be no complications. For that other 1%, patients may need a platelet infusion, but that can easily be arranged. Complications arise with early symptoms of dengue haemorrhagic fever (DHF) looking so similar to those of dengue fever. This syndrome affects mostly children under 12, but can affect anyone. Some symptoms are: pain in the abdomen, haemorrhage and circulatory collapse (shock). It is a dangerous condition, but once you’re admitted to hospital you’ll be on safe grounds. If you have DHF, you’ll definitely need to stay in hospital.
Symptoms of dengue fever may easily be confused, especially at the onset, with other problems. You may, for example, not have dengue at all, but food poisoning (acute gastroenteritis) or influenza, or it may just be a non-specific fever. Fortunately it’s incredibly rare to get dengue fever and influenza together.
Bangkok Hospital Samui, as with all hospitals, advocates prevention of the disease in the first place. They advise you to wear long, loose-fitting clothing during the daytime. The dengue mosquito won’t be able to bite through it, though the night-time mosquitoes will be able to do so. Aedes aegypti needs clean, fresh water to breed, so make sure that there are no residues of water in your immediate area. Dirty water is ironically no problem as the mosquito cannot breed in it. During the day wear mosquito repellent, but it’ll need to contain at least 10% DEET, otherwise it won’t work. Herbal repellents will also be ineffective. Since the dengue-bearing mosquito likes the shade, you’re safe on the beach, but beware of shady plants and the darker spaces under tables – the mosquitoes may lurk there.
As you can see, prevention isn’t so difficult, but you’ll need to start as early as possible during your holiday. However, it you do succumb, seek medical assistance and you’ll soon be on your feet again. When it comes to dengue fever, Bangkok Hospital Samui is making Samui a better place to stay.
For further information, telephone 0 7742 9500.