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Dengue Fever

Dengue fever is not common, but at least one adoptive parent returning from Vietnamhas reported infection by this disease, so you might want to be familiar with the causes and symptoms.

By Dr. Mark Wise

Dengue, which rhymes with shmengee, is a viral infection which has been with us for at least two hundred years. It has a worldwide distribution throughout the tropics.

Dengue is contracted via the bite of the Aedes aegypti mosquito. This species of mosquito differs from the Anopheles mosquito which transmits malaria in two ways. Firstly, it likes to breed in close proximity to humans, in water containers such as discarded tires, barrels, flower vases and buckets. Therefore it is a risk to travellers who spend time in urban areas. Secondly, it is a day biter, preferring its meals at daybreak and the late afternoon.

This infection is not one you would wish on your worst enemy. It begins abruptly with a high fever, severe headache and tremendous pains in the muscles and bones. The name actually means "breakbone fever". A rash sometimes follows on the fourth or fifth day of the illness. Symptoms usually subside within a week, though the victim may be left with prolonged fatigue, aches and pains and depression. There is no vaccine against dengue, and no specific treatment other than symptomatic care.

A more severe form of the infection, dengue hemorrhagic fever, occasionally occurs and may prove fatal. This, however, is much more likely to happen in children, particularly if they have been exposed to the virus before. It is rare in tourists.

Insect avoidance is the main means of preventing dengue. Protective clothing and staying indoors are not always practical. Electric buzzers, garlic and playing reruns of I Love Lucy are also not very effective.

Use insect repellent containing DEET. There is some controversy regarding the safety of DEET. In small children, it is probably best to use a milder concentration, say 35%. In adults, a stronger preparation may be used, which will provide for longer protection.

As with other tropical diseases, the risk of dengue to the average tourist is quite low. With the proper precautions, it is even lower. So cover up, grease up....and enjoy.

Dr. Mark Wise is the director of The Travel Clinic (TM) in Thornhill, Ontario, Canada and the Medical Director of The Travel Wise (TM) Clinic in Scarborough, Ontario, Canada. He is a family physician with training from the London School of Tropical Medicine in Tropical Diseases. He is a parent himself and often see potential adoptive parents in his clinic. Dr. Wise gives lectures and writes articles on the subject of travel medicine, for both medical and non-medical groups.

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