BITTEN: DANG! IT'S DENGUE

02 October 2011 DAWN

by Rabia Ahmed | InpaperMagzine

Life was carrying on as usual this August in Lahore: no electricity, no gas, flooded streets, until an awful pain at the base of my skull: Meningitis? I did not think of Dengue, maybe because this was Eid, a time for sheer khurma, not mosquitoes. By bedtime, though, the pain was severe with a temperature over 102F.
Fortunately, with a doctor in the house, Dengue was suspected, because Dengue it was. Vomiting and nausea were unpleasant symptoms for the first 72 hours. Blood white cells and platelets were low and falling, an indication, and the palms and soles of my feet became red and itchy.


Treatment is symptomatic: Paracetamol based medication for the pain and fever, plenty of fluid, rest. I was told that Aspirin and Brufen must be avoided.


It is easy to confuse Dengue with Malaria. Both cause fever, shivering, body aches, and extreme tiredness. However diseases do not always follow the textbook. While Dengue is normally supposed to cause severe pain behind the eyes and in the bones and joints (explaining its other name: Break-bone fever) I got only some pain in my legs.


Both Malaria and Dengue are carried by mosquitoes, Malaria by the female Anopheles mosquito which bites after dusk; the Aedes mosquito carries the Dengue virus, and it likes to get its biting done by day. Dengue incubates within 3-15 days.


It is hard to accept that a miniscule thing such as a virus can cause this much discomfort, which makes the local governments’ failure to spray the city against mosquitoes doubly criminal. This year fogging machines were deployed late with allegedly substandard spray, neglecting high risk areas. For an uneducated population like Pakistan’s, inspectors should personally check for stagnant waters, and educate people on eliminating mosquitoes. This is done in many countries including Malaysia.


As it is, stagnant water is located unexpectedly, in desert cooler reservoirs which refill during the rains, in bottles under air conditioner pipes, in flower vases, and trays under indoor plants. All these must be removed/sprayed, except the dogs drinking bowl!


The most effective and early diagnosis of Dengue is by means of an antigen test unavailable in Pakistan. The alternative is a series of Complete Blood Picture tests (CBC) and an IGM antibody test which will show results of current infection only after six or seven days into the illness.


In almost 80 per cent of cases, Dengue is asymptomatic. In the remaining 20 per cent there are some who will suffer a severe form of the illness called Dengue Shock Syndrome which has a 20 per cent mortality rate. Warning signs are vomiting, abdominal pain and a drop in blood pressure. This requires hospitalisation and intravenous support. Another severe form is Dengue haemorrhagic fever. Warning signs are falling blood platelet levels, restlessness, clammy extremities, bleeding spots under the skin, and rashes. These patients may require platelet replacement.
Due to the epidemic proportions of Dengue in Lahore, hospitals ran out of platelet replacement facilities and were not admitting patients unless their platelet count went dangerously low.


The disease can be fatal in extreme cases, particularly in the case of the very young or old, or those with chronic diseases.

Papaya leaves

A wide variety of alternative cures surfaced as they always do: a blend/infusion of papaya leaves to raise the platelet count, apples and lemons, pomegranate juice, and even holy water (water infused with a series of prayers) etc, however none of these have been scientifically proven to fight the virus. Calls to pray for divine intervention were infuriating, since government intervention would have been useful but not achieved.


One is grateful eventually to loving friends and family who go to immense trouble to procure all these cures for sufferers. At the end of the day it is their love and nursing care that really counts in this, as well as in any other illness.