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Medical Musings: Dengue Fever

Dengue fever is the most common mosquito-transmitted viral illness in the world. It is seen in Vietnam and over 120 other sub-tropical and tropical countries, wherever the Aedes aegypti mosquito is found. It prefers clean, fresh water and is more common in urban areas.

Ho Chi Minh City has quite a bit of Dengue. It is more common during the rainy season, but is transmitted all year long. It is epidemic every 5 years or so, and our clinic probably sees 2-3 cases weekly.

After being bitten by the mosquito, the Dengue virus passes into the host, and within several days symptoms can begin. Fortunately 70% of patients are asymptomatic or have mild symptoms only.

In others, Dengue earns its reputation as “breakbone fever” because of the severe head and body pain that can develop. Other symptoms include high fevers, sore throat, abdominal pain, and fatigue. There are 4 viral subtypes of Dengue, so people can be infected multiple times.

Symptoms usually last about 1 week, and several days into the illness it is quite common to develop a rash. Many times this is seen on the forearms, and looks like broken blood vessels under the skin. It can spread to include the entire body.

Changes in the blood include low white blood cells, low platelets, and elevated liver enzymes. Low platelets can occasionally lead to bleeding problems, and rarely a condition called Dengue hemorrhagic fever.

There is neither a curative treatment nor an immunization for Dengue. There is currently much work being done on the development of a vaccination, however.

For now, the best approach is to avoid getting bitten. When out in the evening or early morning, use mosquito repellant and cover up as much as possible. At night use a mosquito net if you keep the windows open.

If you develop symptoms of Dengue fever, always see your doctor for an exam. There are simple blood tests that can aid in the diagnosis, and it is important to be monitored during the illness.

Dr. Ostrander is a board-certified American family doctor, practicing at Columbia Asia Saigon International Clinic. For appointments, please contact the clinic at 08 3823 8888, or e-mail customercare.sg@columbiaasia.com.

[Photo via The Star]

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