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Published: October 15th 2017
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Day one is a real bitch. Whatever I got, the accompanying deep-down, throbbing, full-body ache is a new take on the overseas-disease-trying-to-kill-me experience. I also have a 103-degree hallucinatory temperature and a totally debilitating crown-of-thorns headache. But what’s really problematic is I’m supposed to be watching the 2-year old while mama is in Rome. I probably have dengue fever, so I need to not die before the nanny arrives.
Day two dawns with vomiting– the kind where you don’t make it and end up dry heaving bile on the bathroom floor before crawling into the shower half-clothed to sleep because the tiles are cool against you face and the bed is a million miles away. The baby finds this behavior alarming, but this is tropical disease suffering luxury: there’s running water, electricity, air conditioning, and child care. On day three, the diarrhea, sweating, chills and uncontrollable shaking start. Having suffered various unnamed maladies in India, Ethiopia, and the Amazon, I can appreciate how seriously this virus is kicking my ass.
On day four, mama returns, and I go to the hospital. Crawling out of bed and dragging myself through the streets is a surreal, disorienting experience. Everything is fuzzily
drunken and hungover simultaneously. The sunlight is blinding, jagged, and pounding my head like an anvil, which doesn’t make any sense, except sense was boiled up days earlier in a fevered dream. The sky is both overwhelmingly immense and claustrophobically close, and strangely, no one on the street seems bothered that the surrounding high-rise buildings are waving like tall grasses in a prairie breeze. But that’s the great indignity I suppose: your own suffering is monumentally important to you, but the world mostly doesn’t notice or care.
While awaiting the hospital shuttle, I think again about The Sheltering Sky. This is Thailand not northern Africa, but location is inconsequential when a virus is trying to kill you. In the traveler/tourist quixotic quest for authenticity, it doesn’t get more real than dying, and dengue fever is one that can kill you.
An American in the 1780s coined the term ‘bone break fever’, but the more common name, dengue, is older and its origins less clear. It may have come from the Swahili phrase "Ka-dinga pepo", meaning ’cramp-like seizure caused by an evil spirit’. Or it might not have. The first recorded mention compatible with dengue symptoms was
during the Jin Dynasty (265-420 AD) in China. The Chinese associated it with insects rather than evil spirits and called it ‘water poison’. In Thailand, it is simply ‘khai luead auk’, the fever with bleeding. The bleeding stage is the killer and thankfully, a lot less common. Regardless of the etymology, dengue undoubtedly thrived here when it was only a bend in the Chao Phraya river.
Bangkok is an ideal location for mosquito vector tropical diseases. It’s always hot, and it’s built on the flood plain, only 1.5 meters above sea level. During the rainy season, there is a biblical amount of water that dumps out of the sky damn near every day, and no amount of concrete, steel, glass and modernity can stop the flooding . . . or the mosquitoes. Most of the time, you don’t get dengue, except when you do. That’s either shitty luck or evil spirits. Maybe both.
The
Aedes aegypti mosquito transmits the dengue virus. After you get bit, the virus bides its time, incubating for a week or two, multiplying and waiting patiently so other mosquitoes can feed, get infected and spread the suffering. Then the calm before the storm ends,
and the ass kicking begins. The degree of torment the virus unleashes seems unnecessarily excessive, but there are more viruses than everything else on the planet, so debilitating the host is clearly an optimal survival strategy. I guess the evolutionary rationale is if you can’t move, more mosquitoes can feed.
When I make it to the hospital, my white blood cell and platelet counts are still dropping, so I check myself in. They give me an IV, a bunch of electrolyte packets, a bed, a steady supply of paracetamol, and regular meals I cannot stomach. They drain blood at dawn, and once a day, the doctor comes by with bloodwork results. Periodically, a nurse takes my temperature and blood pressure, hands over more paracetamol and disappears again for another 4 – 8 hours. Nothing to do but wait and see if your body wins or if the dengue does. The next day, mama checks in next door with her own case of dengue and a fat lip from fainting and faceplanting on the walk from the doctor’s desk to the examining table.
The tricky thing about dengue is that it is really dangerous after the fever breaks; despite
feeling better, your system is wrecked, so you can slip into the crisis stage and get dengue hemorrhagic fever. Then, heinous things like plasma leakage, bleeding, shock, and organ impairment start; at this stage, dying becomes a statistical probability. That’s enough reason to stay in the hospital. Fortunately, neither mama nor I go down that path, and the only thing we have to survive is excruciating hospital boredom. Five days, five pints of blood, and five thousand milligrams of paracetamol later, they let me out. Mama leaves two days after.
Miraculously, the baby makes it through the miserable blur of intense terrible unscathed. At last, everyone is home, back where it all began. If we’re lucky, there’s only weeks of profound fatigue ahead. Unfortunately, the dance with dengue only makes you immune to a quarter of the known serotypes, or strains, of dengue. If a mosquito carrying a different one bites you, the shit show starts again. Except it’s usually worse, the hemorrhagic fever version of worse.
Dengue is the world’s fastest spreading vector borne disease, having spread from only nine countries in the 1970s to over 100 today, a 30-fold increase over the last 50 years. Today,
over 100 million people are infected annually, and as temperatures warm globally, the geographical range of the
Aedes aegypti mosquito, will grow. This means dengue will soon be spreading to a neighborhood near you. Of course, the United States’ withdrawal from the Paris Accord on Climate Change should hasten this. Stupidity has consequences. Enjoy the bone break fever America. It’s a doozy.
Selected bibliography:
http://www.sciencedirect.com/science/article/pii/S0013935116303127 https://www.breakdengue.org/tales-of-a-well-travelled-virus/ http://www.denguevirusnet.com http://www.who.int/mediacentre/factsheets/fs117/en/ http://www.mosquitoworld.net/when-mosquitoes-bite/diseases/ Dr. Gillian Burkhardt
Images:
Dengue range:
http://www.denguevirusnet.com/epidemiology.html Aedes aegypti:
http://www.godrejhit.com/wp/articles/the-dengue-mosquito-aedes-aegypti/ Dengue Fever: Symptoms and Treatment:
http://www.thehealthsite.com/dengue/
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Brian Boultinghouse
non-member comment
holy cow!
Glad you are all OK! I am planning on mother nature taking drastic steps to reverse the short-sighted stupidity of lazy/greedy humanity so put your survival suit on!