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Dengue Fever in Texas?

In Dengue Fever, Uncategorized, West Nile Virus on September 10, 2012 at 8:51 am
September 4, 2012 

By 

drjane65@gmail.com

Recently, there is a lot of buzz in the news and on-line about Dengue Fever.  I had to really dig in my heels and sort through the published literature on this latest in “medical gossip”.

Normally found in more tropical climates such as the Philippines, Puerto Rico and Mexico, a few cases in recent years have been found in southern Florida according to the Center for Disease Control (CDC).    There is increasing concern that areas on the border such as Juarez, which have experienced an upsurge of Dengue Fever, could put the South Texas region on alert.

According to the most recent CDC map, recent cases in Texas seem to be travelers arriving from places outside the U.S. The concern however, is that increased international commerce from areas with infected mosquitoes and warmer environmental climates could be allowing more mosquitoes to survive thru the winter months.  Remember: it was an unseasonably warm winter this past year.

Approximately 3-8% of travelers returning from the tropics may become infected.  Next to malaria, Dengue is the second most common tropical disease infection resulting in hospitalizations.

Dengue fever is characterized by high fever, vomiting, rash and dehydration and may occur from 3-15 days after an infected mosquito bites its victim.  Headache, chills and swollen lymph nodes may be the first signs of infection.   Symptoms may last 1-2 weeks with complete recovery.  Infected individuals with more severe viral forms of Dengue may develop life-threatening symptoms such as bleeding of the skin, gums and gastrointestinal tract (referred to as Dengue Hemorrhagic Fever).

Not limited to blood work, sometimes a spinal tap is necessary for diagnosis.  Treatment is limited and usually just an increase in fluid intake is needed.  Occasionally IV fluids, and rarely hospitalization is necessary for Dengue Fever.  For Dengue Hemorrhagic Fever, blood transfusions and more intensive care is necessary.

Tylenol is the medication of choice and drugs such as aspirin and NSAIDS (ibuprofen, naproxen, etc) are not recommended as they could increase the risk of bleeding.

The prognosis (outcome) is most always excellent for Dengue Fever. As with West Nile, people with altered immune systems such as the elderly and those on chemotherapy are more likely to experience complications. Overall fatality rate is about 1%.  Although that seems low, world wide about 500,000 to 1 million people die each year from the disease (which is significant).

No vaccines are available at this time and the CDC recommends insect repellent with up to 50% DEET for adults and children over 2 months of age.

So, is the hype real?  I suspect we must all be on alert.  It was a warm winter.  For now, I am going to invest in  DEET insect repellent and pray fo a really good winters freeze.  I suggest you do the same.

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