Basic HTML Version
www.alertdiver.com
|
79
The symptoms typically last about a week, and some patients
experience sudden temperature drops (known as saddleback
fever) during the third or fourth day.
Of particular concern is the more severe form of dengue
fever, known as dengue hemorrhagic fever (DHF). As the
name implies, clinical signs include bleeding, bruising,
blood in the urine and stool, rash and profound shock.
This form of the disease results from repeat infection when
the antibodies from the initial response are still present.
Therefore it is most often seen in endemic areas (areas in
which the disease is known to exist) and in infants within
whom maternal antibodies are still present.
Diagnosis of dengue is largely based on clinical
presentation and is more likely in endemic areas where
clinicians see the condition frequently. People who present
to emergency rooms or primary-care offices who neglect
to talk about recent travel may go undiagnosed. As this
is a viral infection, treatment is supportive (intended to
relieve symptoms), consisting primarily of fluids and pain
medications. Although treatment is not curative, an elevated
clinical suspicion may enable a more focused evaluation
and preclude a lot of unnecessary testing. Such insight may
also enable more appropriate surveillance and more rapid
response in the event that symptoms worsen.
Mosquito Bite Prevention
An important component of preventing dengue and malaria
is reducing the risk of being bitten by mosquitoes. Use of
protective clothing (long sleeves, pants and closed-toe shoes)
and DEET can minimize exposure. There is no evidence
that products containing more than 50 percent DEET are
any more effective. Window screens and removal of free-
standing water in areas around your home will keep living
spaces safer and decrease breeding opportunities. With
regard to dengue fever, Aedes mosquitoes can’t fly higher
than a few feet, so use of elevated beds with mosquito
screens are additional strategies with demonstrated
effectiveness. These precautions also reduce the risk of
bites and stings by other insects that are not as worrisome
as mosquitoes but can nonetheless make a vacation less
enjoyable.
Food and drink
Operators of resorts and large hotels work to ensure the
well-being of their guests; it is in their best interest to
maintain a safe and healthy environment. In circumstances
where you are not confident in the safety of food, consider
the adage “boil it, cook it, peel it or forget it.” Hot and
steaming is safe, as is fruit if it is freshly peeled by the
consumer. Bread is safe, too, but avoid buffets, room-
temperature foods, previously peeled fruit, raw produce and
salads. Also avoid raw or insufficiently cooked seafood and
milk products unless they are boiled or pasteurized.
Tap water at resorts is usually safe to drink, but do not
hesitate to ask about the water supply and purification
process before use. Venturing outside resorts increases
uncertainty. The source of the water may not be known, and
its potability may be suspect. Factory-sealed bottled water
is safe, as are other sealed beverages. Filling water bottles
or obtaining bottled water from the resort before exploring
is a good idea in some areas. If you have any doubt about
whether a water bottle you have bought is truly sealed, do
not drink it. Ice is also suspect, especially if you are uncertain
of the water source.
“The initial infection
may go unnoticed,
or it may appear as
flu-like symptoms.”
S T E P H E N F R I N K