Dengue Fever Information: What to Do?

Nov. 20, 2011 Update: Dengue is the most rapidly spreading mosquito-borne viral disease in the world.   In the last 50 years, incidence has increased 30-fold with increasing geographic expansion to new countries and, in the present decade, from urban to rural settings ….

Dengue:  transmitted  between humans in the Americas  by our friends(?)  Aedes aegypti.

An estimated 50 million dengue infections occur annually,  and approximately 2.5 billion people live in dengue endemic countries.

The affected countries include México and almost all other countries in the Tropics.   Fatality rates from extreme Dengue Virus infections (DHF & DSS)  have ranged from 1%-3.5% in Dengue endemic areas.   Yucatán and along the Gulf coast of Mexico are Dengue endemic areas (areas maintaining Dengue Virus).

The WHO and the Special Programme for Research and Training in Tropical Diseases (TDR) has released their latest guidelines on Dengue Virus.  Their presentation is available in a 160 page format (for those who enjoy a bit of light reading).   The 3’rd Edition report contains all their updates since the 1997 Second Edition.

This article is a summary of bits and pieces (for the rest of us) taken directly from the report, so, I have put things extracted directly from their report in italics, along with my observations in normal type and I will give no other citations or references.

Dengue Virus infections come in several forms:

  • most people get mild infections with few symptoms and possibly a short duration low fever;
  • others get some combination of intense fever, pain behind the eyes, body rash, extreme pain in their bones and joints, and mild nose bleeds;  (these two are called “Dengue Virus Infections” or “Dengue Fever”)
  • WHO reports that a few (3% – 5%) get the potentially fatal symptoms of “Dengue Hemorrhagic Fever” (DHF) of Dengue Shock Syndrome (DSS),  where DHF causes bleeding from the eyes, gums, nose, under the skin, or into the GI tract, vomiting, and black stools. **DHF rates in Mexico have been increasing the past 3 years, with up to 50% of Dengue Virus cases exhibiting DHF or DSS symptoms.

Hydration (at least 5 glasses of liquid per day for adults) and bed rest are the main treatments for the   first two types   of symptoms.  In the cases of DHF or DSS Intravenous rehydration is the therapy of choice;   this intervention can reduce the case fatality rate (for DHF) to less than 1% of severe cases. The main symptoms of DHF and DSS requiring hospitalization are listed below.

Symptomatic dengue virus infections were grouped into three categories: undifferentiated fever, dengue fever (DF) and dengue haemorrhagic fever (DHF).   DHF was further classified into four severity grades, with grades III and IV being defined as dengue shock syndrome (DSS).

The NS1 tests for Dengue virus protein work very well during the first 3 days of fever, so, it is good to get tested before the 5’th or 6’th day of fever.

The treatments for mild Dengue infections are the same (whether you get tested or not):  bed rest,  hydration with water juices etc ( at least 5 glasses per day for adults),  reduce fevers greater than 102º F / 39º C,   using cool baths, cool showers,  alcohol rubdowns,  and possibly Tylenol. There are no pills, no antibiotics, no magic elixers that have been shown to work in treating Dengue cases.

NSAIDs like aspirin, Advil, Motrin, Alleve, ibuprofen, etc and blood thinners should be completely avoided because they inhibit clotting which can cause death if the patient proceeds to DHF or DSS symptoms.

Waiting to get Dengue Virus testing before Day 5 – Day 6 of fever  also fits with the possible progression to Dengue Hemorrhagic Fever (DHF) or Dengue Shock Syndrome (DSS).  If you get positive NS1-test results for Dengue, then you know to pay special attention to your Dengue symptoms to watch for DHF or DSS. Dengue infections can proceed to DHF or DSS around Day 4 – Day 7 of fever, so, patients should be monitored carefully for symptoms of bleeding or shock or abdominal symptoms during this period, where DHF or DSS causes bleeding from the eyes, gums, nose, or into the GI tract.  Patients with severe bleeding symptoms or shock** should be taken to a hospital immediately for IV hydration treatments.


**Several definite indicators of need for immediate hospitalization:

  • black stools (evidence of GI bleeding)
  • coffee-ground vomiting  (congealed blood in vomit)
  • not passing urine for more than 4–6 hours
  • heavy menstruation/vaginal bleeding
  • Frequent vomiting
  • Severe abdominal pain
  • Drowsiness, mental confusion or seizures
  • Pale, cold or clammy hands and feet
  • Difficulty in breathing

Conditions like these require hospitalization:  IV rehydration and possible blood transfusions.
~ Does avoiding these possible consequences make it worth installing screens, getting rid of old tires, draining flower pots,  and cleaning up other mosquito breeding habitats in your and the neighbors’ properties?
======================================================
Dengue viruses occur as 4 different serotypes:  DEN-1, DEN-2, DEN-3, and DEN-4, and we have all 4 serotypes circulating here in Yucatán.

From 2001 to 2007, more than 30 countries of the Americas notified a total of 4,332,731 cases of dengue. The number of cases of dengue haemorrhagic fever (DHF) in the same period was 106,037. The total number of dengue deaths from 2001 to 2007 was 1299, with a DHF case fatality rate of 1.2%. The four serotypes of the dengue virus (DEN-1, DEN-2, DEN-3 and DEN-4) circulate in the region.  In Barbados, Colombia, Dominican Republic, El Salvador, Guatemala, French Guyana, Mexico, Peru, Puerto Rico and Venezuela, all four serotypes were simultaneously identified in one year during this period.

During 2001–2007, a total of 545,049 cases, representing 12.5% of dengue in the Americas, was reported, with 35,746 cases of DHF and 209 deaths. Nicaragua had 64 deaths (31%), followed by Honduras with 52 (25%) and Mexico with 29 (14%). Costa Rica, Honduras and Mexico reported the highest number of cases in this period. DEN-1, -2 and -3 were the serotypes most frequently reported.

The dengue virus enters via the skin while an infected mosquito is taking a bloodmeal, so Dengue is transmitted from Dengue infected humans to Aedes aegyptii (A. ae) female mosquitos.  After the previously uninfected female A. ae mosquitos rest & digest their blood meal for 2-3 days,  they then lay eggs.   Next the now-Dengue-infected females return to bite other humans – infecting those humans.
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It is worth noting that the WHO study results only include Dengue cases that were confirmed by laboratory tests, while Dengue experts routinely report that less than 10% of Dengue patients get tested, so,  all numbers of infections reported here are likely  in reality  10X higher.

There were just over 2,000 Dengue virus infections reported for Yucatán in 2009, which means there were most likely over 20,000 Dengue infections in Yucatán in 2009.  Dengue has been circulating continuously in Mexico since the 1970’s,  when it was re-introduced from Cuba.  Dengue had been eliminated from Western Hemisphere for roughly 12 years, except for Castro’s Cuba, where they denied its presence, refused to treat for mosquitos, and jailed & imprisoned Cuban scientists who dared to report its presence.

Probable Indications & Signs of Dengue Infections:
•Live in / Travel to dengue endemic area.
Fever
and 2 of the following criteria:
• Nausea, vomiting
• Rash
• Aches and pains
• Tourniquet test positive
• Leukopenia
• Any warning sign
(see next list)

Warning signs
• Abdominal pain or tenderness
• Persistent vomiting
• Clinical fluid accumulation
• Mucosal bleed
• Lethargy, restlessness
• Liver enlargement 2 cm
• Laboratory: increase in HCT
concurrent with rapid decrease
in platelet count

Our local Dengue experts add the following warning signs that are unique to Dengue infections:

  • pain behind the eyes (retro-orbital pain),
  • pain in the bones and joints (hence Dengue’s other name:  “Break-Bone Fever”),  and
  • Mild hemorrhagic manifestations like petechiae (small dots of bleeding under the skin) and mucosal membrane bleeding (e.g. nose and gums) may be seen.

CRITERIA FOR SEVERE DENGUE SYMPTOMS
Severe plasma leakage leading to:
• Shock (DSS)
• Fluid accumulation with respiratory distress
• Severe bleeding as evaluated by clinician
• Severe organ involvement
• Liver: AST or ALT =1000
• CNS: Impaired consciousness
• Heart and other organs

…an average Dengue episode represented 14.8 lost days for ambulatory patients and 18.9 days for hospitalized patients.

======================================================
DENGUE IN INTERNATIONAL TRAVEL
Travelers play an essential role in the global epidemiology of dengue infections, as
viraemic travellers carry various dengue serotypes and strains into areas with mosquitoes that can transmit infection. … Travellers often transport the dengue virus from areas in tropical developing countries to developed countries…

Fortunately,  Dengue virus is not communicable from person to person.   Dengue virus is transmitted by only one type of mosquito:   Aedes mosquitoes,  exclusively Aedes aegypti in our part of the world.  The A. ae. mosquitos get infected by biting a human with an active Dengue fever.  For this reason, mosquito control is the key to controlling and limiting Dengue’s spread.   Typical studies find that 90%-95% of A. ae. mosquitos collected in the homes of a Dengue fever patient have Dengue Virus.
====================================================
This means that one of the first actions when a person has a suspected Dengue infections is  to   spray the patient’s home to kill all mosquitos, to protect the home’s other occupants from getting Dengue infections.

A. ae. mosquitos love to  live,  rest, and   digest blood meals,   in dark cool places, like under the bed and in clothes closets (attracted by our smell on our clothes),   so,   focus mosquito spraying efforts on low, cool, dark places.   We treat our rooms by spraying thoroughly with commercial mosquito spray, with the windows and doors tightly closed,  and then we retreat to the next room/area   spraying it,   and continuing that process until the whole house is treated   and then left tightly closed-up for  1 – 2 hours – and we go somewhere else in the meantime.

The A. ae. mosquito is a tropical and subtropical species widely distributed around the world, mostly between latitudes 35 0N and 35 0S. These geographical limits correspond approximately to a winter isotherm of 10 0C. Ae. aegypti has been found as far north as 45 0N, but such invasions have occurred during warmer months and the mosquitoes have not survived the winters. Also, because of lower temperatures, Ae. aegypti is relatively uncommon above 1000 metres.

The immature stages are found in water-filled habitats, mostly in artificial containers closely associated with human dwellings and often indoors. Studies suggest that most female Ae. aegypti may spend their lifetime in or around the houses** where they emerge as adults. This means that people, rather than mosquitoes, rapidly move the virus within and between communities.
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Mosquito Facts  &   Dengue and Mosquito Control:
**A. ae. mosquitos love fresh water and prefer human blood – making them a “City Mosquito”,   not a marsh mosquito, and not a jungle mosquito.   A. ae. mosquitoes can fly very fast, unlike other mosquitos,  and they inject a little anesthetic with their saliva when biting, so   you don’t feel them bite.

A. ae. mosquitos can breed in as little as a tablespoon of residual rainwater, so, you can best eliminate Dengue and A. ae. mosquitos by eliminating their breeding grounds, getting rid of anything around your property that collects standing water:  old tires, old crockery, plastic rubbish,  brush piles,  drill holes in the bottom flower pots, etc.

We cover our unused toilets and drains with Saran wrap – which permanently block mosquitoes, since chlorine dissipates over time.  One other friend uses ammonia in his unoccupied house drains & toilets, because it maintains its potency longer.

If you have a fountain or other water feature:  A variety of fish species have been used to eliminate mosquitoes from larger containers used to store potable water in many countries, and in open freshwater wells, concrete irrigation ditches and industrial tanks.  Guppies and mollies breed like mad, and they eat mosquito larvae,  and Gambusia are especially good at eating mosco larva.  Or you could treat the water with chlorine every 7 days.

Dengue infected A. ae. adult mosquitos can live up to 30 days, and once the females are infected by biting an infected human, they can continue to infect other humans for the rest of their little lives.

Ae. aegypti is one of the most efficient vectors
for arboviruses (like Dengue Virus) because it is highly anthropophilic, (loves humans,) frequently bites several times before completing oogenesis, and thrives in close proximity to humans.

Once the A. ae. mosquitoes’ eggs are laid,  the eggs typically take 7 days to hatch (depending on water temperature) and develop into adult mosquitoes.  This means that it is important to treat or change exposed fresh water at least once every seven days =  time to wash the pet’s water bowl?  (since the mosquito eggs can lay dormant & dry for months to years?)

Typically, these mosquitoes do not fly far, the majority remaining within 100 metres of where they emerged. They feed almost entirely on humans, mainly during daylight hours, and both indoors and outdoors.
A. ae mosquitos tend to feed in the morning  and in the evening.   They typically bite people’s feet, ankles, and lower legs  so, it can help to treat your lower legs and feet with repellent  or   wear socks and long pants.

Since A. ae mosquitos do not feed late at night and since they are also silent,  that buzzing you hear in the middle of the night is   not  a A. ae female mosquito:  it’s likely a Culex instead…

There is accumulating evidence that insecticide-treated window
curtains (net curtains hung in windows, over any existing curtains if necessary) and
long-lasting insecticidal fabric covers for domestic water-storage containers can reduce dengue vector densities to low levels in some communities – with prospects for reducing dengue transmission risk.

A current Mérida study using curtains shows a reduction of moquitoes in homes without screens,  but the homeowners keep tying back the curtains – and they do not like having their doorways covered (blocking breezes) , or they add their own other personal decorative curtains – all of which reduce curtain/net/ITM efficacy – which means that insecticide treated bed netting  and  ceiling net traps work better.

Well,   I’m pooped from writing, and I’ve gone through all 160 pages of the WHO report,   I’ve included a bunch of addition information that I’ve learned while living with a Dengue researcher, and think I’ve covered all the important stuff.

except a few items:

  • Scientists used to think it took 10 days or more between being bitten by a Dengue infected mosquito and the onset of fever & symptoms,  but there have been recent reports of as short as a 4 day incubation period between the insect bite and the Dengue infection…
  • A single dengue infection sets the patient up for future  more intense  dengue infections, with the symptoms getting worse with every subsequent infection, with the possibility of death increasing dramatically with every new infection.
  • Each dengue infection confers a very brief immunity (3-4 months) to ONLY that strain of Dengue, but that single infection leaves the patient even more susceptible to more serious symptoms from the other 3 remaining Dengue strains (serotypes).

Here’s a CDC plot showing how the various medical tests work with Dengue infections:
image: showing comparison between primary and seconcary infections

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MORE RECENT UPDATES ON DENVAXIA by Sanofi  and WHO  2015 Reports:  
If you read the WHO reports and Sanofi’s most recent 2015 reports on the vaccine, readers may make a different choice,  based on facts.

Consider that the “new”  Dengvaxia vaccine only works on less than 40% of patients for protection against the nastiest strain of Dengue (DEN-2).**

Consider that you may likely need at least 4 shots a year, and possibly 8 shots a year to maintain an effective titer (sufficient blood levels) of Dengue antibodies  (depending on patient’s age and immune system health).

**Consider that the vaccine is  at best  only effective about 70% of the time against just 3 of the 4 varieties of Dengue, (DEN1, DEN3, &DEN4) and it works relatively poorly against DEN2 ( < 40% effective).

DEN2 has been very common in recent past Yucatan Dengue infections.

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Please give a shout  if you see something I missed…
steve

hint:  The female shown above (note the long proboscis not present on males)  is a very young A. ae mosquito – as the distinctive black and white markings fade with age….

* * * *
Please Continue to Make Comments and Replies to Help Keep This Information Current!
Disclaimer: This information is not meant as legal advice. It is for educational and informational purposes only. Government policies vary between States and offices, and Mexican Government officials have broad discretion in how they individually enforce policies, so, your personal experiences may vary. See a professional for advice on important issues.

*                 *                 *                 *

Feel free to copy while giving proper attribution: YucaLandia/Surviving Yucatan.
© Steven M. Fry

Read-on MacDuff . . .

200 Responses to Dengue Fever Information: What to Do?

  1. Pingback: Dengue: What to Do? | Surviving Yucatan

  2. Pingback: Yucatán: Bombas, Beisbol, y Beauty | Surviving Yucatan

  3. Nini says:

    Hello Steven,

    First off, I wanna thank you for putting up all this information on your site. Tremendous work, no wonder you’re pooped and I’m grateful.

    You asked if you missed something. Well I came to this site looking to find out what it means to have had dengue, in terms of whether the illness leaves you with other things that you now need to be careful about, stuff that might affect the rest of your life from that point on. All I could find on your site here, is that it does indeed leave you with an increased sensitivity to the remaining dengue serotypes (not good news), but that’s about it.

    So I ask: is that it? Or is there more?

    Many thanks for all your help and good will Steve.
    Nini

  4. yucalandia says:

    Nini,
    You found the one confirmed negative lingering effect of Dengue fever.

    There is one long term beneficial effect that has been noted but not completely proven. People who live in areas endemic with Dengue appear to have unusual resistance to other flaviviruses, like West Nile Virus. It is possible that flaviviruses (like West Nile Virus, Saint Louis Encephalitis, Dengue, and Cache Virus) share enough similarities, that humans who have previously had Dengue infections seem to be very resistant to West Nile Virus infections. Since human trials with dangerous viruses are off-limits (harmful viral experimenting with humans are not permitted under ethics rules), there are no plans to confirm the protective effects of human Dengue Virus infections.

    I will double-check with our local experts, but our extensive literature reviews have turned up no other negative effects.

  5. Pingback: Yucatan Living - Everything About Dengue Fever

  6. Nabanita Dhar says:

    Sir,
    I recently suffered from dengue, to be more accurate it has been a month. But the problem is that i’m still feeling weak and at times i’m experiencing pain in the whole body. Please suggest.

    • yucalandia says:

      Hi Nabanita,
      I am sorry to hear that you are feeling poorly, as Dengue Virus can really compromise our immune systems, leaving us very susceptible to other infections and other health problems. We have heard a few reports recently of a few individuals with Dengue infections who also have contracted other infections like Typhoid Fever or Dysentary. There are also some Cache Valley infections occurring in Yucatan, and it can be important to know exactly what infection you had or have.

      Did you have Dengue Virus tests run, and if so, was this a primary or secondary Dengue infection?

      I strongly suggest you see a physician who is experienced in diagnosing Dengue and in treating Dengue patients.
      If you are near Merida, I suggest you go see the physicans at Centro de Invetigaciones “Hideo Noguchi” at the corner of Avenida Izaes and Calle 59 – across from the Zoo (Parque Centenario) and also across the park from the old penitentiary. There are physicians who specialize in working with Dengue patients on the second floor of this research institute, and if you are willing to have your results confidentially included in research studies, they are glad to provide testing, treatment and advice all for free.

      Can you post an update with answers to the questions listed above, and also keep us updated on how things work out.
      Dr. Steven M. Fry

  7. 蛙鏡 says:

    Hi, can I quote some of the content found in this entry if I provide a link back to your site?

  8. Pingback: Yucatan Living » News » Yucatan News: Chess and Weather

  9. stepahanie says:

    Good day!
    can you give some suggestions on what to do? My brother is suffering from dengue.He has a fever since Sat and until now, sometimes his nose is bleeding. He is now in the hospital and took CVC and platelet laboratory.

    Your fast response is highly appreciated.

    Thank you and God bless!

  10. Pingback: Dengue Fever | Expat Journal: Postcards from the Edge

  11. shubham says:

    can you tell me iam sufferring with fever and i have got red dots in my face so this are the symptoms of dengue i want you know

  12. Thanks for another informative website. Where else could I get that kind of

    info written in such an ideal way? I have a project that I am just now working
    on,

    and I’ve been on the look out for such info.

    • yucalandia says:

      Tell us more about it…

      Read our other Dengue articles, both here on Yucalandia, and our old (slightly out of date ) article on Yucatan Living.com.

      Ask questions… My wife is working on one of the top 5 Dengue research programs in the world.. (as a Lab Director for about 45 scientists/employees)…
      FUN STUFF!
      Dr. Steven M. Fry

      • Stima says:

        I had Dengue fever after taking a Caribbean cruise in Sept 2011.I believe that I was bitten in Key West, Fl. I have made contact via the web with several that have also contracted. I actually diagnosed myself and was surprised at what little information is out there. There is absolutely no mistaking that “bone breaking pain”! My Doctor was not aware of the symptoms and suspected arthritis, lupus, leukemia? … Being a very healthy person I persuaded him to test me for Dengue. (The lab was not even sure how to test?) Six days later dengue was confirmed. I continue to research on my own. Little is out there about the lingering health issues of this horrible sometime deadly disease. I would be interested in more information…Thanks!

  13. omni says:

    Hi, thank you for the information. One thing I an not clear on is the long term or extended period of symptoms. I vacationed in Barbados the day I came home my symptoms started, two weeks of hell. It has been six weeks since symptoms started and I still feel pains in my Liver, Kidneys and Stomach that seem to move around. Since there is no cure I assume over time my body will resolve these issues if same but again is this normal? Yes I had the blood test to confirm type 2.
    Many thanks!
    omni

    • yucalandia says:

      Hello Omni,
      Most people feel almost no symptoms. People with symptoms typically feel them for 2 to 3 weeks. There are some people who feel them for months. One friend of ours reports problems 4 years later.

      You really should see a physician to be sure that there are no other complications, or other illnesses involved.
      steve

  14. Jill Chesser says:

    Hey Everybody that reads this! Greetings from Charleston South Carolina! I contracted Dengue Hemmorhagic fever in 2005 1 week after I came back from a missions trip to Hondorus. I had high fevers of 102-103 for 2 weeks that continued for an additional 2 weeks but only in the evenings. My liver enzyme levels were elevated and my liver was enlarged. This was confimed through liver ultrasound and liver blood test. I had residual spots of blood after urination and a rash on both palms. I had difficulty breathing,abdominal pain at the rib cage, abdominal bloating, loss of appetite, loss of taste, pain behind my eyes,extreme nausea and vomiting, a swollen knee with sharp pains that hindered ambulation from one room in the house to the next and swollen lymph nodes. I was exhauted and slept through so many days I lost tract of the time and dates of each day. It was dreadful. I was unable to stand upright and was out of work for 2 months. I hurt all over. I thought I was going to die and I was so miserable I became discouraged and depressed and didn’t care if I did. My doctors could not figure out what I had. In hindsight I should have seen an infectious disease doctor for immediate diagnosis. It is difficult to treat an illness that has not been identified. I continue to have similar symptoms in the fall and winter months every year but without fever. I spend about 2 months in bed with general malaise and body aches every year around the same time. It is accompanied by congestion, intermittent diarrhea, coughing, head ache, and joint pain. Similar to the symptoms of fibromyalgia but it goes away as quickly as it came. I have started a regime of Vitamin D 5000 IU per day and am presently doing a juice fast/cleanse. If anybody out there as any idea of what I may be going through I would love your input!!!

    • Stima says:

      I had Dengue Fever in Sept 2011. Have always been a healthy positive person with a lot of energy. I eat healthy, exercise and get plenty of sleep. Almost 2 years later I still am experiencing exhaustion. I was told by our local health department that the long term affects would be depression?

      • yucalandia says:

        Hi Stima,
        Unfortunately, this area of Dengue Virus infections has not been deeply studied. It is clear that a small percentage of Dengue Virus infected patients suffer some systemic changes that leave them feeling easily-tired, run-down, and physically less energetic, etc.

        This DOES NOT mean that a prior Dengue infection can cause depression.

        Your CHOICES of lifestyle and activity and behaviors are proven determinants for increased or decreased depression risks.

        ========================================
        Clearly, people who are more physically active have much better levels of diurnal serotonin and melatonin hormone level balances – causing you to reliably be awake and alert in the daytime and to rest/sleep deeply and effectively at night. … Your mechanisms/levels of seratonin uptake are also affected by physical activity.

        People who get up early, and get a GOOD dose of direct Ultra Violet light on their faces (get out of the cave – face the sun – and stretch) have their biological clocks firmly reset/established every day – and the good doses of sunlight clearly keep our “positive” hormone levels at higher amounts – which keeps us from getting depressed… SAD (Seasonal Affective Disorder) is clearly caused/triggered by insufficient UV light levels or UV light exposures at the “wrong” times of day….

        ========================================
        If we allow tired-ness from Dengue to cause us to lay in bed…

        If we allow our reduced stamina to keep us from being physically active ….

        If we allow our post-Dengue low energy levels to cause us to become slugs who have a lousy sleep schedule – using caffeine or alcohol very inappropriately (drinking either one in the evenings or at night) – then you/we can seriously screw up our sleep – causing ourselves to not get effective daily rest/sleep – then YES…. I guess a prior Dengue infection could leave you more susceptible to depression….

        ========================================
        This is yet another example that proves that Medical Doctors (physicians) ARE NOT SCIENTISTS….

        Physicians actually study VERY LOW AMOUNTS of science.
        ~ especially when compared to the professionals who actually “do” science like: Chemists, Physicists, Molecular Biologists, and Biochemists….

        Physicians also DO NOT LEARN critical thinking.

        Physicians DO NOT LEARN how to do effective research,
        ~ NOR do they learn how to effectively read scientific research,
        ~ NOR do they typically understand scientific research – because the Medical School systems actively recruit people who are really excellent at MEMORIZING things – and a good memory is only one small component of being a good scientist. …
        ~ Nor do they learn the statistics needed to determine if a research study has been well-designed or poorly-designed.

        ========================================
        Remember:
        For at least the past 30 years, Physicians have been the 3’rd LEADING CAUSE OF DEATH in the USA. …

        Reliable peer-reviewed large studies of over 2 million patient records consistently show that Physician mis-diagnoses and Physician errors unnecessarily KILL 180,000 – 200,000 Americans every year (for at least the past 20 years). These results do not include the harm and suffering caused by over-medication and various Physicians prescribing 10 to 30 different daily meds for old people – where the patient lives, but suffers unnecessarily – Because the Physicians have NO IDEA of the interactions and side-effects of mixing-meds.

        ========================================
        This means: DON’T BELIEVE what a typical physician tells you about depression.

        Physicians believe that brain-chemistry altering artificial drugs are the near-universal “cure” that is “required” for almost all cases of depression. … Drugs are NOT the universal best answer…

        Consider that the current bible used by Physicians ( the DSM ) says that people who have the blues after the death of even an immediate family member are now: CLINICALLY DEPRESSED … and they should all be put on brain-altering drugs (serotonin uptake inhibitors)….

        Not good. Not good. NOT GOOD. (and non-scientific)

        ========================================
        Read the research on the months of near-debilitating withdrawal problems that a predictable percentage of “depression-medication” patients will suffer – and we find that we should not be eager to take the drugs that under-educated single-track-thinking Physicians imagine they MUST prescribe.

        This means: the “local health department” is frankly wrong to predict that a DIRECT CAUSE AND EFFECT link exists, where prior Dengue infection somehow causes depression. …

        ========================================
        Yes, a prior Dengue infection can leave you physically and emotionally tired, and hence more susceptible to behaviors that are known triggers to depression. …

        This means: make a conscious effort ~ work ~ to avoid the triggers for depression… Maintain good sleep schedules…. Do NOT drink caffeine within 4-8 hours of sleeping. DO NOT drink alcohol or take depressants (like pot or THC) withing 3 or 4 hours of sleeping…. All of these things seriously interfere with melatonin levels, and they ALL inhibit deep restful sleep….

        NO DRINKING a “glass of wine” to get drowsy…

        ========================================
        Why?
        Our internal hormonal system causes a mild energy-lifting rebound effect 1 – 3 hours after consuming the depressant alcohol, and you actually “wake-up” due to the hormonal “bounce” (from moving from sleepy-hormone levels bouncing to create alert/brain-active/awake hormone levels) – which causes you to only get very-light, ineffective sleep for much of the rest of the night, due to “taking a drink” to fall asleep….

        Since the typical Physician knows ALMOST NOTHING of endocrinology, NOR OF SLEEP SCIENCE, NOR OF the effects of their drugs (like their anti-depressant drugs or alcohol), the Physicians AND the local Health Department people are likely to give exactly the wrong advice.

        ========================================
        Remember, these “much respected” Physicians are the LEADING CAUSE of UNNECESSARY DEATHs in the USA for 3 decades – and they have buried these facts – and blame the deaths on other causes for over 30 years. …

        ========================================
        Note that Physicians are very good at trauma medicine and at treating some infections: They are good at prescribing antibiotics (created by real scientists) and they are good at washing out wounds, and good at sawing and bolting and screwing broken bones back together, and good at sawing off limbs of diabetic patients, and good at cutting off pieces of bad skin like moles, and good at stitching wounds back together, good at inserting bags of chemicals to make bigger-looking breasts, and changing the shapes of noses and eyes to fit the beholder’s imagined ideas of beauty ….

        ========================================
        Finally, consider that for at least 30 years, 25% of hospital patients got totally unnecessary nasty secondary bacterial infections from… the Physician who may or may not wash their hands immediately before touching the patient – and that same Physician grabs his dirty non-sterile pen… and picks up the dirty non-sterile chart, and touches the dirty non-sterile bed foot, railings, headboard…. etc…. and then touches the patient and touches the things the patients touch….

        and that same Physician, with the same now-dirty pathogen contaminated pen, from touching an infected patient and then GRABBING HIS PEN to make notes, … then goes on to touch … many other patients… charts and notebooks etc that other hospital staff also touch, along with DOOR HANDLES, … Computer and instrument keyboards … and control panels, …. counter tops, nurses station desks, etc etc…

        ========================================
        Would it be outrageous for Doctors to buy and use pens made out of anti-septic plastics – and to use clipboards and notebooks with antiseptic components? And to SCRUB their hands with antiseptic soaps for over 20 seconds of soapy suds, IMMEDIATELY BEFORE and IMMEDIATELY AFTER every patient contact… ???

        Why not scrub every time? Or at least use sanitizing alcohol-gels (like the rest of us?) ?
        Because they are convinced that like all humans: “This is how we have always done it….

        This stuff is NOT rocket-science…. it is simple microbiology, known for over 120 years….

        Yet, they refuse to acknowledge their roles and responsibilities – even when there are 2 million patient studies – published a decade ago – in 2002 – 2004 ~ proving that Physicians are the largest cause of unnecessary deaths ~ …. And yet, they refuse to change. Refusing to change even their minor-but-risky infection-causing personal behaviors. -like touching a patient and then touching their pen, or their tie, or ….

        ========================================
        Should we trust them?
        Dr. Steven M. Fry

    • nickel says:

      I am so sorry to read your story. My husband had something similar 1 1/2 years ago but never diagnosed. What we did learn from a nutritionist is that even though he was ‘recovered’ officially from the virus, his body would take time to heal completely, his liver particularly. He was affected by the weather and foods. He got on a very specific diet and immune booster which helped him a lot. I hope you are well now!

  15. K says:

    Hi.
    You wrote that after having one strain on Dengue you are briefly immune to only that type of Dengue (3-4 months) I thought that once you have had 1 type it is not possible to get the same type again, only the remaining 3… Is this not correct? I have had Dengue 3x now and 2x within the space of 3 months last year ( I live in Indonesia) It is the worst I have ever felt in my life but i felt some comfort in the thought that my chances have been decreased as I only have 1 more strain left and lets hope I dont ever experience it again anyway.

    • yucalandia says:

      Hi K,
      I would believe the results that researchers and doctors have found for the past 15 years vs. what we might imagine on our own.

      You wrote:
      I thought that once you have had 1 type it is not possible to get the same type again, only the remaining 3… Is this not correct?

      This is NOT correct. The serology, the patient reports, physician reports, and research all show exactly what we report. If you don’t believe it: Read the 2 previous WHO reports on Dengue, read the PAHO reports, read PubMed research papers, etc.

      To prove it to yourself, if you had gotten the second round of blood tests made after 10 days of fever (when you had your 3 Dengue infections), then you would have gotten IGM results for both which serotype of Dengue infection you had (DEN-1, DEN-2, DEN-3, or DEN4), and IGG proof of past infections. Do a Google search of “Dengue serotypes DEN ” and you can quickly pull up articles like: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626838/pdf/8903160.pdf Dengue/Dengue Hemorrhagic Fever: The Emergence of a Global Health Problem
      or
      http://www.ncbi.nlm.nih.gov/pubmed/16207951 Serotype-specific detection of dengue viruses in a fourplex real-time reverse transcriptase PCR assay.

      The first article is by a good friend (Dr. Duane Gubler) and former co-worker with my wife, so, realize that anything you read by Duane is very high quality, and worth trusting. Dr. Gubler (and my wife) have spent 4 decades studying Dengue for CDC, for Johns Hopkins, etc etc, so, we at Yucalandia actually provide first-hand expert advice on Dengue… *grin*

      Hope you stay healthy, and get no more Dengue Infections, because the rates of Dengue Hemorrhagic fever have been running between 50% and 80% in some areas, due to the high rates of secondary and tertiary Dengue infections (like your repeated Dengue infections).
      All the best,
      steve

      • Stima says:

        I was never told which strain I had. Is there a way to detect Dengue in blood work after two years? Something interesting that my mother told me after I was diagnosed. My father contracted a severe case of Dengue Fever while stationed in the Philippines. (This was prior to my birth). Interesting ….could it be a gene thing that made me more susceptible?

      • yucalandia says:

        Hi Stima,
        Consider genetic factors that make you more likely to be bitten by Aedes Aegypti:
        Since some people emit more chemical odors that attract more biting mosquitos, then if you and your Dad were the “one person that the mosquitos bite (gene)” when sitting with a group of people, then yes – you could have some combination of genes or RNA that make you more likely to be bitten.

        If you have your Dad’s characteristic of having your feet or ankles uncovered in the morning, with your feet down low (like under a desk) – or sleeping late in the morning with a foot or leg exposed (“too hot gene“?) near a pile of dirty clothes (is there a leave dirty-clothes-in-a-pile gene?) or next to the supposedly “clean” clothes in the closet (since our detergents really do NOT remove the human odor molecules when we launder them – unless you use a little bleach in every load)…. And yes, behavior genetics predicts that there are some combinations of genes that can determine how ~ bold ~ we are, or how ~ timid ~, or how ~ independent ~, or how ~ dependent ~ => community/group oriented we are. …

        For example, if you are a loner (independent), up early in the morning (when Aedes Aegypti are active and biting) and you have exposed feet/ankles/lower legs (hot-feet/high-metabolism gene), sitting at a desk or sitting reading (where the Aedes Aegypti like to lurk under furniture) – then yes, your combination of genes and RNA from your Dad could bias your behaviors to place you in situations where you are more likely to be bitten by Aedes Aegypti. ….

        Or… maybe you have a strong expression of the “boldness gene” or “wanderlust gene” – which prompts or encourages/allows you to travel comfortably to exotic places …. where you have put yourself at increased risk of encountering Aedes Aegypti mosquitoes….?

        Really…..

        The next effect that could likely have a genetic component – your levels of activity: Some people get bitten by Dengue infected (female) Aedes Aegypti mosquitoes and NEVER get the Dengue virus (maybe they taste nasty and the female mosquito bites/feeds only once on that person… or maybe both you and your Dad are ant-sy people who do not sit quietly to be bitten multiple times by that infected mosquito – or maybe you two don’t sit still long enough for the mosquito to feed for long enough times for the mosquito to transfer enough saliva to transfer the Dengue Virus….) …

        Or maybe it could be an inherited immune system effect: Maybe your immune system is too weak to nail the virus before it can effectively replicate…. some people get bitten, with infected mosquito saliva being transferred, but they never get infected….

        OR maybe you both just happened to be in an area with Aedes Aegypti (when Mom was not there), and you each got bitten….

        Re detection of past Dengue Virus infections by serum testing:
        Yes, we maintain IGG immune system antibody molecules against Dengue Virus in our blood for the rest of our life. Unfortunately, the presence Dengue Virus related IGG antibodies in our blood only shows that we had a past Dengue Virus infection. There are no traces of the original virus left after the infection, so we cannot determine the strain after the infection has passed.
        Dr. Steven M. Fry

        (rarely just one cause and effect. There are no studies to show evidence of a gene that makes us more susceptible to becoming

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  17. Stima says:

    Good info and I totally agree! I have worked in the medical profession for over 10 years. My point was that there is little information available about dengue fever. Of course when it was confirmed that I did have dengue fever it was reported to the DOH that told me that dengue fever could cause depression.

    • yucalandia says:

      Hi Stima,
      I apologize for making multiple ongoing changes and edits to my response – but we really must change our attitudes towards Physicians and to Hospitals and to the whole Medical profession – applying the same skepticism and good judgement and follow-up research/investigating our options, as when an incompetent or marginally competent mechanic tells us something “fishy” about what is wrong with our car or with our tires…

      There is ZERO, ZIP, NO evidence that prior Dengue Virus infections can cause depression.

      Facts: Some patients do have residual metabolic and hormonal changes/effects that leave the patient more susceptible to falling-into behaviors that have been shown to either trigger depression or to contribute to depression – but THERE IS NO CAUSAL LINKAGE between Dengue fever and depression

      At least there is no more cause and effect, than the relationship between people carrying umbrellas that could somehow cause it to rain.
      steve

  18. Jill Chesser says:

    Wow Stephen! Well written! An applause to you. I am a practicing registered nurse at a university hospital and truly enjoy learning all forms of healing both physical and spiritual. We do have a long way to go in progressing to better treatment options for our patients. Let us put our heads together on this as ignorance is the cause of so many deaths. The younger generation of physicians will hopefully be more approachable at coming out of the box of memorization towards better treatment options for patient care. In out community most of our more holistic physicians refuse to settle for health insurance payments and prefer cash only as well as charging very high office visit charges. The natural supplements are often expensive as well. I think if this one issue can be addressed mor pAtients would be willing to switch over to other health treatments . Patient education and responsibility is at an all time low as the average American can only read at a 6th grade level. Crazy as we are in an Information Age. However I see it everyday at the hospital. Patients who just don’t have a clue about what is going on with their bodies. On the most part people are more knowledgeable about their automobiles and what needs to be repaired on them than they are on there own bodies. Thanks for sharing and listening . Nurse chesser(a post dengue survivor$

  19. Has anyone suffered severe hair loss some months later after dengue fever?
    bianca

    • Nick says:

      Hi Bianca, yes I am experiencing hair loss still 7 weeks after contracting Dengue.
      I would not call it severe though
      Nick

    • Zaigham says:

      Yes, I have suffered severe hair loss after dengue fever and there is no sign of recovery. My hair have become so thin now that my scalp is visible. I wish there was a treatment for that. I am 21 years of age.

    • Libby says:

      I had dengue hemorrhagic fever and about three months afterwards I too had significant hair loss. I would say that a third of my hair fell out. During a followup with the infectious disease doctor who treated my dengue, she said that this is a common occurrence. The prolonged high fever damages the hair follicles that are developing during that time and then as the hair grows out of the scalp, the damaged part of the hair shaft breaks. It can be very alarming but don’t worry, it will totally grow back. It took about a 18 months for my hair to feel as thick as it did before dengue.

  20. Jill Chesser says:

    Hey Bianca , I had severe dengue hemmoragic fever in 2005 with elevated liver levels, blood in my urine, blood clots in my left leg/knee and ran 102 fever every afternoon through the night which slowly tapered to the 100’s over a 2 month period . I did experience hair loss but I don’t think it was the dengue fever but it was a thyroid issue from the long term stress of the disease as I was already suffering from hypothyroidism. My syntroid dose had to be increased and my hair is back as thick as ever. Also you may want to consider a possible fungal infection to the scalp as a result of your immune system being compromised from the illness. A nizorel shampoo should help as well as a strong probiotic best purchased at a gnc or vitamin shoppe as they carry a more concentrated form. I wish to encourage you to eat. Diet rich in vegetables, fruits, whole grains, seeds , nuts, and lean proteins as well as whey protein shakes. Also begin exercise as best you can by walking and getting some sunshine if around 20 minutes 3 x a week. Vitamin d3 5000 iu daily well strengthen your immune system along with 1000 mg of vitamin c. Also you may find alkalinized water with an 8 to 9.5 ph to be vey helpful in decreasing acidity and inflammation that may be afflicting you systemically. These have been some of my answers as well as prayer and reading my bible for spiritual renewal. Dengue recovery is a long journey but I have been blessed to have better health now than before I went through the disease process . Hope this helps you !!
    Jill Chesser

  21. Miriam Stewart says:

    Hi Steve,
    I’m 19 and about to head off to university. I contracted hemorrhagic dengue just over three months ago and am still in the very slow recovery. I am currently contemplating whether or not to defer another year to give my body more time to get better. I am still easily exhausted, frequent aches and pains in the bones and get bad headaches if I do too much.

    When hospitalised, I had a full body rash, blood pressure of 76/43, bleeding from nose and gums, heavy bruising all over backs of legs, blood platelets of 32, the virus attacked my bone marrow, white blood cells and vital organs. Do you by any chance have any idea as to how long I will be suffering the consequences of Dengue?
    Many thanks,
    Miriam

    • Mark millard says:

      Hello my friend thankyou for you very informative web site.i contracted dhf 4 weeks ago .i was in hospital for 8 days I came out very weak but otherwise not too bad .2 weeks later back in Australia I’m having problems with my stomach .eg cramps and bloating .is this a common after effect of dengue ? .i only have the problem after I have eaten .meals are bigger here than Thailand ,obviously ,any ideas and also would all the antibiotics the pump into you in the hospital create any intolerances like gluton or lactose.thanks for your help and time.

      • yucalandia says:

        Hi Mark,
        Unfortunately, some individuals come away with unusual, somewhat unique after affects from Dengue. These have not been well studied nor well characterized. Most people do not get them. You many have another cause of the stomach problems. See below**

        Re consequences of heavy antibiotic use:
        This is another area that has not been well studied.

        It is recognized that the lower GI tract has the most immune sites in all of our bodies. It has also been found that many people carry bacteria in their colons (normal) that release immune system mediating (calming) compounds. People with these special bacteria seem to have no allergy, no asthma, no ‘gluten intolerance’, no ‘lactose intolerance’.

        When we take large doses of antibiotics, it can kill-off much of our important gut-flora. One result~consequence of killing off gut-flora can be that some individuals lose those important bacteria that were keeping allergies to lactose, allergies to gluten, and allergies to other foods like wheat, corn, & dairy products that were being kept in check by the immune system mediating compounds released by the beneficial gut flora.

        Dairy has lactose, a sugar, which too many doctors focus on exclusively, while they ignore the protein (casein) in dairy. Many many people are allergic to both the sugar (lactose) and the protein (casein) in dairy.

        This means that while the lactose is almost completely consumed in the process of making hard cheese (like a good cheddar), there is lots of casein in the cheese, that can trigger many immune system reactions.

        **So, a simple test for new food allergies (caused by taking antibiotics) is to eat a Stone Age diet for 4 days.

        Eat just meat, fruit, and green vegetables, all as only freshly prepared foods.

        No nuts, no dairy, no soy oil, no soy lecithin (in packaged foods), no wheat, no beans, no peanuts (in the bean~legume family) no corn (no soda pop made with high fructose sugar => corn syrup), etc.

        On the morning of the 5’th day, eat a breakfast of just one thing you want to add to your diet: Say … cheese

        Or… maybe not cheese because cheese is highly likely to make you ill, so try a big breakfast of potatoes.

        Then eat nothing else until about 4 pm that afternoon, to create a bolus of just potatoes to pass through your GI tract.

        As the bolus of potatoes (or cheese) passes active immunilogical sites in your Gut, you may have strong reactions, or not.

        Strong reactions can include diarrhea, vomiting, itching, irritability, joint pain, hives~urticaria, dizziness, etc.

        If you have any of these reactions, during the following 24 hours, you are now allergic to that food, and should not eat it for at least 6 months. These reactions to the breakfast of potatoes (or cheese) may even happen at 2:00 in the morning, when your breakfast reaches your lower-GI system / colon.

        Benedryl may help with symptoms.

        If you have no symptoms, then try introducing another food back into your diet… say … wheat or tomatoes.

        If you have any reactions, then you start the Stone Age diet-cycle over for another 4 days of clean simple natural fruits & meats.

        Because it takes most of us 3 days to deficate out all of the antigens from a food allergen we ate, you may feel miserable for 2 – 3 days after eating the new food.

        When you’ve had no symptoms on Day 4, then on Day 5, you can try to add another food back into your diet by eating a big breakfast of say … wheat.

        You may find that like many people, you now have allergies to dairy, wheat, corn, soya, and peanuts.

        Note that when you choose an oil, stick with olive oil or canola… and maybe date-palm or coconut oil. The other generic ‘vegetable oils’ are highly allergenic,

        Read about Clinical Ecology if you want to learn more.
        steve

  22. Jill Chesser says:

    Hello Miriam ! I don’t know if you will get this comment but I hope you do . I too suffered from hemmoragic dengue in 2005 and was very ill for quite some time . I am doing well now but it did take some time to regain all that was lost in my physical body. I am praying for you as I well remember being in your position. Please look on you tube for a Dr. Joel Wallach who can guide you into the direction of needed supplements, vitamins, and minerals that can be the tools your body needs to rebuild itself. Do not be discouraged though you feel very weak at this point. The human body is amazing and given the proper ingredients is quite capable of repairing and restoring all that’s been lost. Hope this helps in your recovery process. It will not take you very long as you are in your youth. I suggest supplementation, start school part time and add classes in as your stamina builds. And…. Start walking everyday as far as you can go. Cause if you don’t use it you’ll lose it. Jill Chesser dengue survivor er and fully restored!!!

  23. Boots Smith says:

    Thanks so much for the clear, unemotional info. I have encountered local programmes and warning notices in both Yucatan and Jalisco & have always wondered what Dengue was. Now I know.

  24. Jessica Neils says:

    Hi my dad had dengue fever. But is still experiencing running nose and sinus in his throat which gives off a very bad smell also when he sleeps and wake up. I just want to ask what could be the cause of it because his second dengue test showed negative

    • yucalandia says:

      Hi Jessica,
      Microbiology tells us that a running nose with foul smelling discharge draining into his throat says he likely has a sinus infection. Have him see a doctor to get his apparent sinus infection treated. In the meantime, physicians have recommended sniffing/snorting warm salt water up into each nostril, to help clean sinuses and inhibit bacterial growth. Since our sinuses are poorly vascularized (sinuses do not have a good blood supply), it can be difficult and time consuming to completely treat a sinus infection.
      Best of luck,
      steve

      • Jessica Neils says:

        Thanks very much. But i just have one more question. While sleeping and he sweats there is a bad smell what could be the cause of this happening to him every night when he sweats

      • yucalandia says:

        Hi Jessica,
        smelly sleeping and smelly sweat…??? Maybe smelly bacteria growing in his sweat glands?

        Talk with a doctor. Antibiotics to clean up his sinuses may also resolve the smelly sweat.
        steve

  25. Jessica Neils says:

    He takes tablets for it but it not really working.

  26. Nick says:

    Hi everyone, its been 7 weeks since contracting dengue fever and my recovery is very slow. I have a constant abdominal pain and can not eat anything acidic like citrus. Anyone getting this? By the way I have found juicing cabbage and brocoli helpful for my recovery.

  27. Nick says:

    G’day Steve from South Australia,
    Yes I have seen several doctors and they tell me to just to rest and take it easy.
    Having a constant dull pain in my abdomen is stressing me out and I will get a CT scan on 25th November and a Colonoscopy on Dec. 18.
    I still get the stinging in the hands and my feet are peeling…..
    This is a great forum but I wish there was a support group and a doctor in my state who is an expert on all of this.
    Nick

  28. barbara says:

    Hey

    I started with Dengue 8 weeks ago. I was in bed for 3 weeks! I am still very tired no matter how much sleep I get, I am also suffering with a general feeling of not being with it and painful slightly swollen glands. Does it really take months to recover from this dreadful disease?

  29. Maureen says:

    Hi Barbara…I had dengue fever two years ago and I am still experiencing symptoms. I am always extremely tired and find it hard to concentrate.I have always been a very healthy active person. Dengue fever has done a number on my health! I am now in a dengue research study. Hopefully one day Doctors will be able to understand this horrible disease and not tell patients that you recover completely after a few weeks.

  30. barbara says:

    Thanks Steve I was beginning to think i was going crazy! Its definitely left me with some kind of post viral syndrome. Glands fatigue,( I’m always tired) and general feeling of being unwell 😦 I had no idea how evil Dengue was, Its scares me!! When should it start to pass any idea?

  31. Nick says:

    Hi Barbara, I contracted dengue at the same time as you and feel fatigue 2 months on as well. I am suffering from hair loss, tingling/stinging/numbness in the hands, dry skin, TMJ and heavy /jeelly legs. I am basically house bound. Doctors have no answers other than to rest and eat right.They say its PVS.I have been through many tests but they have come back negative. I am taking lots of supplements and getting around 8 hours a sleep a night. One month a go I was able to go for brisk walks and that gave me a false hope I was getting better. My big mistake was not letting my body heal first …..more rest….
    Nick from South Australia

  32. Maureen says:

    Hi Nick and Barbara,
    I had dengue fever 2 years ago and still experience complete exhaustion. I get 8 or more hours of sleep every night, exercise and also take supplements. All blood work, cardiology tests came back negative. This disease kicked my ass! I am now in a dengue research study in Florida. I am hoping that one day they will be able to find what the long term affects this mosquito has on ones health. Feel better soon!

  33. Nick says:

    Hi Maureen, Yes the disease does kick ass….and good on you for doing a job you do with a passion! Can I ask after how many weeks were you able to start exercising? In my case I started after a month of contracting it and I thought that I had gotten over it but 10 days later the disease came back with a vengence and now I have not done any exercise at all.I have been mostly house bound but can go out and do a bit of shopping and thats about it.
    All the best
    Nick from South Australia

  34. Elizabeth says:

    Hello Doctor!
    I am a 47 year old mother who contracted dengue when I was in 6th grade in Puerto Rico. (Not sure which kind – I recall pain, high fever, vomiting, extreme weakness, blood dots on skin.) I am wondering now about the long term effects dengue can have on health and the brain. Can dengue effect memory, and other mental functions? Can dengue fever effect verbal memory short term? Executive functioning? I now have Hashimoto’s thyroid disease and Reynauds. Thank you for your thoughts.

    • yucalandia says:

      Hi Elizabeth,
      I would gladly answer your questions if I knew the answers. My training is in public health, chemistry, and virology, (including West Nile Virus, Dengue Virus and Aedes Aegypti mosquitos), but I do not know the long term clinical health effects of Dengue, other than the long term persistence of subneutralizing antibodies in patients, which causes Dengue patients to be successively more susceptible to worse Dengue infections and worse symptoms with every subsequent Dengue infection.

      Dr Srikant Sharma, Consultant, Internal Medicine at Moolchand Medcity reports:
      What are the long term effects of Dengue fever?

      A dengue patient may have certain long term effects:
      -Immunological reaction in body developed following infection by one of the four dengue viruses appears to increase the risk of severe dengue when the same individual is infected with any of the remaining three virus.
      -Vague muscle pain, joint pain and weakness which sustain for some weeks to several months.
      -Patient becomes more vulnerable to several other diseases due to low body immunity.
      -If dengue is accompanied by certain complications like encephalitis, seizures, depression, pneumonia, cardio myopathy, liver injury, orchitis, oophoritis etc then it may persist during post dengue period.

      Read more at: http://indiatoday.intoday.in/story/myths-and-facts-about-dengue/1/327080.html

  35. Chris Gordon says:

    I served in Haiti (operation uphold democracy) from 94-95. I remember being very sick with some of these symptoms. IE blood in stool fever and a rash. Every time I get sick now I get the same red splotchy rash on my torso arms back and neck.
    My wife was researching rashes and came across an article about dengue fever in military personnel in Haiti.
    Is there any long term symptoms of dengue fever? Can my rash by symptomatic still from possibly having it 19 years ago now? I was never diagnosed as having it but I remember being extremely sick for a week or so with these same symptoms. My pcp now has no idea what could be causing this rash. He and his colleges are pretty much stumped at this point. Any info would be greatly appreciated!

    • Belinda says:

      Chris, did anyone ever get back to you? I get that same rash, even think my immunity is somewhat lower. Love to know if i still carry something in my system (clearly) and if there is a way of getting rid of it. It has been 11 years now.
      Any leads would be of interest.
      Thanks
      Belinda

  36. dorieller says:

    Hi! I am 15 and reside in Guyana, South America. Since the 14th January, 2014 I’ve started experiencing pain behind the eyes, headache, fever, chills, pain, fatigue, weakness, nausea, and dizziness, but honestly, my guardians didn’t believe me and thought i was faking an illness because i didn’t want to go to school. However, Today on the 18th, I woke up feeling very uncomfortable with rashes on my arms and was rapidly breathing and it was then they realized that i wasn’t kidding and so sent me to the hospital. The doctor said that i show all the signs of dengue fever however, the blood test was negative. Question: Are the blood tests always reliable? And what other reason could be causing me to feel like this?

    • yucalandia says:

      Hi Do,
      The NS1 and IGM and IGA Dengue tests routinely run between 10% – 15% false negatives (where the patient had Dengue, but the laboratory test results were negative).

      The clinical symptoms you describe fit Dengue, so do NOT take any aspirin or NSAs for fever or pain.

      Watch for bleeding or shock symptoms after 4 days of fever, and stay hydrated. Did they test your platelet levels?

      Hope you are feeling better,
      steve

      • dorieller says:

        Thank you, and Yes, they did a full blood count. My platelet levels were normal but my white blood cell count was low, so I was advised to take alot of vitamin C.

  37. Linzi says:

    Anybody experience an increase in hair loss after having Dengue? I had Dengue in October it really kicked my a** I’m still not feeling 100% I have never experienced anything like it and wouldn’t wish Dengue on a worst enemy!!

  38. Cindy says:

    How long am i infectious. Eg if a mosquito bites me when i had dengue and fever, would it transfer. How do we alleviate the bouts of fatigue weeks after.

    • yucalandia says:

      Hi Cindy,
      I understand your viral loads may remain high enough to infect other mosquitoes for around 12 days after the fever starts.

      Lots of rest, proper hydration, sleep well on a regular schedule, and eat well are the recommendations for bouts of fatigue weeks after a dengue infection.
      steve

  39. Bona's World says:

    Hi Dr Steve,
    I got dengue for two weeks and went back to business as usual afterthat. However this weekend I had 6 beers and 2 cigarette and felt terrible afterwards. Is this because my body could not handel it? Could I have caused permanent damage?
    Thanks for your help

    • yucalandia says:

      Hi Vero,
      Some people report ongoing bouts of fatigue and feeling poorly for even several years after a nasty bout of Dengue. 6 beers may be enough to trigger it for you…
      steve

  40. Bona's World says:

    Hi Dr Steve,
    Thanks for all the information. I recently got dengue from a trip to Colombia and it took me two weeks to get back to work and business as usual. I did drink this weekend and smoke and have felt terrible ever since, is it possible I could not handle it and simply over did it or could I have cause some permanent damage? I will not smoke again but can I never drink? Or was it simply too soon?
    Thanks again

    • yucalandia says:

      Hi Vero,
      I doubt that you have permanent damage, but some people report ongoing bouts of fatigue and feeling poorly for even several years after a nasty bout of Dengue. 6 beers may be enough to trigger it for you…
      steve

    • Barbara says:

      Hi,

      I had dengue in October. It took me till late December to feel strong enough to go out and have a drink and now if and when I do I also feel terrible and it lasts for a good few days after my glands even swell!! Im still not 100% and i am now experiencing excess hair shedding 😦 Dengue sucks!

  41. Andrea says:

    Dr Steve:
    I just tested positive for Dengue after returning from Haiti. I travel 2-3 a year to Haiti for my job. Now I am concerned about getting Dengue again. Do you know where I can find out the estimated rates of the more serious Dengue infection in Haiti? Should I seriously reconsider traveling to Haiti or any other country with a known Dengue outbreak now that I’ve had it once?

    • yucalandia says:

      Hi Andrea,
      We live in a Dengue endemic area, and many many people get a second or 3’rd Dengue infection – with more severe symptoms each time – but not necessarily having DHF symptoms. I strongly encourage you to protect yourself from future Dengue infections, living in places with good window and door screens. Use mosquito repellent, especially on any exposed skin on your lower legs and feet – especially in the morning. Keep the property where you live free of mosquito breeding sites (cleaning up plastic waste and old tires etc, flower pots must have holes in their bottoms, etc). If you take reasonable precautions, you should be fine.

      Still, the choice is yours,
      steve

  42. Donna says:

    5 glasses of water? more like 10 glasses, and that is at least number.
    Here’s a another good read about handling dengue fever : http://www.solving-dengue-fever.com/

    • yucalandia says:

      Hi Donna,
      Note that this Thai physician is only talking from his personal experiences in Thailand with Dengue, that does not represent the 50% levels of dengue infections reported in Mexico that become potentially fatal Dengue Hemorrhagic Fever (DHF). It is also peculiar (and worth noting) that as a supposed “expert”, this Thai physician does not cite nor reference peer-reviewed research results and advice, nor does he cite WHO or CDC or the results nor professional expert advice from people whose careers are based on studying Dengue. This means this physician’s advice is an interesting anecdotal story, not based in the scientific method nor based on testing.

      e.g. He notably completely ignores the crucial effects of subneutralizing antibodies that cause secondary and tertiary Dengue infections to progress to the potentially lethal Dengue Hemorrhagic Fever (DHF) or Dengue Shock Syndrome (DSS). These potentially fatal Dengue conditions are CAUSED by the presence of special (unique) subneutralizing antibodies made by the patient after a prior Dengue infection.

      Drinking lots of water has NO EFFECT on these subneutralizing antibodies – and hence drinking lots of water has no effect on preventing DHF symptoms or DSS symptoms.

      e.g. When people start bleeding into the gut, producing coffee-grounds like vomit, it is NOT because they did not drink enough water.

      When capillaries start to leak blood, drinking lots of water is not a cure.

      If someone has any of the DHF or DSS symptoms, or bleeding from the gums, or bleeding from the eyes, or vomiting congealed blood – DO NOT start drinking water. Instead, get into a hospital immediately.

      This physician’s advice – that is missing key very important facts and that is missing key very important advice for patients – borders on crossing the line of giving seemingly-“professional” and apparently “expert” advice, partial advice that could cause some patients serious problems.

      Since roughly 50% of Dengue cases reported in Mexico in the past 3 years have been the potentially fatal DHF form of Dengue, this physician’s personal experiences and personal advice really DO NOT FIT the facts for ½ of the Dengue cases in Mexico.
      Happy Trails,
      steve

  43. Will says:

    Dear Steven,

    I went to South East Asia last July/August (2013), and contracted DHF, although they did not classify which stage I was of it. I was planning on going to South America in July/August again this year. I know that the chances of death increase hugely when you contract dengue a second time (particularly after DHF), but are there any statistics on this? Also do these high chances reduce with time?

    The countries I plan to visit are Argentina, Bolivia, Peru, and Columbia. I am effectively asking if it is stupid for me to come travelling down to South America for 6 weeks.

    I know this was written in 2011, so the statistics will be less significant 3 years on, but this article has been the most useful I have found on the internet in my fairly extensive search!

    Thanks a lot,

    Will

    • yucalandia says:

      Hi Will,
      The risks of death are still small with multiple Dengue infections – as long as you get treatment if you have DHF symptoms. For the last 2 years, roughly 50% of Mexican Dengue patients have had DHF symptoms (indicating they have had prior Dengue infections), but with hydration and hospital treatments for platelet count issues, the death rates have been low (on the order of 50 people out of 2000 cases).
      steve

  44. Will says:

    Thanks a lot for replying so quickly Steve. Is there a common occurrence of post-viral symptoms? I read on here some people have been struggling with going out to the pub and suchlike.

    Do you have any idea on the chances of someone contracting Dengue over a 6 week trip to those countries?

    Thanks so much again

    Will

    • yucalandia says:

      Hi Will,
      I’d love to give you a firm answer on the risks, but the factors that control your risks for Dengue include some we can control, and others that are unknowable:
      ~ You can keep your lower extremities protected from mosquitoes, especially in the mornings. (and evenings to a lesser degree)
      ~ You can select places that have good screens – to reduce or eliminate mosquitoes indoors.
      ~ You can select places that don’t have mosquito breeding sites (no standing water unless it also has little fish).
      ~ Since viral outbreaks are NOTORIOUSLY difficult to predict, none of us knows where the next outbreak will be in this Hemisphere.
      ~ It takes human hosts for Dengue transmission, so isolated low-density population rural areas generally don’t support Dengue outbreaks.

      So, if you keep your feet, ankles, and below the knee covered – or treated with a good insect repellent, and you avoid areas with lots of aedes aegyptii mosquitoes in the mornings, then your risks should be quite low.

      Re long term clinical sequelae: The major journals and major health organizations do not report much on this – so, I suspect that if the likelihoods were large (or even significant) of having serious long term deleterious health effects, there should be reports of them by now. I would imagine that the typical reported Dengue statistics are correct: only 1 in 10 first time Dengue infections report significant symptoms (most never realize they have Dengue) – so most people either don’t have bad symptoms or do not report it. ???
      steve

  45. Maureen says:

    There needs to be follow-up studies from those that have had Dengue Fever months or years after. There are long term health affects. Why not start reporting on that?

    • yucalandia says:

      Hi Maureen,
      I believe it – but I’m not sure to go about how to formally document the problems: Interviews – where the person describes exactly when the first, second, third dengue infections occurred. What strains of Dengue (1, 2, 3, or 4)? What initial symptoms, fever or not, some ranking of intensity those symptoms. What follow on symptoms, details (when where how). What other complicating factors – symptoms not due to Dengue – what other illneses the people have, medical histories, …. Interesting problem – and a surprising amount of work to do well.

      I’m glad to have people report these things here, and I’d collate the results.
      steve

  46. Will says:

    Ok so its looking fairly low level risk in terms of death/ long term complications! Thanks a million Steve, particularly for your quick help, I’ll be sure to adhere to these precautions, you’ve helped a lot, I was getting quite nervous.

    Cheers again

    Will

  47. Rudresh says:

    I got dengue in november..and now i m experiencing lot of hair fall…more than 100 hairs per day…and i can see my scalp…Is there any solutions to this..?? can i recover my fallen hairs back..??please reply….

    • yucalandia says:

      Hi Rudresh,
      Wow, that is unpleasant. I don’t know of solutions.
      steve

    • Nick says:

      Hi, I had severe hair loss too after getting dengue in Oct. 2013. Don’t worry it will stop. My hair loss stopped in early March 2014….
      Still have dryness and slight stinging in hands so I try to avoid any soap or shampoo getting in contact with my hands
      Other than that I am 100% fit….
      You will get better…..for me it took 6 months

  48. Nick says:

    I got dengue in October 2014 with hair loss starting in late November. Recently I have noticed the hair loss has slowed to some extent. Don’t worry it will not last forever.
    I still have stinging in my hands where I had the rash. Avoiding chemicals does help.

  49. Dina says:

    Hello Steven,

    I hope you don’t mind these questions. I can’t seem to find the post I last commented on. My son was discharged from the hospital about 3 weeks ago, and since then he has been experienced middle of the night nose bleeds. Not a lot of blood, but enough to scare me, especially since he did not have regular nose bleeds prior to dengue. In between the nosebleeds, everytime he sneezes he has blood in his mucus. We went to see a doctor last week, and apart from calling me paranoid (a title which i hold with great pride!), I was told this could be because he may not have fully recovered from dengue, and his nose capilliaries are still weak. The doctor thinks, everytime my son gets overtired, his nose will then start to bleed. We were given medication to strengthen the capilliaries, and after 3 days they seemed to work…but this midnight, he had blood on his pillow again. His most recent bloodwork was all within normal range.

    I am wondering if you have ever come across this in the dengue-recovered patients you have encountered. You are the only person I “know” who has such vast knowledge and experience with dengue. Should I take this seriously? And look for another opinion (prehaps in Singapore)? Or treat it as another regular nosebleed?

    Any advise would be greatly and deeply appreciate.

    Thank you!
    Dina

    • yucalandia says:

      Hi Dina,
      Excellent questions. Since Dengue does damage capillaries**, and because the Dengue virus targets and damages the vascular endothelium (esp. in the walls of capillaries), it is reasonable to attribute his nose bleeds are due to damage from his last Dengue infection.

      If the nosebleeds continue, return to the physician, and describe the current symptoms and his sequelae.

      My knowledge of Dengue is based on helping write research papers and helping with my wife’s dissertation on Dengue and West Nile virus. She is the director of a 25 person biosafety level 3 lab here at Universidad Autonoma de Yucatan, plus working with Barry Beatty & Lars Eisen at Colorado State University, doing work with the Bill and Melinda Gates Foundation, with PAHO, and with the US NIH. Really, they deserve all the recognition and credit. I am just a humble student of theirs. As a former Chemistry prof, I had only a very minor background in tropical diseases before working with them.
      steve

      ** If you want more details, see: http://www.ncbi.nlm.nih.gov/pubmed/18522648
      “… Increased vascular permeability without morphological damage to the capillary endothelium is the cardinal feature of dengue haemorrhagic fever. “

      • Dina says:

        Hi Steve,

        I’m sorry it took me so long to reply to your message. My son had a couple more days of nosebleeds, and I am pleased to say that he no longer has them. He has gone 2 weeks without a single bleed. You justified my concerns more then our doctors…and you made me feel less crazy. I was so sure his nosebleeds were the after effects of dengue. Thank you to you and all the work your wife does. Maybe one day you can speak to the Indonesian government about Dengue, I don’t think anyone here really understands how to prevent it…we definitely need more awarness. For a country who has “dengue season” every 3 months, we truly lack knowledge. I am so grateful to this blog and again to you and your wife. Wishing you both much success!!

      • yucalandia says:

        Hooray!
        I’m so glad he has improved.

        Re Indonesia: I might gab with some of our old-hand CDC cohorts about it at the next Tropical Disease convention in Fort Collins, Colorado in June. Fun fun fun !

        Strangely, there’s been an active culture of Dengue awareness and Dengue research & tracking by your neighboring Thailand- so maybe there’s a Muslim component or Indonesian cultural component(s) involved in Dengue being a non-event in Indonesia ???

        Governments who have ignored Dengue or down-played Dengue are often less-than-eager to admit they were wrong for the past 20 years. ??? (Making change more difficult than one would first imagine.)
        steve

  50. Dorianne says:

    Hi Steve,
    I got DHF in July 2013 during backpacking in South East Asia. I was in the hospital for 3 days and was extremely tired for months. Exactly 3 months after I got diagnosed I got massive hair loss which continued for about 5 to 6 weeks. Then it completely stopped and I was so happy. It has been growing back last few months, although it’s going very slow, so now there are small hairs of only 3 centimeter all over my head (in between all my “normal” hair, I didn’t loose it all by far). But now for a few weeks already I’m losing a lot of hair again, it begins to look like that time in October. Is it possible that this is still because of the Dengue, even though the symptoms disappeared before?
    thanks,
    Dorianne

    • yucalandia says:

      Hi Dorianne,
      I don’t know.

      I will ask some people with more experience in the unusual side-effects of DHF infections.
      steve

      • Dorianne says:

        Hi Steve,
        thank you, I hope they might have an idea on if it still is the Dengue, or if it is possible to develop some sort of returning hair loss problem after dengue.
        thanks again,
        Dorianne

  51. Sarah says:

    I had confirmed Dengue after a trip to Bali in jan 2014. I have a close friend who is a senior nurse in the Solomon Islands. I asked her how they treat dengue and she said they have good success with young paw paw leave juice. I was unable to source paw paw leaves however did come across paw paw extract. This is a fermented drink made by a company called roachway.
    I was bed ridden before having the paw paw and believe this greatly aided my recovery. I stopped taking the paw paw after a month because I was feeling so well. I have begun to feel very tired again plus severe hair loss. I have restarted the paw paw drink, again it has noticibly increased my energy levels. However still losing a lot of hair. Anyone know how dengue effects hair?
    Thanks
    Sarah

  52. Your advice seems to differ from the WHO’s take on immunity. You said that “Each dengue infection confers a very brief immunity (3-4 months) to ONLY that strain of Dengue, but that single infection leaves the patient even more susceptible to more serious symptoms from the other 3 remaining Dengue strains (serotypes).”

    But the WHO says,
    “There are four distinct, but closely related, serotypes of the virus that cause dengue (DEN-1, DEN-2, DEN-3 and DEN-4). Recovery from infection by one provides lifelong immunity against that particular serotype. However, cross-immunity to the other serotypes after recovery is only partial and temporary. Subsequent infections by other serotypes increase the risk of developing severe dengue. – W.H.O.(http://www.who.int/mediacentre/factsheets/fs117/en/)”

    Am I missing something?

    • yucalandia says:

      Hi American Ex patch,
      You are not missing anything.

      You have caught a grievous error by the programmers who typed the information into the WHO website.

      Oddly, the website you quote is written in British English – and that error directly contradicts the WHO’s major hard-copy publications on Dengue. It is very clear that prior Dengue infections DEFINITELY cause the patient to be MORE SUSCEPTIBLE to future Dengue Infections, and to HAVE WORSE SYMPTOMS with every subsequent Dengue infection due to sub neutralizing antibodies created by the first Dengue infection. THERE IS NO LIFETIME PROTECTION FROM DENGUE.

      So, please know the the WHO DOES NOT say that a Dengue infection provides permanent protection. Just one FAULTY WHO website makes this error.

      All the best,
      steve

    • yucalandia says:

      Consider: ” Both in vitro and in vivo, macrophages and monocytes participate in antibody-dependent enhancement (ADE) (18–20). ADE occurs when mononuclear phagocytes are infected through their Fc receptors by immune complexes that form between DENVs and non-neutralizing antibodies. these non-neutralizing antibodies result from previous heterotypic dengue infections or from low concentrations of dengue antibodies of maternal origin in infant sera (21). ” from the official PEER REVIEWED – properly-edited WHO publication: http://ocean.otr.usm.edu/~w777157/Guzman%20et%20al%202010.pdf

      and the most recent research results confirm that any single Dengue infection can cause patients to be more susceptible to worse future Dengue infections: (Nov. 2013)
      “Following natural dengue virus (DENV) infection, humans produce some antibodies that recognize only the serotype of infection (type specific) and others that cross-react with all four serotypes (cross-reactive). Recent studies with human antibodies indicate that type-specific antibodies at high concentrations are often strongly neutralizing in vitro and protective in animal models. In general, cross-reactive antibodies are poorly neutralizing and can enhance the ability of DENV to infect Fc receptor-bearing cells under some conditions. Type-specific antibodies at low concentrations also may enhance infection.
      http://mbio.asm.org/content/4/6/e00873-13.short

      WHO’s web programmers need better oversight/editing,
      steve
      .

  53. Steve,

    You’ve previously replied to a question I submitted under my blog name of American Expat in Chiang Mai. It was about a typo on the WHO site.

    I am finishing the manuscript of “Dealing With Dengue”, a 120-page paperback and e-book for people in areas where Dengue is a relatively new phenomenon.

    I’ve quoted you extensively in it and, although I’ve credited you as you would expect, but I’ve chosen some of your more controversial statements for inclusion.

    Would you glance at it to see if you are comfortable with my choices? I’m happy to make any changes you suggest, including deleting entire chunks.

    I can send the Ms in Amazon’s Kindle format or any other that suits you.

    My email is godfree at gmail dot com.

    Many thanks,

    Godfree

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  55. Michele says:

    My husband and I both contracted Dengue while in Costa Rica in January. I just had blood work last week and I still tested positive for it. How long until it leaves my system? We have a place in Costa Rica and I am very hesitant to go back in fear I will get it again. We both had several weeks of being ill.

    • yucalandia says:

      Hi Michelle,
      The blood test they ran is NOT for Dengue virus. It is a test for antibodies your body made to fight the Dengue Virus. Your body continues to make these antibodies for the rest of your life. Usually, with most diseases, this is a good thing (only getting the mumps once, or measles once in a lifetime). Unfortunately, our antibodies to the Dengue virus are WEIRD…

      Our Dengue antibodies mysteriously potentiate us for future WORSE Dengue infections – with a higher likelihood of potentially fatal Dengue Hemhorrhagic Fever (DHF) symptoms or potentially fatal Dengue Shock Syndrome (DSS) symptoms with every subsequent Dengue infection. Our antibodies to Dengue virus infections are called “sub-neutralizing” antibodies – which is a fancy way of saying that when you have a Dengue virus infections, your body creates weird antibodies that open-the-door to allow future Dengue viruses to more easily enter your cells – permanently compromising your body’s defenses.

      You will always have some level of the subneutralizing Dengue antibodies in your body for the rest of your life, making you at risk of worse and worse symptoms with every subsequent Dengue infection => not good. This effect is likely the cause of 50% of recent year’s diagnosed Dengue infections in Mexicans to progress to the nasty DHF symptoms of bleeding from the eyes, gums, and GI tract – along with huge crashes in platelet counts.

      Avoid exposure to Aedes aegypti mosquitoes…
      steve

  56. Michele says:

    Thank you Steve for your response. So when the health department called me today and said my levels were down to 1 point something form 10 point something back in January, does that mean the amount of antibodies? I am confused. I had been to Costa Rica around 10 times before and not sure I want to go back.

    • yucalandia says:

      Hi Michele,
      Yes, that’s a good explanation, if they did an IgM test (or possibly a Dengue RNA-PCR test). IgG behaves oppositely – by rising over time: http://www.nature.com/nrmicro/journal/v8/n12_supp/fig_tab/nrmicro2459_F2.html

      You can go back to Costa Rica – but if you do, keep your feet, ankles and lower legs well protected, as that is where Aedes aegypti like to bite. As described in our Dengue articles, A. ae. mosquitoes are most active and biting in the mornings and somewhat in the evenings. DEET works.

      We live in a Dengue-endemic area, but by keeping our property and the neighbor’s properties free of A. ae breeding sites, and having good screens, we get only 1 or 2 mosquitoes in the house every month.
      steve

  57. Michele says:

    Ok, thank you for your help!

  58. Nick says:

    Hi Steve and post dengue sufferers, It has been 10 months on since getting dengue on the island of Palawan. My energy levels have improved over time and my hair loss stopped 5 months ago. My only gripe is very dry/stinging hands and feet about once a week that lasts a day or two. I wonder if this is due to the fact that when I had dengue on the 4th day I experienced a severe rash on my feet and hands?
    Does anybody else suffer from this?
    When I returned to Manila for a 2 month vacation in April 2014 I was paranoid. I wore long pants and full sleeve shirt, shoes and DEET on exposed skin. Hard to do in a humid climate but I never got one bite in 2 months.
    Nick

    • yucalandia says:

      Hi Nick,
      I’m very glad to hear that you are improving – and glad that you experienced no fresh bites on your most recent trip to Manila.
      Best wishes for continuing improvements, esp with your hands & feet,
      steve

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  60. Hannah says:

    Hi Steve.
    Is there evidence to show that subsequent illnesses after a dengue infection can be complicated because of dengue?
    I had dengue fever three years ago and periodically experience flulike symptoms to this day.
    Is it possible that this is interrelated?

    Thank you,
    Hannah

    • yucalandia says:

      Hi Hannah,
      In years of reading Dengue studies, WHO reports, CDC reports etc., I have not seen it mentioned, but there are so many first-hand anecdotal reports of new symptoms the patients had not previously experienced, appearing months after the Dengue Virus infection and persisting for years afterwards, that there seems to be something there, especially for the patients reporting new ongoing weakness, fatigue and neurological issues.

      Are these new ailments actually caused by the Dengue infection, or is the resulting Dengue-compromised immune system and other possible Dengue infection damage, resulting in compromised health that leaves the patients more susceptible to new problems?

      My wife and I have not read anything in 30 yrs of the published scientific literature to confirm these problems/issues.
      steve

  61. Stima says:

    Hi Steve, In the 30 years of public scientific literature we never had the internet and also the research to document long term effects from people that have actually had dengue fever. From the previous posts, it seems evident that there is long term health issues. My Doctor told me that there was little know about dengue fever and that was in 2011.

    • yucalandia says:

      Hi Stima,
      It may be time to find a new doctor.

      My wife has been a Dengue researcher since the early 1980’s and the basic science of Dengue infections and the epidemiology of Dengue, and the tracking of Dengue, and the treatments have been well known for decades.

      Any physician who would tell a patient that “little was known about Dengue Virus and Dengue Fever infections” in 2011 clearly did not keep up with the previous 40 years of easily found Dengue literature. For example: The World Health Organization published an updated compendium of Dengue information in 2009 as a 3’rd edition.

      Here’s a short list of some very good basic references – all available on the internet – from before 2011:
      References:
      (1) “The Devil’s Disease, Dengue Fever”, P. McGuire, Johns Hopkins Public Health, Spring 2010 Ed., 2010, pp 16-21.

      (2) Dengue: guidelines for diagnosis, treatment, prevention and control — New edition, WHO and the Special Programme for Research and Training in Tropical Diseases (TDR), 3rd Edition report, ISBN 978 92 4 154787 1, 2009.

      (3) A Timeline for Dengue in the Americas to December 31, 2000 and Noted First Occurrences”. J Schneider, MPH and D Droll, Pan American Health Organization: Division of Disease Prevention and Control, June, 2001, 99 1-20.

      (4) Mexico Worried by Rise in Hemorrhagic Dengue by Mark Stevenson, Associated Press, July 21 2010.

      Really, your doctor was completely wrong in telling you that,
      steve

  62. Michele says:

    I have a lot of new ailments and am starting to wonder if it is dengue related since I never had them before and it is still in my system.

    • yucalandia says:

      Hi Michele,
      Really, there is no evidence that Dengue Virus stays in your system.

      Your body’s immune system makes anti-bodies to fight Dengue Virus, and after the infection, your body continues to make antibodies against Dengue, but Dengue Virus is knocked out of your body by your immune system.
      steve

  63. joana faith says:

    hello,,my partner encounter dengue fever last week.he out at the hospital last two days..the rashes still coming out all over his body.his doctor suggest not to go outside in our house,avoid expose in direct sunlight,also his doctor prescribed a sleeping pills..is that how to get back the imunne sytem,of the dengue survivor patient?thank you.have a nice day..

    • yucalandia says:

      Hi Joana,
      Unfortunately, there’s nothing else that can be done at this point, except rest and plenty of fluids.
      steve

      • joana faith says:

        the rashes that coming, may be more severe if expose to sunlight?

      • yucalandia says:

        The potential rashes are not typically aggravated by sunlight, (unless you get a sunburn). Your doctor may be recommending avoiding sun exposure due to side effects from the medications your are taking.
        steve

  64. joana faith says:

    thank you have a nice day 🙂

  65. jez says:

    Hi there,

    I contracted Dengue and Chikungunya on a trip to the Philippines over xmas (2013/14). I returned and had no symptoms until mid feb when I began to have a heat sensation inside my foot. Following this I have had a crazy array of neuro problems, internal vibrating, twitching from head to toe, palatal myoclonus and basically pain in every nerve in my body. I am recovering I think but find it strange that not many people report similar issues to me. The doctors in the UK have been useless, it took 6 month to find out what was up since they initially though I had MS. Any advice on how to stop this dreaded virus? So far tried a wide array of vits and mineral, was a fitness fanatic before this but am now overweight due to a lack of exercise. My main issue now is tingling in my face and twitches/jerks in limbs and face.

    wish you all a quick recovery!

    • yucalandia says:

      Hi jez,
      Since all Dengue findings report incubation of 3 days to 14 days between being bitten and the onset of symptoms, I don’t see how you could be exposed to Dengue at Christmas, and not show Dengue symptoms until mid-February – as there are no reports of lab-test confirmed Dengue infection symptoms onset occurring 30 – 45 after being bitten.

      Chikungunya virus symptoms onset is 1 day to 12 days after being bitten.

      Click to access CHIKV_Clinicians.pdf

      Based on your reported dates of exposure (Christmas) and the 25 – 50 day delay until symptoms appeared, it really is not likely that you got Dengue or Chikungunya virus in the Philippines – which would explain why that other patients do not report similar issues.

      Have you actually had Chikungunya antibodies or Dengue antibodies found in your blood sample testing?

      Did those tests show that you had a primary infection (first time infected) or that you were experiencing a secondary infection – where your first infection occurred before your Philippines trip, and you have been exposed a second time since that first infection?

      I am not saying that you did not have a Dengue or Chikungunya infection, just saying that the sequelae of symptoms you describe, do not fit Dengue or Chikungunya viral infections acquired at Christmas.

      Really hoping you find relief … and the cause(s) of your symptoms,
      steve

      • jez zahra says:

        Hi Steve

        Thanks for your reply. I was shocked to find I had these viruses as I was never ill,my only symptoms on return was a few shivers here and there so thought nothing off it.

        I have had antibody tests for both and they showed positive for img. It was my first time out of Europe so I’m certain this is were I picked up the viruses as to why they didn’t affect me in the usual way I have no idea. It seems my body didn’t put up the usual fight it should of. According to the nuerologist it is likely the infection is in my brain stem which is why I am getting all these Neuro issues. I have a follow up today of serum tests so may get some answers. my concern is that my symptoms aren’t don’t match up and that it is something else. Although the fact that one of my early issues was carpal tunnel syndrome matches with reports of chikv and Neuro issues.

        Thanks a lot

        Jez

      • jez zahra says:

        following my appointent today I think you might be correct, I no longer have + for dengue img but am -igg. Weak +chikv still but no igg so im not to sure what I have any more but it seems that its highly unlikely to be either of these since rna test were negative. THe tropical diseases docs now have no clue what to do for me? my mri was clear so its not neurological so who knows. Booked in for a nerve conduction study so will have to wait till then. Im confused as to whether i even had a virus, do you know what could casue +deng and Chik img? a mutated virus possiblly or a rare one. anyway thanks for your response!

        Jez

      • yucalandia says:

        Hi jez,
        I’m sorry to hear that they have no clear idea of what you have, but by doing the Dengue and Chikungunya tests – maybe they can ultimately figure out what your problem(s) is – and come up with a treatment plan based on knowledge (vs guessing).

        Positive for IgM (+) DENV along with negative for IgG (-) DENV says you had your first Dengue virus within the last few months. The same result applies for IgM (+) CHIKV along with negative for IgG (-) CHIKV says you had your first Chikungunya virus within the last few months. The negative IgG results say that you have not had prior infections of these diseases in the more distant past.

        Assuming the lab results are correct, it seems you may have been bitten by mosquitoes in the Philippines and contracted both viruses, but since roughly 80% of the first time infections for each virus gives the patients no fever symptoms, no rash etc, you may have been in that 80% group of no symptoms in 3 – 14 days.

        Does having both viral infections at the same time – cause later neurological complications?: We just don’t know

        possibly because Chikungunya is relatively new, you may be an early example of a condition not yet reported. The DENV and Chikungunya virology researchers in our lab have not heard of any cases like yours.

        There are some “new” emerging viruses – like “Cache” virus here for the last few years in Yucatan, but we have read nothing about new viruses in the Philippines.

        ???
        steve

    • I have same issue after dengue my symptoms getting worse weakness muscle twitching headache muscle stuffness night sweats ihave done emg eeg ncv normal mri abdomen normal cbc normal till date I am not understanding why this is happening to me

  66. jez zahra says:

    hi Steve,

    Thanks for your response it has given me some things to think about? I still wonder if these could be false positive potentially caused by an unknown virus? but two positives on the Chikv IgM would suggest to me that I had it, bloods for my first tests (+deng IgM & +Chikv Igm) were in late March and the ones I got today (-dengue IgM, RNA, IgG & +Chikv IgM, -RNA, -IgG) were from bloods in July…so I wonder whether my the ones taken today will show a clearer picture.

    I guess it would be considered strange not to have produced IgG after 6 months of contracting the virus? although many of my early symptoms fit well with both viruses, for example joint, and pain behind my eyes. also I had a few nights of sweats in mid Jan which could of been related but didn’t realize I was sick at the time.

    Thank you very much for discussing it with your colleagues, it is very difficult to discuss these thing with doctors here since appointments tend to be at least three months apart – not to mention that none of the doctors I have met knew anything about Chikv.

    Jez

  67. dean1v1 says:

    Hi Steve I have left comments before, we debate the septic systems. I am hoping to finally convince you to tell people now that they need to screen off septic and house vents nd inspect them for cracks openings. Before I had told your readers about the PR results that they found them breeding. Now finally I have the CDC on posting the septic systems vents and so on….

    So it is official, please check the CDC links I have on my website, they finally agree, that hundreds to thousands of AE mosquitos can breed in them a day. I have talked to people that have also seen that, (two reported thick clouds of mosquitos flying out in the thousands) I personally have not seen thousands but with my own eyes 15 years ago hundreds and have also proved it several times in some areas. Again I live in baja and in our town our only mosquito is AE, so a more controlled . The AE lives here year round and in some year spans we do not get but 3 rains of less than 2 inches total for 4-7 year periods yet we have constant AE mosquitos. IT IS NOT RAIN that allows them to survive and thrive in drought years in a desert it is man and his septic and house vent systems. This translates to rain areas too.

    Not sure where my posts went, it is fine to remove my posts as I am a no-body engineer, but your other responders now need to debate the wisdom of the CDC putting it on front page of their website for stopping the AE from breeding.

    Click to access 214629ASepticTankFacSheet508english.pdf

    http://www.cdc.gov/Dengue/entomologyEcology/index.html
    It is likely that Ae.aegypti is continually responding or adapting to environmental change. For example, it was recently found that Ae. aegypti is able to undergo immature development in broken or open septic tanks Adobe PDF file [PDF – 1 page] in Puerto Rico, resulting in the production of hundreds or thousands of Ae.aegypti adults per day. In general, it is expected that control interventions will change the spatial and temporal dispersal of Ae. aegypti and perhaps the pattern of habitat utilization. For these reasons, entomological studies should be included to give support before and throughout vector control operations.

  68. Ashish says:

    you should also mention treatment given at home side e.g. home remedy for ex. papayas leave’s juice is the sure remedy to combat dangue

  69. Sarah says:

    I mentioned paw paw leave juice 12 months ago. This is what islanders in the Solomon Islands use and also what some villagers use in southern India. I took a prepared paw paw leave fermented extract made in Australia and the results were amazing. Why is science ignoring what locals use with excellent results. More research needed here!

  70. Maureen says:

    What is paw paw juice? I have heard that papaya leaves and neem leaves boiled and drank as a tea are also options in treating dengue fever. Yes…more research needed!

    • Carla says:

      Paw paw is what they call papaya in Australia.

      • yucalandia says:

        Hi Carla,
        Is Australian “paw paw” the same papaya of Mexico and South America? (Green or yellow fruit?)

        The USA and Canada also has a fruit (green) that called “paw paw” – and is very common/popular among American Southerners in Missouri, Alabama, etc – even with songs about “down in the paw paw patch“…

        Anyway, the US “paw paw” is not actually a mango – but is a distant cousin of mangos: “Pawpaws are in the same plant family (Annonaceae) as the custard-apple, cherimoya, sweetsop, ylang-ylang and soursop;[6] the genus is the only member of that family not confined to the tropics.
        http://en.wikipedia.org/wiki/Asimina

        The mango, instead, is in the genus Mangifera, consisting of numerous tropical fruiting trees. The majority of these “mango” species are found in nature as wild mangoes. They all belong to the flowering plant family Anacardiaceae. … (not the American paw-paw Annonaceae family)

        Based on the science – MOST Yucalandia readers should know that the advice about paw-paws – and about mangos – curing or preventing Dengue Fever – have no proven healing abilities.

        — just like the “paw paws” eaten by millions of Americans, are not mangos.

        The Australian “paw paw” could be in the Mangifera family (a true mango), or it might be in the Annonaceae/Asimina family….

        I mention all these things to clear up the problems caused by false folk wisdom – since a lot of folk-wisdom is not based in actual testing – and as shown from this example – even the terminology used by folk-wisdom is not consistent with reality.

        ~ We encourage people to choose Dengue prevention methods and Dengue treatments that are proven to work…
        HAPPY NEW YEAR,
        steve

  71. Heather Gramman says:

    Hi, I went to Rivera Mya Mexico a month ago. About 5 days after I got home I suddenly started feeling sick with severe body pain all over. Even my ankles hurt. The body pain was all day long for about 4 days then seemed to be getting better for the pain was only at night. I also had night sweats, occasional facial and neck flushing to where my face felt burnt, and head pressure, and very tired. As of today I am still having pretty bad body pain at night to where it wakes me up because I hurt. I have been to the dr. 5 times now. It has been so hard to get anyone to take me seriously. All the doctors keep say you’re young you probably just have some kind of virus. I finally got my internest to refer me to an infectious diseases dr. But couldn’t get in for another 3 weeks. This has been very frustrating and scary month!! I have never had any health issues and never go to the dr. I’m worried something is really wrong with me! I’ve been reading alot about dengue and alot of my symptoms match up. I’m worried that by the time they test me it won’t show up.

    • yucalandia says:

      Hi Heather,
      Welcome to modern Western medicine. Medical doctors look for what they know, so if you are in the USA, Canada, or Gr. Britain the doctors typically have not learned about Dengue, even though it affects 40% of the world’s population.

      You could get tested now for antibodies to Dengue: IgM antibodies for dengue may remain elevated for 2 to 3 months after the illness, while IGG testing would reveal even an old Dengue infection.

      Here’s some CDC plots showing your options:
      image: showing comparison between primary and seconcary infections

      steve

  72. doreen says:

    Hi Steve,

    My son (5 yrs old) had Dengue Shock Syndrome 2 months ago, intubated for 7 days, B/P dropped at 70/40.. I thank God for healing my precious son, for me its a miracle, its my son’s 2nd life.. My son has fully recovered but then im concerned about my 2 other children ages 9 & 7, is it true that when a person has dengue virus on his body, that virus will remain forever in his body? what if a mosquito will bite my son (DSS patient before) and that mosquito will bite my 2 other children, will they be infected? or is it the person with current dengue fever are the only one who can transmit the virus? thanks

    • yucalandia says:

      Hi doreen,
      Wonderful that your son recovered.

      Your son will not have Dengue Virus in his body, but he will have neutralizing antibodies to Dengue Virus for the rest of his life – and the neutralizing antibodies (made by his immune system) make him permanently more susceptible to worse and worse symptoms with every subsequent Dengue infection.

      Since your son only carried the Dengue Virus back while he had a fever and DSS symptoms, then there is NO current risk of cross-infecting your other children with your son’s old (long past) viral infection. As you proposed: only people with active Dengue infections can infect Aedes Aegypti mosquitoes – which is why experts advise rigorously spraying our homes for mosquitoes whenever a family member gets a Dengue Virus infection.

      Hope it all goes well – keep good screens in place, and clean up any mosquito breeding sites within 300 ft of your home,
      steve

  73. Michelle says:

    Hi Steve
    I contracted DEN 4 last August in Koh Samui Thailand and spent 12 days in hospital over there. I am from New Zealand and the doctors here know very little about it. A question that I would like clarified is …. I was advised by the doctors in Thailand not to travel to a country again that has dengue fever as each time you get the infection it gets worse and they do not think that I would survive another attack. I was also told by the doctors in Thailand that apparently i was extremely lucky to have survived what I had. Has your research found this to be true? looking forward to hearing your reply.

    Michelle

    • yucalandia says:

      Hi Michelle,
      As described in our other Dengue articles (like https://yucalandia.com/science-health-issues/dengue-fact-sheet/ ):
      Prior Dengue infections almost universally interfere with our subsequent immune responses to new Dengue infections, (see ADE theory), with each new subsequent infection producing more severe symptoms, increasing the chances of possibly fatal Dengue Hemorrhagic Fever (DHF) symptoms or Dengue Shock Syndrome (DSS). (See Subneutralizing Antibodies)”

      Our body’s reactions to Dengue virus infections include continuing to produce subneutralizing antibodies for years. These rather unique antibodies REDUCE our immune system’s ability to fight future Dengue virus infections – so the Dengue symptoms get more and more intense with each subsequent Dengue infection.

      If your first immune system reaction to Dengue virus was weak – poor – so research from around the world shows/predicts your subsequent immune responses would likely be even worse. This is why the Thai doctors recommended avoiding Dengue endemic areas for future travels.

      This stuff is widely-known, published for 2 decades by the WHO, PAHO, CDC and British health official publications et al – so it’s peculiar that your New Zealand physicians don’t know about this, because it is a key feature of Dengue diagnoses & treatments – and can be found in just 10 minutes of reading WHO, PAHO, CDC pamphlets or internet sites.

      ??
      steve

  74. Dave says:

    Hi There Steve
    I became extremely sick whilst holidaying in Vietnam in 2012 and was taken to a medical centre where I had a blood test taken, the result confirmed that I had dengue fever and I was sent to hospital for 4 nights, I suffered extreme vomiting and diarrhoea and dehydration, exhaustion, I don’t remember if I had joint pain in my body, however on my return to Australia, I was tested, and the doctors found no antibodies to Dengue, I was tested again recently and another negative result for dengue, is it possible I did have dengue but the antibodies are not now evident in my blood ? or is it likely that I had another virus that had similar symptoms ?
    Many Thanks for your interesting and informative forum
    Dave

    • yucalandia says:

      Hi Dave,
      If you had a 2012 Dengue infection, you would still have antibodies to Dengue.

      No antibodies now say that the Vietnamese diagnosis of Dengue was incorrect.

      Is that what your Australian physicians confirm?
      steve

  75. Dave says:

    Hi Steve
    Yes the doctors here have told me i have no antibodies to any dengue strain, I am curious as to why the Vietnam doctor diagnosed me with Dengue ? is it likely I had a similar virus with similar symptoms ? they did take a blood test and checked for the virus in the medical clinic in Vietnam and told me it was Dengue, are there other viruses that could be mistaken by the Vietnam doctors ?
    Many Thanks for taking the time to reply to me.
    Regards
    Dave

  76. varsha says:

    I had symptoms including nausea,fever(for 3days),body(muscle and joint pains), rapid and slow heart beat rate,BP(100/60).
    I consulted doctor,he asked me to get Dengue Serology test done.
    But the report says its negative.
    Is it correct? How can i cross check it.
    i gave my blood at around 8 in the morning,he was still testing it at 2:45.
    Is the diagonsis right?
    Please.do help.me out
    thank u

    • yucalandia says:

      Hi Varsha,
      Do you have other symptoms that are characteristic of Dengue?

      like pain behind the eyes, rash, bleeding from gums, eyes, or into the gut?

      You could also have one of the other flaviviruses like West Nile or Chikungunya … There’s also a similar virus called Cache Virus, but I understand that its presence is likely limited to Yucatan/Mexico.

      The treatments are basically the same: Stay hydrated (keep drinking enough fluids – e,g, 5 glasses per day), kill all mosquitoes in your home to avoid infecting other mosquitoes that could subsequently infect your family or neighbors, … rest, see the doctor if your symtoms get worse.

      There are both IGG/IGA serological tests and RT-PCR based testing for Dengue, but I’m not sure what it would accomplish at this moment for you to know whether you have Dengue or not.

      Wish I had better news,
      steve

  77. Michele says:

    I was sick for weeks and had throbbing pain in my ears and eyes. Maybe yours really isn’t dengue. I also still tested positive 6 months later.

  78. Richard says:

    My daughter in the philipines had dengue 2 weeks ago and was hospitalized for a week. still weak, now her husband has it. I have heard of using oatmeal leaf tea and papaya leaf juice (tastes disgusting) to combat the virus and help increase platelet activity. have you heard anything about these “natural” helpers? My daughters platelets went as low as 39,000 when she was in the hospital. now that it is basically over, the level went back to 360,000.
    we were told that under 50k she probably should have ahd transfusions. we waited, Thank God, and 2 days after the lowest numbers, she went up to 60,000. 4 days later up to 360,000.

    now about those natural helpers,,,any idea??

    thank you,
    Richard

    • yucalandia says:

      Hi Richard,
      After over 35 years of study, there are still no “helpers”, natural or synthetic, that have been proven to work any better than rest and hydration.

      Placebo effects can be strong, so, if you believe in something deeply enough, it can work
      … just as well as a sugar pill.

      Believe in the oatmeal leaf tea and papaya leaf juice, and they can work
      … just as well as a sugar pill.

      I’m very glad that she is better!

      The best medicines for Dengue are still rest and hydration.

      ~ and transfusions if the person’s platelet counts dive too low. ~
      steve

      • Sarah says:

        Don’t ask a scientist about natural therapies…I had dengue. I took a fermented paw paw (papaya leaf) juice. The results were astounding. I live in Australia, caught dengue in Bali. Called my best friend who is a nurse manager at the major referal hospital in the Solomon Islands. They treat patients with young paw paw leave juice. I am a registered nurse. My colleagues from South India also treat dengue with young paw paw leaf juice. So don’t be dismissive of symptomatic remedies. I took the paw paw juice for quiet sometime because without it I would feel so exhausted.
        Thanks , Sarah.

      • yucalandia says:

        Hi Sarah,
        You’re partly right about asking scientists.
        and very wrong about other aspects of scientists.**
        (See below.**)

        We scientists point out pesky things like that paw paws are not papayas. Paw paws are not even in the papaya family.

        Paw paws are in the mango family … very different seeds … very different structures … very different chemistry from the papaya family.

        I’m really glad that the papaya leaf juice helped you feel more energetic – we should also emphasize that
        ~ it does NOT cure Dengue, and
        ~ it does NOT shorten the duration of the Dengue infection, and
        ~ it does NOT reduce the risks of DHF and other serious Dengue symptoms.

        Sarah, Can you prove that papaya leaf juice works any better than an excellent placebo?

        Sarah, What possible side effects does papaya leaf juice have?

        Sarah, What contraindications are there for papaya leaf juice?

        Must the papaya leaf juice be only from young leaves?
        (as you imply in one comment)

        Must the papaya leaf juice be fermented ?
        … fermented with bacteria?
        … fermented with yeast?

        You’ve implied these requirements in your comments … while other past reports of papaya leaf extracts wonder-cures say nothing about young leaves, or fermented.

        Just what is papaya leaf juice ?
        Other people advocating “papaya-leaf cures” for Dengue have described it as an extract or tea

        Juices are squeezed from a plant,
        or squeezed from a fruit,
        while extracts require some soaking in solvent (heated? or not?) like acidified water, or organic solvents.

        I’m not saying that “young … fermented … papaya leaf … juice” … does not work … because papaya seeds have been shown to contain both mild antibiotic mild anti-parasitic agents – so, the leaves may also contain medicinal chemicals.

        =============================
        Sarah, When you say
        “They treat Dengue with young paw paw leaf juice.”

        unfortunately, you are saying SEVERAL FALSE THINGs.

        Your statement says that the papaya leaf juice ONLY RELIEVES SOME of Dengue’s symptoms.

        Symptom relief is NOT necessarily a disease treatment.
        Taking aspirin helps with the pain of cancer, but aspirin (or red-willow bark tea) does NOT cure nor treat cancer.

        Sarah writes about “young paw paw leaf juice” … while the paw paw plant is in a completely different family from papaya.

        Mangos (paw paws) are NOT papaya…
        Mangos have a single huge seed.
        In contrast: Papaya have hundreds of small black seeds.

        So, people reading and choosing folksy remedies should know… EXACTLY what plant to use.

        Using folk remedies requires diligence, accuracy, precision, and KNOWLEDGE.

        Patients considering folk remedies …
        ~ must know EXACTLY what part of the plant to use …
        ~ must know which strain and age of plant to use…
        ~ must know EXACTLY what time of year to harvest the plant…
        ~ must know how much of the plant to use…
        ~ must know EXACTLY how to precisely prepare the plant parts to get viable medicines…
        ~ must know the shelf life of the plant or plant extract (or risk harming patients)…

        **As a scientist, I’ve studied and prepared a number of very good home-remedy plant pharmaceuticals … and yes, they are pharmaceuticals when done CORRECTLY.

        e.g. Consider the 5 species of echinacea …
        ~ Which one species has all 3 active compounds?
        ~ How do you know which echinacea is the only good one?
        ~ What part of the echinacea plant do you want?
        ~ What specific month of the year do you pick echinacea?
        ~ Exactly which sub-part of the echinacea plant, and how much do you use?
        ~ How do you know that it’s too late to harvest the echinacea?
        ~ How do you properly store your echinacea?
        ~ How do you know when your echinacea plant product is too old ?

        Similar things go for horse-weed for skin inflammation and muscle problems, bentonite clay for nausea, poultices for infections & boils, bitter roof for … , sassafras bark tea for stomach/GI infections, black walnut hull extracts for GI parasites, et al …

        So, there’s a LOT OF VALUE in internet announcements like:
        Don’t ask a scientist about natural therapies.
        … because scientists ask … and find … the real answers to pesky-but-very-important questions.

        Would you give your child a synthetic chemical medicine that has not been tested?

        Would you believe lots of claims and promises about some new medicine from a remote country, without any proof?

        Happy Trails,
        steve

  79. Pingback: Zika: A New Mosquito Borne Virus Arrives in Yucatan | Surviving Yucatan

  80. amit says:

    thanks for all this sharing… I m feeling that suffering from fvr lst 36 hrs. when should I go for blood test. please advise.. its body pain joint pain and sudden high fever.

    • yucalandia says:

      Hi amit,
      The blood tests do not work for at least the first 4 days.

      Th treatments are the same, whether it is Dengue or Chikungunya virus: rest, stay hydrated, take tylenol for pain, NO aspirin, NO alleve, NO advil, NO ibuprofen or other NSAIDs.

      Even though it is unlikely: Watch for signs of low platelet counts, especially between days 4-6: bleeding into the gut (coffee grounds-like vomit), passing black fecal blood, petichiae, etc. If you have these signs, go to a hospital for platelet count testing and possible blood transfusions.

      No alcohol consumption (in case it is Chikungunya).
      steve

  81. Ahmed pathan says:

    Sir
    Pls say what do if my son is suffering from breathing problem in dengue stomach
    Is also paining since last to day he is not gone to Bathroom yesterday when i shown to bses hospital doctor he said acidty problem is there
    Is there any serious pls help me

    • yucalandia says:

      Ahmed,
      Follow your doctor’s advice. Make sure your son is drinking enough water (5 – 9 glasses of water a day) to stay hydrated.

      Watch for signs of low platelet counts – and take him in for a blood transfusion if needed:

      ~ Easy or excessive bruising (purpura)
      ~ Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs
      ~ Prolonged bleeding from cuts
      ~ Bleeding from your gums or nose
      ~ Blood in urine or stools
      ~ Unusually heavy menstrual flows
      ~ Fatigue
      ~ Enlarged spleen
      ~ Jaundice

      Have him get plenty of rest,
      steve

  82. Shruti says:

    My daughter suffered dengue fever in 2014 & is planning to travel through Europe in 2016. Would there be any risk of relapse or other problems? She recovered very well and is in perfect health now. Does she need to disclose this illness in her travel documents?

    • yucalandia says:

      Hi Shruti,
      Your daughter presents ZERO dengue risk to others, so there is no need to report/disclose her old dengue infection from 1 year ago. Dengue patients can ONLY transmit the disease while they have an active fever.

      Europe had Dengue outbreaks in 2012 & 2013 in Portugal – but there are no reports of Dengue for 2014 or 2015 in Europe.

      She should be fine … but you can check this site: http://ecdc.europa.eu/en/healthtopics/dengue_fever/pages/index.aspx

      before she travels next year – for 2016 updates on Dengue in Europe.

      Happy Trails,
      steve

      • Sue Dawson says:

        Hi Steve,

        Isn’t it true that the 2012/2013 dengue outbreak in Portugal was actually limited to the Portuguese owned island of Madeira? Madeira is geographically closer to Africa than mainland Europe, and due to it’s year round tropical climate, the dreaded mosquito is now considered endemic there. I don’t believe mainland Europe does support the dengue carrying mosquito endemically, but it can appear in Southern Europe if climactic conditions are favourable.

      • yucalandia says:

        Hi Sue,
        Mainland Europe has ‘officially’ had their own endemic populations of Dengue, Chikungunya, and Yellow Fever carrying mosquitoes … in the form of year-round (likely-permanent) populations of Aedes Albopictus mosquitoes in Southern France, Italy, and Spain.

        This means that the mosquitoes are present year round in Southern/Mediterranean Europe that have been supporting semi-regular outbreaks of Chikungunya & Dengue.

        https://www.pasteur.fr/en/institut-pasteur/press/fact-sheets/chikungunya

        Happy Trails,
        steve

  83. Anil kumar says:

    Hello,
    I’m from india. I’m 25. I got dengue on 19th Oct 2015. I went to the doctor and test result was positive. Doctor adviced to check platelates count daily and take rest and plenty of water as you also adviced. After 10 days, my platelates count increased but unfortunately dengue was still positive. I got scared, went to the doctor again but the doctor told me that there is nothing to worry if your dengue is positive. You should only concentrate on your platelates count. Dengue may be positive for a week or a month or for years. It does not matter. I’m very confused. Is doctor adviced me right? I’m taking papaya leaf juice, goat’s milk and kiwi fruit regularly. It has been 29th Nov 2015 (one and half months have passed after dengue) but my dengue is still positive. What should I do? I’m scared. Please suggest me. Thanks in advance.

    • yucalandia says:

      Hi Anil,
      Your medical doctor has given you very poor advice.

      As described above, your body makes and will continue making antibodies to the Dengue virus for the REST OF YOUR LIFE.

      This means that when laboratories test your blood for the IgG antibodies to Dengue virus => you will TEST IgG POSITIVE for having had at least one prior Dengue virus infection… for the REST OF YOUR LIFE.

      The medical doctor and your laboratory are running the WRONG TEST:
      IgM antibodies to Dengue rise quickly WHILE you have an active Dengue infection … and then fall. (The IgM antibody test is one of several useful tests available to tell if you currently have a Dengue infection.)

      Alternately: IgG antibodies to Dengue rise slowly while you have an active Dengue infection … and then our bodies CONTINUE TO PRODUCE IgG antibodies for DECADES => a test that proves you had a Dengue infection IN THE PAST.

      Continuing to test mistakenly test for IgG is likely making you think (imagine) you still have an active Dengue infection.

      Final Issue with Good Lab Testing: The key days for testing for low platelets are the 4’th – 7’th days of fever.

      Your medical doctor and your laboratory are UNNECESSARILY SCARING YOU …

      … because they don’t understand the life-cycle of the Dengue virus …
      and
      … because they don’t understand correct laboratory testing nor diagnosis.

      Here’s a 10 year old article that your medical doctor and lab could read to educate themselves, and STOP SCARING people. (*sad*)

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870461/

      Hope you feel better,
      steve

      • Anil kumar says:

        Thanks for your advice sir,
        But I’m sorry to say that they have not tested for IgG & IgM. The positive test result is for “DENGUE FEVER NS1 ANTIGEN (lateral flow ICT)”. It means I still have dengue virus. And one more question, Is it possible to have dengue NS1 ANTIGEN test positive for a long time. If yes, then how long? What is the life cycle of dengue virus in body?
        Also which test will be conducted for dengue confirmation after one month because one and half month has been passed for myself.

      • yucalandia says:

        Hi Anil,
        There are a variety of NS1 antigen test kits, and it’s been known since 2002 that all the NS1 tests have extremely high false positive rates ~ postinfection ~– which means they incorrectly/falsely report that Dengue virus is present in the patient, when there is no infection remaining.

        Dengue virus infections are correctly detected by NS1 antigen tests from day 3 to days 8 … and then the NS1 test becomes NOTORIOUS for incorrectly falsely reporting false positives for typically 9 days after our first Dengue infection is OVER.

        Again:
        Your doctor and your laboratory do not seem to be familiar with the Dengue literature since 2002 – as commonly cited by 100’s of papers.

        Again, your doctor and laboratory should read the Dengue research results for the past 15 years – rather than UNNECESSARILY SCARING THEIR PATIENTS …

        They could read:
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3008478/
        and
        Alcon, S., A. Talarmin, M. Debruyne, A. Falconar, V. Deubel, and M. Flamand. 2002. Enzyme-linked immunosorbent assay specific to dengue virus type 1 nonstructural protein NS1 reveals circulation of the antigen in the blood during the acute phase of disease in patients experiencing primary or secondary infections. J. Clin. Microbiol. 40:376-381.
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC153354/

        Are you having symptoms?

        or … Did your medical doctor mistakenly have you keep taking NS1 tests … long after your fever and your Dengue infection were done?

        Hope you are well,
        and
        you might consider changing doctors and changing labs to find ones that know common Dengue facts,
        steve

  84. Gail says:

    Thank you for this article. Can you explain more on long term effects on those who get this Dengue fever on their body’s and time frame to continue with symptoms. What kind of time frame and what kind of symptoms? Thank you

    • yucalandia says:

      Hi Gail,
      It depends on each person.

      For most
      people, after the fever ends, they are tired and run down for a few weeks, and you slowly recover.

      For others, after the fever ends, they have some continuing joint pain, sometimes for months – but that is NOT common.

      A even smaller few have ongoing problems with other physiological systems, but those are not well documented.

      Hope you feel better soon …

      and do your best to avoid a second or 3’rd Dengue infection in the future, because the subsequent Dengue symptoms are dramatically worse,
      steve

  85. Emily says:

    Hi Steve, thanks for this information! I’m on day 4 of Dengue and am wondering if a previously infected person can receive the vaccine that will be distributed soon in Mexico?

    • yucalandia says:

      Hi Emily,
      Sure, a previously infected person can receive the vaccine, but if you read the WHO reports and Sanofi’s reports on the vaccine, you may make a different choice, based on facts.

      Consider that the vaccine only works on 40% of patients for protection against the nastiest strain of Dengue (DEN-2).**

      Consider that you likely need at least 4 shots a year, and possibly 8 shots a year to maintain an effectivetiter of Dengue antibodies.

      **Consider that the vaccine is at best only effective about 70% of the time against just 3 of the 4 varieties of Dengue, (DEN1, DEN3, &DEN4) and works poorly against DEN2.

      DEN2 has been very common in recent past Yucatan Dengue infections.

      ???
      steve

  86. Jill Chesser says:

    Yes!! Doing great! It took a good year after the dengue experience. I had to take all the same measures as your husband to grab back my health! Thank you for your concern and for sharing. I hope you and your husband have an awesome 2016!

  87. Sue Dawson says:

    Hi Steve,
    I caught dengue in Barbados in 2003. I hadn’t heard of it previously and there was only basic information available on the Internet at that time. I’m very grateful for the good information you have provided here, as it’s an experience one never forgets!

    I was diagnosed locally but without blood tests and didn’t bother to report it to my doctors here in UK, as no treatment was required and I doubted they would have much to add to the situation.

    One issue I’ve never seen discussed though, is whether or not people who have had DF should be blood donors or even organ donors? What are your thoughts? I guess in the case of organ donation, the benefits outweigh the risks for the recipient. But in the case of blood donations, should those who have had DF be excluded to minimise risk of DHF for recipients?

    I haven’t contacted the UK blood donation programme to see if they screen for dengue, but having had a friend who contracted hepatitis C from from a blood transfusion before screening for that was routine, it kind of makes me wonder.

    I would be interested to know what you think.

    • yucalandia says:

      Hi Sue,
      In our area, the blood banks do say an acceptable blood donor must not have had a fever of any kind for at least the previous month.

      I understand the same rule is used for transplants of organs or marrow.

      When we have an active fever, it is an indication that we have significant levels of the Dengue virus in our blood stream (called “high viraemic loads” or “high viraemic levels”).

      While we have Dengue virus in out bloodstream, that virus can be transmitted by either tissue/organ donation or blood donations … though there have only been 2 recorded transmissions by blood transmission, one by organ donation, and one by marrow donation … and in ALL cases, the transmission occurred when the donations were made during (or just before) the donating patients had a fever … so you anticipated correctly:

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2713854/

      40 years of recorded evidence say that you can make donations without putting recipients at Dengue risk.
      steve

      The

      • Sue Dawson says:

        Thank you for your answers. I appreciate that donating blood while carrying active fever would be inappropriate, but what I was really questioning was the possible transmission of antibodies after the active virus had passed. Could that put a transfusion recipient at greater risk of developing severe dengue symptoms if they subsequently contract the disease? Or is it too unlikely to be a consideration?

        Thanks for your advice.

      • yucalandia says:

        Hi Sue,
        Antibodies do not make us sick.

        Active, live virus causes Dengue fever.

        The transfer of the donor’s antibodies (from a prior Dengue infection), to a recipient has not been shown to cause any problems in the past 35 years of Dengue reporting & research.

        As I said above, blood bank’s and tissue bank’s general policy is NO active fevers for donors within the last 30 days.
        steve

  88. Maureen says:

    I have a question about the Zika Virus. I am very confused! This virus is caused by a bite from the same breed of mosquito that causes Dengue Fever? From what is being reported, the symptoms are the same? I have had dengue fever before and I will be taking a trip to areas where Zika has been reported. I am concerned. Thanks

  89. Hi Steve, last Saturday I had some symptoms of feeling really lethargic, and no appetite at all, so I ate very, very little. I have a cough problem associated with an ongoing sinus problem, so when the coughing got worse on Saturday; I just put the cough down to a sinus problem. Sunday, totally drained of energy, headache, flu symptoms but no fever, no appetite, …. and ended up vomiting shortly after eating what little I could eat. Used electrolyte drinks….
    Kept drinking water/watered down juices, and tea also. Monday morning went to work, symptoms the same as yesterday, coughing worse, and then on Monday afternoon extra symptoms to the ones I already had appeared……….fever, temperature 98.9*F, aching body, coughing kept me awake, so stayed home on Tuesday, started getting abdominal pain when I had heavy coughing bouts, and there was a continuation of all previous symptoms, and temperature stayed at 98*F.
    I’d looked up symptoms on the internet, and came up with Dengue fever. So Wednesday morning I went to a nearby hospital, in Asia where I’m working…… so Dengue fever is a widespread problem. I was given the 2 Dengue tests, and a blood test. Both tests proved negative, and my placelets were normal……. and temperature still around 98.5*F. The doctors concluded that I didn’t have Dengue. For what they believe my sinus related cough they gave me antihistamines, and after looking at my chest x-ray gave me antibiotics and a short course of steroids. I ‘ve also been taking Tylenol to reduce my temperature. At 2.30 on Thursday morning a new problem occurred, sweating heavily…. waking up drenched in sweat from head to toe. I know Asia’s hot, but I was sleeping in an air conditioned room. The sweating spells continued during the day.. However, appetite is now improving, no sickness, and feeling better than before. coughing still bad, and when I coughed late afternoon it still hurt my abdomen. It still feels uncomfortable when i’m not coughing.
    My question is… should I ask the doctor for another Dengue test, and placelet test? Is it possible that I have Dengue, or do the facts that I haven’t had major muscle and bone pain, or skin rashes
    Negate that idea. Look forward to hearing your comments……….

  90. Hi Steve, Great website. Last Saturday 18th March I had some symptoms of feeling really lethargic, and no appetite at all, so I ate very, very little. I have a cough problem associated with an ongoing sinus problem, so when the coughing got worse on Saturday; I just put the cough down to a sinus problem. Sunday, totally drained of energy, headache, flu symptoms but no fever, no appetite, …. and ended up vomiting shortly after eating what little I could eat. Used electrolyte drinks….
    Kept drinking water/watered down juices, and tea also. Monday morning went to work, symptoms the same as yesterday, coughing worse, and then on Monday afternoon extra symptoms to the ones I already had appeared……….fever, temperature 98.9*F, aching body, coughing kept me awake, so stayed home on Tuesday, started getting abdominal pain when I had heavy coughing bouts, and there was a continuation of all previous symptoms, and temperature stayed at 98*F.
    I’d looked up symptoms on the internet, and came up with Dengue fever. So Wednesday morning I went to a nearby hospital, in Asia where I’m working…… so Dengue fever is a widespread problem. I was given the 2 Dengue tests, and a blood test. Both tests proved negative, and my placelets were normal……. and temperature still around 98.5*F. The doctors concluded that I didn’t have Dengue. For what they believe my sinus related cough they gave me antihistamines, and after looking at my chest x-ray gave me antibiotics and a short course of steroids. I ‘ve also been taking Tylenol to reduce my temperature. At 2.30 on Thursday morning a new problem occurred, sweating heavily…. waking up drenched in sweat from head to toe. I know Asia’s hot, but I was sleeping in an air conditioned room. The sweating spells continued during the day.. However, appetite is now improving, no sickness, and feeling better than before. coughing still bad, and when I coughed late afternoon it still hurt my abdomen. It still feels uncomfortable when i’m not coughing.
    My question is… should I ask the doctor for another Dengue test, and placelet test? Is it possible that I have Dengue, or do the facts that I haven’t had major muscle and bone pain, or skin rashes
    negate that idea. Is it possible the results may not register a true picture so shortly after the fever started. Look forward to hearing your comments……….
    You have a lot of useful information on the webpage. Please keep up the great work..

  91. Hey Steve..New question. I had confirmed Dengue fever in 2011. Being a travel consultant I am traveling all over the Caribbean. Next week I am going to Barbados. I see that now the problem all over is Zika. Same mosquito. I am all ready with my deet. Should I be overly concerned about being bitten and contracting Zika? This is all very confusing! Same mosquito, same symptoms??
    Thanks!

  92. Jill Chesser says:

    I had hemorrhagic dengue in 2005 with detrimental liver Enlargement accompanied by jaundice as well as a blood clot in my left knee. I’ve studied Dr. Thomas E. Levy who recommends Liposomal vitaminC. It has helped me overcome low immune system and other symptoms you’ve described. You can get his information by going on You Tube. Lectures on Liposomal Vitamin C are available as well as his own case and success with a Dengue patient he treated.

  93. chris says:

    i’m back in america after being hospitalized in indonesia for several days with dengue fever. experienced a few of the worst days of my health life in the run-up to my hospital admission.

    my lack of energy is pronounced, but now, 10 days post-admission, i am having issues with my joints. i feel achy like the flu is coming on. other joints feel tight and painful–knees, elbows, shoulders, fingers.

    i’m not able to return to work and i’m concerned how this is going to play out… especially with the lack of knowledge among american doctors. i haven’t been to one since coming home and wish i were back in indonesia with the experts!

    no real questions, just thankful for excellent information here, comments included.

  94. Marga says:

    I am already 26 years old and got two kids…what i have learned avout dengue is that if the ptient has cough and runny nose then he is not positive with dengue…i am shock to read this article…i hope you will help me better undrrstand this…or correct me if i am wrong.thank you

  95. Tok'ra says:

    I contracted dengue fever 3 years ago in Cambodia while kayaking down the Mekong River and I’m still suffering today. DV has changed my life, and not for the better. I’ve had pain since first infected and auto immune diseases ifibromyalgia (sever pain and fatigue) and yesterday my immunologist diagnosed arthritis… The long-term effects of DV are vastly underestimated

  96. Peter Bradley says:

    I am a dengue survivor.
    Infected in latter part of 2012.
    I have been experiencing un explained bouts if severe muscle spasm around my lower rib cage.
    Are you aware of any other dengue survivors who have experienced these symptoms?

  97. Shelly Langerud says:

    I am Interested to know the correlation between Dingue fever and depression. I contracted dingue fever in 1989 in Burkina Faso, W AFRICA. I was sick for about 4 days. I had fever, diarrhea, vomiting, and terrible pain behind my eyes. I could hardly look at the light. I had to keep a cool cloth over my eyes. It felt Like my eyes would fall out of my head. I was not hospitalized because we were in a rural setting.
    Since then I have suffered from depression. We Left Burkina Faso in 1991 because of my declining health situation.
    To present I am still suffering from depression but am being treated for it.
    Do you think there is real medical proof of the depression from dingue fever?
    I would be interested to know anymore medical proof.
    Thank you for your information.
    Shelly

  98. HH says:

    Steve, thanks for all of the info about the dangers of Dengue in Yucatan.
    In a couple of months I will be going to Progreso for one school year as an exchange teacher. Is Dengue common in this area? Is there any difference between Progreso and Merida in terms of severity of the threat of Dengue? Do you recommend the vaccine? I plan to take precautions (wearing repellent frequently, long sleeves and pants as possible, etc.), but I am still afraid of contracting this during my 9 month term in Yucatan and am considering requesting the vaccine upon arrival, if that’s recommended. I’m from Texas and have never contracted a mosquito-borne illness.
    Thank you in advance for your reply.

    • yucalandia says:

      Good Evening HH,
      Fortunately, most of the mosquitoes in the Yucatan beach areas do not carry Dengue, so the numbers of Dengue cases has been quite low.

      Since mornings are the primary time that the Aedes aegypti mosquitoes are actively feeding, then that’s the time to either stay in a well screened area … or cover feet, ankles & shins with socks & long pants … or put a little DEET on down below your knees.

      Some people find that treating their socks with DEET is sufficient to keep mosquitoes away from their lower extremities.

      The vaccine may not be available, and I believe that the last test results showed that the vaccine’s effects last only a few months.

      Fortunately, Dengue cases at the beach are currently at only very very low levels.
      steve

      • HH says:

        Thanks, Steve. That’s a relief that the beach areas aren’t as affected. In which areas of the Yucatan peninsula are Dengue cases most common? Are there alternatives to DEET that you recommend? Is picaridin effective?

      • yucalandia says:

        HH,
        Predicting future viral outbreaks is notoriously difficult. … One year the Dengue outbreaks happen in the Juan Pablo Segundo neighborhoods of Merida… Another year Dengue breaks out in Maxcanu … another year in Caucel.

        Picardin: Performance depends on the brand~manufacturer. Sawyer picaridin products have performed well.

        Avon brand picaridin products perform poorly…

        OFF brand picaridin products perform very poorly.
        steve

      • HH says:

        Thank you so much. I will look into Sawyer products.
        One more question on a slightly different topic although still health related. I’m thinking about how I will wash and disinfect vegetables to make them safe to eat (for salad making especially). What method and product do you recommend? I read Microdyn is popular, but is it really effective? Is a bleach solution soak better?
        Un saludo cordial

      • yucalandia says:

        Hi HH,
        You’re thinking clearly. Microdyne sounds like iodine (which works), but it is actually colloidal silver, which does not work. Salmonella is our biggest food poisoning issue here, and all the colloidal silver products are work very poorly against salmonella.

        We have a whole article on this

        Salmonella & Parasites: Food Contamination in Mexico

        “**Bleach Dilution Schemes:

        Stored Water Treatment (tinacos etc): 10 mL (1 tsp) bleach per 100 L of non-turbid clear water or 1/4 cup of bleach per 275 gal tinaco makes water microbially safe in 15 minutes.
        Toilets and Sinks: Apply bleach without dilution via spray or brush for 10 minutes and rinse.
        Drinking water: 2 drops of bleach per liter of clear water (20 drops per mL) and wait 15 min.
        Fruits and Vegetables: Wash & scrub thoroughly first to remove dirt, then 10 drops bleach per liter of water and soak for 5 minutes. Rinse thoroughly.
        Floors and bathroom surfaces (tub & shower): 1/4 cup (60 mL) bleach per gal of wash water and leave it on the surface for 5 minutes before rinsing.
        Children’s Plastic Toys: Remove dirt first with soap and water, then use 1/4 cup (60 mL) bleach per liter of water and soak for 5 minutes and rinse.
        Baby Bottles & Nipples: 1 drop of bleach per liter, soak for 2 minutes and rinse.
        Other Plastic Objects: Apply straight bleach for 5 minutes and rinse – note that this might cause a permanent bleaching of some plastics.
        Glasses and Plates: 1/4 cup (60 mL) per gallon of dish washing soapy water, scrub off food residues, and allow to soak for 5 minutes.
        Notes:
        – Only use unscented normal bleach for these purposes: do not use scented or non-splash bleach. (Blanqueador de Ropa)
        – NEVER COMBINE BLEACH WITH ANY BASE (higher pH chemical)
        – NEVER MIX BLEACH SOLUTIONS WITH AMMONIA PRODUCTS OR DRIED URINE (concentrated UREA),
        ***because Base + Bleach = Toxic Chlorine Gas***
        – Some people report that regular dosing with freeze dried probiotic mixtures of beneficial bacteria and fungi can overseed our GI systems with microbes that put out the “No Vacancy” sign to incoming pathogens.”

        Happy Trails,
        steve

      • HH says:

        Once again, thanks so much for the info. I will follow that protocol. A new question has popped into my mind. I have a relative on anti-coagulants (Xarelto). Am I correct in thinking that if he were infected with dengue while visiting me, the results could be disastrous?

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