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Dengue Fever outbreak

  • sassafrass

    Joined Travelfish
    22nd May, 2013
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    Hello,
    I have been following the news as we are going to be in Thailand (and Cambodia) in one week. Myself and 13 year old daughter. The mass outbreak (is it really mass?) has me a little on edge and I really just want to enjoy our trip without feeling paranoid. We are going to Chiang Mai while we are there and I have read that it is the worst up there. We are both very healthy, taking herbal supplements to boost our immune systems currently and I will be taking a whole lot with us. How concerned truly should I be? We also purchased travel insurance from World Nomads in case we need care from a physician over there. My daughter has been wanting to go here forever so it is her 13th bday present, I want it to be more than awesome! Thank you for insights

    #1 Posted: 9/6/2013 - 10:13

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  • MADMAC

    Joined Travelfish
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    Wear long pants, sox and shoes. Use mosquito repellent for any uncovered areas. This should minimize your exposure and you should be fine.

    #2 Posted: 9/6/2013 - 12:18

  • busylizzy

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    I hadn't heard about an 'outbreak' as such, but if you are sticking to the main tourist trail (Chiang Mai, etc), I would suggest that the risk of Dengue Fever is minimal. As MM says, use plenty of repellant. His advice about covering up with long pants, socks and shoes is wise - but not so practical in my opinion. He has lived in Thailand for many years so he is acclimatised to the hot temps. Even after travelling in the region for 6 months I still wouldn't be able to bring myself to cover up so completely! So yes, it makes good sense, but it's hard advice to follow. The areas that you leave exposed, just spray with repellant. Don't forget the back of your neck, your feet and ankles, etc.

    There are natural products that you can use although I don't know how effective they really are. There's been plenty of discussion on this in the past - search on 'repellant' and similar and you'll find various suggestions. You can go to the other extreme and get a product with a high level of Deet. I brought some with me once, and I hated it so much that I gave it away after one use. It felt very thick and gluggy on- not sure if that was the particular product that I bought or not, but it was pretty icky!

    #3 Posted: 9/6/2013 - 17:18

  • busylizzy

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    You can also go a step further and soak some of your clothes and sleeping bag liner in pyrethrin. It's supposed to be a natural product as well, but I can't bring myself to use it, particularly on my sleeping bag liner, as I don't want to be breathing the stuff in all night long. Best defence at night when in bed is to turn the fan on in your room. It's a portable fan, aim it over your bed. Mozzies don't like the moving air.

    #4 Posted: 9/6/2013 - 17:21

  • goonistik

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    There is a risk of contracting dengue throughout the year, though cases increase when the rainy season sets in. The risk is higher in urbanized areas as there are plenty of breeding grounds for the mosquitoes and the close proximity of the population makes transmission more likely. If you are hearing about an "outbreak," it is probably because precipitation increases around this time of the year and there more breeding grounds for mosquitoes.

    According to this news report there have been 2,000 cases of dengue so far in Chiang Mai . Even if the report is just referring to the urbanized area of Chiang Mai (population about 1 million), you can see that it is unlikely you will get dengue. So I say go to Chiang Mai and enjoy. Just do the common sense precautions against mosquitoes.
    http://thainews.prd.go.th/centerweb/newsen/NewsDetail?NT01_NewsID=WNSOC5606060010009

    If you do get dengue, many people get flu-like symptoms. A few people require hospitalization if the symptoms become more serious.

    #5 Posted: 9/6/2013 - 22:28

  • MADMAC

    Joined Travelfish
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    We had a dengue outbreak last month. It's under control now. One of my dancers had a mild case (he was lucky). It happens, but it's not something to be paranoid about.

    Liz, I must be a freak, as I was have never worn shorts or sandals for one day of my life (save trunks at the beach). I hate them and find them uncomfortable. No protection from the elements. Even in the blistering heat of East Africa I didn't wear shorts or sandals. My body loves the heat. Training in Tae Kwon Do we don't have air conditioning and our uniforms are long pants and shirts made of heavy material. The room is roasting. We'll sweat, to be sure, but the heat makes the workout all the better.

    #6 Posted: 9/6/2013 - 23:26

  • sassafrass

    Joined Travelfish
    22nd May, 2013
    Posts: 7

    Thank you all so much! You have helped me ease my paranoia. We will take the precautions and have a splendid time :)

    #7 Posted: 9/6/2013 - 23:49

  • MADMAC

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    Have a great trip.

    #8 Posted: 10/6/2013 - 04:28

  • sassafrass

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    Madmac, I am curious what kind of dance you teach as you said one of your dancers was sick?

    #9 Posted: 10/6/2013 - 10:24

  • MADMAC

    Joined Travelfish
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    I teach salsa.

    #10 Posted: 10/6/2013 - 11:42

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  • LeonardCohe-
    n1

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    "as I was have never worn shorts or sandals for one day of my life (save trunks at the beach). I hate them and find them uncomfortable. No protection from the elements"

    Must be hiding those legs of yours. How weird to never wear shorts. I wear shorts 90% of the time.

    #11 Posted: 10/6/2013 - 17:28

  • MADMAC

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    Legs are solid - train the hell out of them. But no, I do not like shorts at all. Never wore them. Not when I lived in the States, not when I lived in Africa or Europe and not here. On the farm nobody wears them because there are a lot of things that bite and itch and you need protection. In the city (where I am most of the time) I ride every day. And I don't ride in shorts and sandals. You put the bike down wearing that - road rash in a major way. Then there's mosquitos. Friend of mine wearing sandals was bitten by a centipede. One look at that wound and I knew I was never going to adopt sandals as footwear. Nope - I wear long pants and shoes, always.

    #12 Posted: 11/6/2013 - 00:04

  • SBE

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    In most Thai households it's considered rather rude and uncouth not to remove shoes at the front door and people mostly get bitten by centipedes in their own homes, especially in bathrooms. Centipedes seem to like lurking in dark drain pipes when they aren't curled up in a corner on the floor.

    #13 Posted: 11/6/2013 - 03:09

  • MADMAC

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    Well my friend was bitten walking down the street. The thing was HUGE (approaching eight inches long) and just wrapped around his sandal and bang. Nasty.

    Of course when I enter someone elses home I take off my shoes. At the Tae Kwon Do dojo as well I go barefoot. But those are outliers... in general I wear shoes when I leave the house. In restaraunts, in bars or clubs, when riding I wear shoes.

    #14 Posted: 11/6/2013 - 03:34

  • LeonardCohe-
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    I find it amusing the whole shoe thing when the inside of a lot of Thai homes are dirty or concrete floors so barefeet get grubby. Unless you are walking on carpet it makes no sense to remove shoes and is a rather stupid custom.

    #15 Posted: 11/6/2013 - 10:13

  • MADMAC

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    It is what it is.

    In village life this is often true - in city life a little less so.

    No point in trying to figure out if it should be so though.

    #16 Posted: 11/6/2013 - 10:49

  • chopin

    Joined Travelfish
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    "Unless you are walking on carpet it makes no sense to remove shoes and is a rather stupid custom."

    a stupid custom? well, almost the whole SEA has the tropical climate with high humidity, and all year round temperature is above 28C. it would be very very unpractical to have carpets at home because they collect lots of dust, and absorb too much moisture and they will rot faster, it would also be a good habitat for mites. In climate like this, the best solution is to have concrete or tiled floors (marbles are best if one can afford it) - easy to clean and it is cooling, the latter is especially important, it makes bare feet feel much better and healthier. in this climate, if you wear socks and shoes all day long, your feet will sweat a lot and Athlete's foot is the next thing to come. so bare feet is the original lifestyle in this part of the world for a reason.

    I do understand that people from cold countries have difficulty adopting this so it is ok for you to carry on with your shoe-wearing custom, but there's no need to call the opposite as a stupid custom.

    #17 Posted: 11/6/2013 - 21:11

  • LeonardCohe-
    n1

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    I agree tiles make more sense than carpet but having bare feet doesn't. I have tiles and I wear croc slides to keep the feet from getting dirty. (Also helps if a pin or glass gets onto the floor)

    "so bare feet is the original lifestyle in this part of the world for a reason."

    It makes no sense and a lot of it was due to poverty in the 1st place and with Thais sitting in a Buddha position on the floor. Customs change over time and so should people when they have a more practical solution than some false custom that has little relevance anymore. If you are sitting on sofas and lounges and walking around on a tiled floor it makes more sense to wear some kind of shoes. Thais I know even do this.

    #18 Posted: 11/6/2013 - 21:40

  • chopin

    Joined Travelfish
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    back to sassa's question.

    I'd recommend to use lemongrass mosquito repellent in your hotel room if you suspect it has mossies. It is a small round plastic container, you just open the lid before you sleep and place it on the floor near you bed, the lemongrass smell will drive mossies away. I've used it and it's effective. it should be better than using coils or mats. I'm not sure if Thailand have this but it can be purchased in supermarkets in Malaysia easily.

    #19 Posted: 11/6/2013 - 22:06

  • LeonardCohe-
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    #20 Posted: 11/6/2013 - 22:15

  • sassafrass

    Joined Travelfish
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    Thanks for your posts guys and gals!
    I made my own repellent of aloe, witch hazel, neem oil, rosemary, rose geranium, lemon eucalyptus, and lavender. The CDC recognized lemon eucalyptus to work as effectively as DEET. We shall see.
    MadMac, do you know of any African dance classes in Chiang Mai? That is my form of dance and I would love to find some while traveling! Thank you all! See you in SE Asia!

    #21 Posted: 11/6/2013 - 22:36

  • chopin

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    Leaonard, I beg to differ. Majority of the Europeans were dirt poor farmers like Thais during the Middle Ages, but they were not bare feet, else they would be dead during winters - correct me if I was wrong. As for tropical Asians, most of the people even after becoming rich still remain bare feet at home. Stepping on glass or pins at home is never a problem here because people who are bare feet at home are usually more particular about cleanliness at least at their own habitat. I still think it has more to do with climate and secondly culture, not poverty. it makes no sense to you mainly due to your culture and habits, but it makes perfect sense for the local people. I have met Europeans here who put on formal shoes at their own house at evenings and I feel weird but I respect that this is their choice. I think they won't take off their shoes even if I pay them to, they probably will feel naked if their feet are bare :-)

    Another example is eating with hands. You probably know that Indians and Malays like to eat with their bare fingers - no fork and spoon. I myself don't practice this and I still think it is not too hygienic, but that's the way they like it and I'll respect that, even if it makes no sense to me. heck, they even claim that curry tastes better that way... :-)

    there is really no point to claim that your way is the more practical solution here in their home turf, really. Just stick to your way and be happy about it.

    #22 Posted: 11/6/2013 - 22:37

  • LeonardCohe-
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    Plenty of hot nations where people wear shoes at home. Slides/thongs are cool anyway. Thais like to sit in a Buddha position when on the floor and doing so with thongs/slides isn't so practical.

    You eat sticky rice and pizza with utensils? What about fruit? It's just common sense to eat some foods with hands as long as you wash them.

    #23 Posted: 11/6/2013 - 22:50

  • MADMAC

    Joined Travelfish
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    "in this climate, if you wear socks and shoes all day long, your feet will sweat a lot and Athlete's foot is the next thing to come. so bare feet is the original lifestyle in this part of the world for a reason."

    I wear sox and shoes and have lived here for six years and never had athletes foot or any fungus at all on my feet.

    I agree with Leonard, it's about resources. Sure in Europe nobody went barefoot because the climate would not permit it. So poor or not, they had to acquire footwear to survive. Here you don't have to. But make no mistake, going barefoot here was also frought with problems, including stepping on sharp objects and getting bitten by peksy and sometimes poisonous critters. Sandals you can get away with although they don't offer a lot of protection to the feet. But at least they protect the bottom of the foot, which is the most vulnerable part. The idea that "it makes sense" in this climate I find foolish. It's just that hot. If you ride a motorcycle - which a lot of people do - it's outright foolish. Do the "locals" do it? Yep. They also ride in shorts and without helmuts, drunk, at night with no headlight. And they die accordingly.

    #24 Posted: 12/6/2013 - 00:21

  • chopin

    Joined Travelfish
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    Leonard, pizza and fruits are easy, try curry with normal white rice, stir-tried vege, and fish. but, i have mentioned, even if i don't practice eating a full meal with bare fingers, i don't find them foolish, i respect them.

    Mac, we were talking about going barefoot "at home", and why is it foolish in this climate? you are right though, one won't necessarily get athlete's foot, just that the chance is higher. Hong Kong people even has a phrase for it (http://en.wiktionary.org/wiki/Hong_Kong_foot), no prize for correctly guessing that HK's climate shares a lot of similarities to SEA.

    my whole point is, you don't have to label all these local customs as foolish or "no sense", rather, why don't we try to understand and appreciate the differences? isn't that the reason why we all love travel?

    #25 Posted: 12/6/2013 - 01:08

  • LeonardCohe-
    n1

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    Taking off shoes isn't unique to Thailand or Asia. It depends on the house set up and what suits the people who live there. And no I don't love travel because of some silly shoe issue.

    #26 Posted: 12/6/2013 - 07:40

  • SBE

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    I made my own repellent of aloe, witch hazel, neem oil, rosemary, rose geranium, lemon eucalyptus, and lavender

    It might not be a good idea to make too much of your home made repellent in advance.

    A friend of mine once tested a 20% neem 80%coconut oil mix vs 100% deet she'd bought in Alaska after reading about research that showed Neem oil was a more effective mosquito repellent than deet.

    She put the neem oil mixture on one leg and 100% deet on the other and sat back to watch how many Bangkok mosquitoes tried to bite her. Not one mosquito tried to land on the neem oil leg but the 100% deet didn't seem to bother them much at all.

    Her simple experiment seemed to confirm the scientists' results so she mixed up a fair sized bottle of coconut and neem oil repellant and set off on her travels.

    What the research scientists DIDN'T bother testing was how long the neem oil mixture remained effective and my friend noticed that the mosquito repellent qualities of her oil mixture diminished after a few weeks. She reckons you'd need to keep making fresh stuff for it to be effective. This makes sense when you think about it. There were no preservatives in her oil mixture and it was kept unrefrigerated in a clear plastic bottle. It's quite possible that the neem oil would oxidize under such conditions and lose some of it's repellant properties.

    Catnip oil seems to be more effective than deet as well and they tested it against Aedes aegypti, the species of mosquito which transmits dengue.

    http://www.sciencedaily.com/releases/2001/08/010828075659.htm

    You'd be able to use catnip oil on its own by the sound of it, but I don't how stable it is or what it smells like. Might smell nicer than neem oil does though!

    #27 Posted: 12/6/2013 - 09:27

  • LeonardCohe-
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    Field tests were conducted using a hydrogenated form of catnip oil in Florida and Maine. First, the essential oil of catnip was catalytically hydrogenated to yield dihydronepetalactones (DHN). Strictly speaking, hydrogenated catnip oil (HCO) is not something the average person can make without a palladium catalyst, hydrogen gas and a pressure vessel. DHN was previously detected in the defensive secretions of certain insects and it had been reported that DHN had the ability to repel ants. HCO was formulated into a lotion or alcohol-based spray. All HCO formulas exhibited some degree of extended protection with the 15% by weight HCO lotion providing complete protection during the eight hour tests. The authors suggest that formulations of HCO can be effective alternative to existing repellents such as DEET.
    In Australia, a commercial product containing 5% catnip essential oil was tested as repellent against four different species of mosquitoes. Significant variation was observed for protection afforded against different mosquito species ranging from no protect to four hours on average. In contrast, a 7% DEET spray provided complete protection over a six hour period. Overall, the authors concluded that catnip does provide limited protection against some mosquito species in Australia, and may be more effective than other products containing natural plant extracts, but it was not as effective as DEET.
    A study from China compared catnip essential oil along with other plant essential oils and DEET. Catnip essential oil (composed of 36%, 45%, 18% isomer 1, isomer 2, and caryophyllene) provided the best protection against mosquitoes and the only oil to provide complete protection for over six hours. When testing the major ingredients of catnip oil, their tests showed that a blend containing the nepetalactone isomers at a 3:1 ratio has the highest and longest repellent activity.
    The most recent study published in 2011 on the use of catnip essential oils was performed on Afro-topical mosquitoes originally cultivated from Tanzania. They compared two different batches of catnip and found that the isomeric composition of nepatalactone varied considerable (batch A: 92% isomer 1 and 8% caryophyllene, and batch B: 17% isomer 1, 70% isomer 2, and 13% caryophyllene). Upon testing, batch A was not as effective at repelling mosquitoes as compared to batch B. Purified isomers provided inferior protection to either batches of essential oils. Testing of binary mixtures confirmed the synergistic effect between the two isomers. Lower activity was seen with purified isomers and, surprisingly, with equivalent or near equivalent binary mixtures. Highest activity was afforded when the isomers were mixed in 3:1 ratios. Furthermore, a ratio mixture equivalent to batch B did not perform as well compared to either batch of essential oils. A three component blend containing caryophyllene at the levels found in batch B had the same activity as the essential oil.
    Typical of plant extracts, the concentration of active ingredients various from batch to batch and the variation is dependent upon things like supply location, seasonal variations, age of the plant, and extraction procedure. Indeed, the ratio of isomers within a catnip plant was shown to vary weekly and the effectiveness of the essential oils to repel insects varied greatly.
    Overall, the research on catnip essential oil has proven it to be an effective repellent of mosquitoes. Some variation on the species of mosquitoes repelled and the duration of effectiveness was found. The data suggests that catnip can be used as an effective insect repellent when used as an unfractionated essential oil due to the presence of both nepetalactone isomers and other components such as caryophyllene. However, for practical use of these plant essential oils, further studies on their safety to human health are necessary.
    http://www.miskeptics.org/2011/06/does-catnip-essential-oil-protect-against-mosquitoes/

    #28 Posted: 12/6/2013 - 09:55

  • sassafrass

    Joined Travelfish
    22nd May, 2013
    Posts: 7

    Thanks for all the info, I am going on a search for some catnip EO to bring as well. I am still going to bring what I made already but I will keep an eye out for how long it seems to work for, as in how long it remains stable. I was wondering if neem oil is something I would be able to easily find in Thailand and what kind of place would I look for it? I will keep you all posted when I return of the effectiveness of my natural repellent. Maybe I have a new travel product I can market! (he he)
    Thanks for the catnip links I have heard about it but haven't read good info such as this.

    #29 Posted: 12/6/2013 - 10:20

  • LeonardCohe-
    n1

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    Yes, it's interesting stuff.

    #30 Posted: 12/6/2013 - 10:50

  • MADMAC

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    Holy cow, that had legs.

    #31 Posted: 12/6/2013 - 13:23

  • mikepoppe

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    As a traveller who has actually HAD dengue on a trip, I have to say it's not much fun. My wife and I picked it up in Samui, and i suffered through there. When she started coming down with symptoms we headed to Phuket in case a hospital was needed, but luckily all was well. We holed up in a hostel with a lot of movies and good AC for about 4 days and were much better after that.

    One thing to note is that dengue mosquitoes don't bite at night, they bite during the day. Wearing bug repellent is the best way (I can't wear pants and long sleeves in that heat). I can't vouch for the natural versions above, but am keen to try them out on my next trip. What I can recommend, is to buy repellent locally, as the formulas are slightly different based ont he region you are visiting, as different types of mosquitoes are in different areas.

    Another big note on dengue is that the first time you get it, you will likely be fine. Any subsequent time after (there are 4 types) can be quite serious, and you are best to get yourself to good medical care just in case (preferably a large city).

    Also, on a side note, getting your blood taken by a horrendously under qualified ladyboy nurse on Samui is an experience I would rather forget, but can laugh about now.

    All in all, it wasn't a great experience, but we didn't let it ruin our vacation. If you are not elderly or very young, you should be in good shape. The chances of getting it are minimal, and it is really luck of the draw.

    #32 Posted: 12/6/2013 - 14:55

  • busylizzy

    Joined Travelfish
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    There was an article in the paper yesterday about an outbreak in Singapore - and their approach to dealing with it.

    "Singapore is fighting back against a rapidly worsening dengue epidemic by distributing insect repellants to every household and recruiting hundreds of disease control officers, officials said."


    http://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=10890142

    #33 Posted: 12/6/2013 - 16:09

  • LeonardCohe-
    n1

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    "getting your blood taken by a horrendously under qualified ladyboy nurse on Samui is an experience I would rather forget,"

    rather high risk as well

    #34 Posted: 13/6/2013 - 09:27

  • litingtings-
    mile

    Joined Travelfish
    5th January, 2013
    Posts: 3

    I also saw in the newspaper this news oh。

    #35 Posted: 13/6/2013 - 21:48

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