Dengue fever in Southeast Asia
First published 6th November, 2010
For many first time visitors to Southeast Asia, a visit to a "travel doctor" is a part of the pre-departure planning. Invariably discussion revolves around nasties like rabies, hepatitis and malaria as there are preventative shots, pills and potions you can buy for all these. What gets discussed far less frequently, yet in all likelihood you're just as likely to pick up, is dengue fever.
One of the reasons dengue doesn't get brought up, is because there is no pill potion or shot for it — if you catch it, you just have to ride it out — but unfortunately, for too many people, dengue kills.
What is dengue fever?
Dengue fever is a virus which is caused by any one of four related viruses (DENV 1, DENV 2, DENV 3, or DENV 4). There is also the more serious Dengue Hemorrhagic Fever (DHF). Each of the viruses is slightly different, meaning that if you've already had one strain of dengue, you are not immune to the others — sequential infections put you at greater risk for dengue hemorraghic fever.
The virus manifests itself via high fever, severe pain behind the eyeballs, in some cases a bad rash, and in most cases extreme pain in the bones and joints (especially in the lower body). This last symptom led to the virus also being known as "Breakbone Fever".
A typical "dengue experience" lasts around a week to ten days. It commences with loss of appetite, a high fever and aching joints. It is after the fever subsides that the changes in platelet count normally occur. This count needs to be closely monitored as treatment is determined by how low your platelets are. Left unmonitored and therefore untreated can lead to death.
There is no "cure" for dengue. Instead painkillers can be taken to bring down the fever. It is important to note that aspirin and non-steroidal anti-inflammatory drugs such as ibuprofen (otherwise known as brufen or nurofen) must be avoided as they 'thin' the blood and can worsen the situation. Muscle relaxants can be taken in an attempt to reduce the bone and joint pain. Once hospitalised, patients may be placed on a drip and have a blood test each day to monitor their platelet level. In cases where platelets drop too far a platelet transfusion may be given and in extreme (life threatening) situations a blood transfusion takes place.
Aedes aegypti: shoot on sight. Photo by Marcos Teixeira de Freitas
How do you catch dengue fever?
The virus is spread primarily by two types of mosquito Aedes aegypti and Aedes albopictus. They tend to bite in the early morning and have white bands on their legs. They like to rest in cool, dark areas, like cupboards and under beds and are extremely resilient to control measures. The CDC (Centre for Disease Control) says "if we were to eliminate all larvae, pupae, and adult Aedes aegypti at once from a site, its population could recover two weeks later as a result of egg hatching following rainfall or the addition of water to containers harboring eggs."
Dengue fever can take up to four days after infection to begin displaying symptoms and it can take a number of blood tests to determine that an infection is present.
How to protect yourself from dengue fever
Unlike malaria there is no preventative medication for dengue and a vaccine is not currently available. The only way to exercise preventative care is to avoid being bitten by mosquitoes. There are a number of core practices that can help reduce the chance of you being bitten.
- Wear repellent.
- Where practical, use a mosquito net. Be sure to fix any holes in the net.
- Burn mosquito coils, but make sure they are a safe distance from the net.
- Dress sensibly 1: Avoid dark, heavy clothes.
- Dress sensibly 2: Wear light cotton clothing with long sleeves and pants/dress.
- If your accommodation has still water in it, keep the bathroom door closed.
- Kill every single mosquito you see — regardless of if they have stripy legs or not.
- Once infected, it is important to protect others around you by wearing repellant yourself and abiding by the other recommendations above to reduce potential for cross-infection.
How big a problem is dengue fever?
Unlike malaria, which is primarily found in rural areas, dengue is found both in rural and urban areas. This substantially increases the risk for casual tourists.
When I was being treated, the doctor said that last year (2009) there were around 4,000 dengue cases in Bali. This year, as of September, there had been 8,000. While generally a disease of the tropics, fatalities have been recorded in cooler climates from Perth to Paris as well. If you return to your home country and start to display symptoms, it is crucial that you explain to medical staff you have just come from a "dengue region" as they won't suspect it otherwise.
The CDC estimates that there are over 100 million cases of dengue, worldwide, each year while the World Health Organisation (WHO) estimates that there are 50 to 100 million infections annually, including 500,000 DHF cases and 22,000 deaths, most of which are children. In 2010, dengue fever outbreaks (not including countries where the virus is normally present) have been recorded in Australia, Pakistan, Puerto Rico and USA.
Turns out you don't have to ask around much to find others who had dengue — here are three examples (from myself and two travellers) who all had dengue around the same time.
I came down with dengue in September 2010 and was bed ridden for a week, including a two night stay in hospital. I woke up feeling a little off and within a couple of hours had a 40 degree fever. By afternoon was suffering intense pain in hips and lower legs along with exhaustion. Couldn't walk without considerable pain. The pain in the eyeballs was intense and maddening. It was two days before dengue was confirmed (by blood test) and I went to hospital once my platelet level fell below 70,000 (on day five). Once in hospital, was put on a drip and kept under observation for two nights.
I felt like I had the worst hangover that lasted days. I had headaches, my eyes hurt when I would move them, and my fever was around 104F (40degC) for a couple of days. Of course, when your temperature is that high your body gets sweaty and you start getting the chills. After the fever passed, it felt like I had mono. I was tired all the time and didn't have an appetite to eat much. When I did eat, I wanted the blandest food possible, which is weird for me because I love spicy food. It took me a while to get my appetite back. I was lucky in that I had only mild bone pain.
Kyle blogs at "On Our Own Path", recently hit 1,000 days of straight travel and is currently hanging out in Chiang Mai.
It started with flu-like symptoms... very achy and fatigued and just a general feeling of being sick. Then I got a horrible headache with pain behind my eyes, which worsened whenever I moved my eyes. It got so bad that I had to move my head whenever I wanted to look at something. Not moving your eyes at all is MUCH harder than you'd think! Around the same time as the headache started, I also started feeling very feverish- chills, sweating, etc. Over the next few days all of the symptoms got increasingly worse. My muscles and joints hurt so much I had to lay in bed all day, which actually worked out well since I was so tired, I slept all day every day. I actually had all of the symptoms of Malaria, so I went to the hospital to get tested for that. They told me that no, I didn't have malaria, but surprise! I had dengue! As the disease started to clear up towards the end, my fever was on and off. Once the fever had completely broken, my body was COVERED in an incredibly itchy rash. My hands and feet were unbearably itchy, and the rest of my body was covered in a hive-like rash, that ended up spreading so much that you couldn't see a single spot of "normal" skin on my arms, legs, or stomach.
Brianne blogs at Mai Ow Pet.
More about dengue fever
Thanks to our resident nurse, Susanne, for sorting out my medical hoo haa in the story. Thanks Sus!
Related readingTravelfish tips on travel health & safety
Medical treatment in Thailand
10 points on buying travel insurance
Read 23 comment(s)
Add your comment
Feature story quicklinks
- Giving back in Southeast Asia (10)
- All stories
- COPE: Helping people move on
- Helping Phuket's children in need
- Helping Siem Reap's rubbish dump families
- Helping Singapore's transient workers
- Helping the Karen of Burma
- Humanitarian Services for Children of Vietnam
- Lifestart Foundation, Hoi An
- Thai Freedom House, Chiang Mai
- The Samui Prison Project
- The SET Foundation
- Burma (6)
- Cambodia (21)
- All stories
- A Cambodian Eco-lodge
- A honeymoon in Cambodia
- Angkorian traffic woes
- Battambang weekend
- Elephant riding in Cambodia: Should you?
- Great places to stay in Siem Reap
- Is Preah Vihear safe to visit?
- Koh Rong: Trouble in paradise?
- Kompong Cham escape
- Northeast Cambodia in photos
- Oh Poipet!
- PEPY:Sustainable Cambodian tourism
- Phnom Tamao Wildlife Refuge
- Sihanoukville beaches lure expats
- Spas, shopping & seers in Siem Reap
- The best islands in Cambodia
- The best places to stay on Cambodia's islands
- The Death Highway
- Trekking the Cardamoms in Cambodia
- Which Cambodian island is right for you?
- Why you should go to Cambodia
- Indonesia (13)
- All stories
- A funeral in Toraja, Sulawesi
- Climbing Rinjani
- How to hire a boat in Indonesia: Without drowning
- Learn to surf in Bali
- Medewi: A great Bali getaway
- Mountain biking in Bali: A ride in the woods
- The Gili islands: Which is the right one for you?
- Ubud bird watching: From waterhens to witchcraft
- Ubud shopping guide
- Village trekking in Tana Toraja
- Weekend in Nusa Penida
- Yogya's student scene
- Laos (15)
- All stories
- Best budget rooms in Luang Prabang 2013
- Elephant trekking in Laos
- Exploring Laos' Bolaven Plateau
- Huay Xai to Pak Tha by slowboat
- Is Lao Airlines safe to fly?
- Laos' vanishing elephants
- Luang Prabang escape
- Muang Ngoi Escape
- Photos of Luang Prabang, Laos
- Pi Mai Lao in Luang Prabang: In 1999
- Southern Laos by scooter
- Temples in Luang Prabang
- The Gibbon Experience
- The Phonsavan adventure
- Vientiane's Chinatown
- Malaysia (6)
- Singapore (9)
- Thailand (70)
- All stories
- 10 Bangkok galleries worth a look-see
- 10 Thai treks aside from Chiang Mai
- 24 Hours in Bangkok: Sukhumvit to Siam Square
- 5 Southern Thai towns to lose time in
- A Thai homestay in Ayutthaya
- A weekend in Phra Phradaeng
- A weekend on Ko Samet, Thailand
- An extra day in Krabi
- Andaman Sea island hopper
- Ayutthaya temple tour
- Bangkok for art lovers
- Bangkok's Charoen Krung Road
- Bangkok's Thonburi: exploring the west side
- Brilliant Bangkok
- Chiang Dao getaway
- Chiang Mai's temples
- Corruption in Thailand
- Eating on the edge
- Elephant's World Kanchanaburi
- Exploring Lamphun
- Exploring the Lungs of Bangkok
- Far southern Thailand: Go or not?
- Floating markets around Bangkok
- Highlights of Chanthaburi province
- How to do Khao Yai National Park
- Khao San Road safety and scams
- Ko Mun Nork: a nearby paradise
- Ko Pha Ngan 7-day detox:Colonic fast
- Ko Pha Ngan's best beaches in 2013
- Ko Phi Phi on a budget
- Ko Tao for non-divers guide
- Ko Yao: the islands you're looking for
- Learning Muay Thai in Bangkok
- Motorcycling the Chiang Rai loop
- Narathiwat: residence of good people
- Navigating Bangkok: The BTS Skytrain
- Phuket by night
- Phuket for Kids
- Phuket heritage walk: Car parts to saris
- Phuket's secret beaches
- Planning around Thailand's civil unrest
- Roll your own Kanchanaburi
- Should I book for the full moon party?
- Should I cancel my Thai holiday? No.
- Soi Thong Lo, Bangkok
- Sorting out Suvarnabhumi Airport
- Staying at a Thai monastery
- Thai islands for nature lovers
- Thai islands to lose yourself on
- Thai visa FAQ
- Thailand tsunami wrap
- Thailand's Mae Khlong market
- Thailand: Where to from here?
- The best beach on Ko Samui
- The best places to stay on Ko Kut, Thailand
- The bridge over the River Kwai festival
- The road to Sangkhlaburi
- Travelling through north-east Thailand
- Trekking in Thailand
- Trisara -- decadent luxury at its best
- Two days in Kamphaeng Phet
- What is the best beach on Ko Tao?
- What is the best island in Thailand?
- What's a good beach on Ko Pha Ngan?
- What's a good beach on Ko Samui?
- Where to stay at Railay Bay, Thailand
- Where to stay in Sukhothai?
- Where to stay on Ko Samet, Thailand
- Which beach on Ko Samui?
- Which island in Trang?
- Vietnam (31)
- All stories
- A short break in Nha Trang
- A Weekend in Can Tho
- Being fed Fido: Eating dog in Vietnam
- Buying a touring motorbike in Vietnam
- Con Dao escape
- Do nothing and see the best of Hanoi
- Doing the DMZ from Hue
- Exploring Kon Tum
- Exploring Vietnam's Mekong Delta
- Ha Long Bay conclusions
- Ha Long Bay for backpackers
- Ha Long Bay for budget-busters
- Ha Long Bay for flashpackers
- Hanoi escape
- Hanoi or Saigon?
- Hoi An -- Walking over the dragon
- How to do the Dien Bien Phu loop
- How to enjoy your time in Vietnam
- How to pick a good Ha Long Bay cruise
- Is the Hoi An culture tour worth it?
- Motorbike Vietnam's Central Highlands
- One day in Hanoi
- Responsible shopping and eating in Hoi An
- Saigon's top 10 cafés
- Sapa or Bac Ha?
- Saving Vietnam's bears
- Street food safety
- The DMZ: Traveller tactical briefing
- Travel tips for Tet in Vietnam 2013
- Two Wheels & Ricefields: A review
- Which is the best street food tour in Hanoi?
- Accommodation guides (19)
- All stories
- 2005 Top guesthouses in Bangkok
- 2005 Top guesthouses in Chiang Mai
- 2006 Top guesthouses in Hanoi
- 2006 Top guesthouses in Phnom Penh
- 2006 Top guesthouses on Ko Phi Phi
- 2006 Top Luang Prabang guesthouses
- 2008 Top Bangkok airport guesthouses
- 2008 Top Luang Prabang guesthouses
- 2008 Top spots on Phu Quoc Island
- 2009 Top guesthouses in Bangkok
- 2009 Top Phnom Penh guesthouses
- 2011 Best places to stay in Kuala Lumpur
- 2011 Best places to stay on Ko Phi Phi
- Best places to stay in Hanoi 2012
- Cheap Phuket guesthouses & hotels
- Five special hotels in Cambodia
- Ko Lipe's best budget guesthouses 2012
- The changing face of Khao San Road
- Where to stay on Koh Rong Samloem
- Travel with kids (7)
- Opinion & advice (14)
- All stories
- 10 reasons to do an adventure tour
- 10 reasons to travel independently
- A year's worth of travel for 2013
- Beach hideaways in Asia
- Do I need reservations for my holiday?
- Evil man of Krabi
- Fifteen tips for a great holiday in Asia
- Getting a cheap airfare to Asia
- Hotels should never charge extra for WiFi
- Long distance buses in Southeast Asia
- Mass tourism in Southeast Asia
- Nine Asian upcountry hideaways
- Planning a Gap Year? Some advice.
- Ten Southeast Asian trips for 2008
- How do I? (11)
- All stories
- Bangkok to Ko Samui, Pha Ngan & Tao
- Bangkok to Siem Reap
- Catching a train in Thailand
- Catching a train in Vietnam
- Cheap flights with Discovery Airpass
- Chiang Mai to Luang Prabang
- Crossing the Cambodia Laos border
- Ko Chang to Phu Quoc Island
- Siem Reap to Ko Chang
- Stops between Bangkok & Chiang Mai
- Visa run from Thailand to Burma
- Cycling Asia (13)
- All stories
- 24 hours in Bangkok
- An Angkor cycling guide
- An introduction
- Battambang, bamboo trains & guides
- Confessions of a "cheating cyclist"
- Cycles of all sorts
- Ha Long Bay independently
- Ko Samet Vs Pattaya
- Muay Thai night
- Phonsavan and Luang Prabang
- The hills of Vietnam
- The road less travelled
- Tubing in Vang Vieng
- Health and safety (6)
- Money and finance (4)
- Diving guides (6)
- Photo essay (3)
- Guest blog (2)
- General (15)
- All stories
- 10 Christmas days in Asia we're yet to have
- 10 dumb things I've done while travelling
- 34 ways to travel greener
- Asian animal experiences
- Call me Mr Massage Magic
- Chefs Without Borders
- Flying is fun!
- Mr Golden
- On being a travel writer
- Teaching ESL in Asia
- The 211 country honeymoon
- The Boxing Day Tsunami: 5 years on.
- To Teach or Not to Teach
- Travel writing scholarship 2012
- Tuk to the Road Charity ride
- Book reviews (5)
- Interviews (8)
- Explore Bangkok by BTS (16)
- All stories
- Bangkok by skytrain: Ari
- Bangkok by skytrain: Chid Lom
- Bangkok by skytrain: Chong Nonsi
- Bangkok by skytrain: Mo Chit
- Bangkok by skytrain: National Stadium
- Bangkok by skytrain: On Nut
- Bangkok by skytrain: Phaya Thai
- Bangkok by skytrain: Phloen Chit
- Bangkok by skytrain: Phrom Phong
- Bangkok by skytrain: Ratchadamri
- Bangkok by skytrain: Ratchathewi
- Bangkok by skytrain: Sala Daeng (S2)
- Bangkok by skytrain: Sanam Pao
- Bangkok by skytrain: Saphan Taksin
- Bangkok by skytrain: Surasak
- Bangkok by skytrain: Thong Lor
Sign up for Travelfish Burp!
Our weekly wrap on Southeast Asian travel.
Click here to see a recent newsletter.