Dengue fever is the causative agent. Complications of Dengue fever. Description of the hemorrhagic form of the disease

I myself have never had dengue fever (t-t-t), but some of my friends have not been so lucky. There are too many myths around this fever Lately, so there was a need to write this post so that you understand what it is, whether you should be afraid, whether you need to take out insurance, and in general how to avoid it. I hope this information will help you draw your own conclusions.

Dengue fever has 4 strains (serotypes) that cause it, and 2 forms of the disease: classic Dengue fever and hemorrhagic. Hemorrhagic is more severe and dangerous form, it only happens to those who have already had one of the strains, and, unfortunately, to newborns, if the mother has already had dengue and the child has received antibodies from her. So when deciding to give birth in Thailand, take care to choose a very good hospital.

Those who have had Dengue at least once already know everything about its symptoms and treatment, and they are unlikely to read this post. Therefore, further I will write only in the context of the classical form.

Symptoms

Symptoms that confirm it will be the following: chills (temperature jumps sharply to 39-40′), headache, area behind the eyes, muscles, spine and joints (mainly knees), a rash appears on the skin. All this begins suddenly, without preliminary ailments, with rare exceptions when a person begins to headache and a feeling of being overwhelmed. Nausea, lack of appetite, swelling of the face, swollen lymph nodes, redness of the eyes and throat are also symptoms of dengue fever.

If listed symptoms hit the mark on more than three points along with a high temperature, then there are three news for you: two good and one bad. The bad news is that about 4-7 days ago, somewhere on the veranda of a hotel or in the evening in a restaurant, you were bitten by an infected mosquito. Dengue fever is an acute viral disease with an incubation period ranging from 3 to 14 days, so many “lucky” people experience symptoms far from the tropics and tropical doctors. The good news is that you are not contagious to others, and Russian doctors have already learned to identify the symptoms of Dengue fever no worse than Thai ones.

Treatment

Under no circumstances should you take ASPIRIN, IBUPROFEN AND NUROFEN - this is the main thing you need to know when symptoms appear in the first days. Until you know whether you have Dengue or not, assume by default that this is it and take only PARACETAMOL to reduce the temperature.

People get sick in different ways, so on the Internet you can find how bad experience with a bunch of complications, including death, and cheerful reviews a la “it went away in a couple of days.” One is sick for 2 days, another can die for 2 weeks and then recover for another month. As a rule, the high temperature subsides after 3-4 days and then rises again for several days, 2 waves. During fever, red blood cells drop significantly in the blood, and it is from them that Dengue can be absolutely confirmed. True, a blood test can be done no earlier than 3-4 days of the course of the disease. That is, you will have already rewinded half the term by then.

There is no cure for Dengue fever; there is no cure for it at all. Whether you have it or not, be sure to go to the hospital. Although, according to some expats, there is no point in visiting a doctor at all if your symptoms are classic, and you should run to the doctors if hemorrhagic occurs. But I personally would play it safe, especially if we're talking about about the child, for them even the classical form can be difficult. So the doctor will be able to do the same blood test, tell you how to alleviate the disease, and hospitalize you if necessary. The main problem for children with high temperatures is dehydration, and sometimes this is impossible without an IV. However, an adult may also need an IV.

• The temperature is brought down with paracetamol every 4-6 hours, observing the dosage according to age and weight. Please note that paracetamol does not immediately provide a relief effect, so you can alleviate the condition by wiping with water.
• Be sure to drink regularly and plentifully, drink a lot. I repeat once again, do not ignore dehydration in your child, it comes unnoticed and quite quickly. If you see that the child is weakening, then immediately go to the hospital. Alternatively, force yourself to drink coconut water as a natural electrolyte. And you don’t have to buy green coconuts themselves; you can get bottled water at 7-eleven; sports drinks with electrolytes are also suitable.
• To avoid putting stress on sore joints - bed rest To relieve pain in the eye area - dim lights and curtains, and sleep. And to relieve aches throughout the body, Thais use papaya leaves. They buy it ready-made in a bottle at the pharmacy, or prepare it themselves - squeeze it in a juicer, make a decoction or mix it as a smoothie with honey. The taste is simply monstrous, but it is a very effective aid for Dengue.
• If a rash appears that itches terribly, use Calamine, an inexpensive but effective Thai remedy. Look at the skin more carefully; if small red dots appear, as with hickeys, it means the platelets in the blood have dropped to such a level that there is a danger of bleeding and now it is extremely undesirable to injure the skin and mucous membranes (brush your teeth only by rinsing, do not shave).

Due to nausea and lack of appetite, you will not eat, this only increases the loss of strength, and people literally walk holding onto the wall, and cannot even hold a spoon in their hands. In this regard, of course, Dengue fever is hell.

How to Avoid Dengue

Prevention

Dengue fever is transmitted by Aedes Aegypti and Aedes Albopictus mosquitoes. Mostly sources write about Edes aegypti, although when studying the topic of Dengue, I still did not understand what the difference is between egyptian and albopicus. Both are striped, both live in urban environments and easily tolerate near-zero air temperatures, breeding wherever there is water. After catching an infection from a bat, monkey or sick person, aedes remain carriers of the infection for the rest of their short life.

The only one effective measure protection against Dengue that you can take for yourself - use repellent frequently and mosquito repellent (available at 7-eleven), coils and fans in your hotel room or home. Every night before going to bed, inspect all the corners of the rooms and especially in the closets where these bastards like to hide. An electric fly swatter from Tesco will help you a lot with this - it’s an amazingly effective thing.

Peak danger hours are early morning and an hour after sunset, so avoid fresh water bodies and potentially dangerous places during these hours, and carry repellent with you. Try to choose housing with mosquito nets on the windows and no swamp nearby. By the way, in good resorts they periodically do anti-mosquito treatment.

Mosquito vectors Aedes Aegypti - photo by Muhammad Mahdi Karim

Medical insurance

Another way to protect yourself from the consequences of Dengue fever is to buy a normal health insurance(), which includes Dengue coating. Look at my rating, it shows which ones are insured and which ones are not. Currently they do not cover Dengue: Consent, Gaide, VSK.

But, as I wrote above, with a short vacation it may well be that you will already be sick with Dengue at home. However, always take out medical insurance for your travels, especially for children. I know what I'm talking about.

Hospitalization for Dengue fever is not necessary, yes. But if your illness is severe or repeated, then you cannot do without a hospital, and medicine in Thailand is expensive. You can, of course, lie down in a state medical institution, but it will be a bed behind a curtain in a general ward for twenty people, with the appropriate surroundings. Or you can get sick in a separate ward of a decent hospital such as Bandon Hospital or Bangkok Hospital, with prices ranging from 5-20 thousand baht/day. You spend a week on a drip, then you work for half a year to pay off the financial gap. Insurance in this regard is a necessary thing; one hospitalization immediately takes off years of insurance.

According to data from the WHO (World Health Organization) website, a person who has recovered from Dengue receives lifelong immunity to a specific strain and partial (or temporary) immunity to some of the remaining three. If you are unlucky with the second part of the bonuses, then if you are bitten by a mosquito carrier of a different strain, you have every chance of getting sick even 2 months after recovery.

Dengue fever vaccination

For arrivals for a period of less than a year, a Dengue vaccination upon arrival does not make sense.

Since December 2015, information has been circulating on the Internet about a vaccination produced by Sanofi Pasteur based on the Dengvaxia vaccine, which supposedly protects comprehensively against all 4 strains at once. But upon closer examination of the issue, it turns out that the current vaccination against Dengue fever is not a panacea at all. On the WHO website you can find their recommendation - to use only locally, on local residents, in areas with a real epidemiological threat. As you understand, tourists do not belong to this category.

Firstly, for a full effect, vaccination against Dengue fever is done 3 times every six months: 0 months - 6 months - 12 months. That is, it will begin to work fully only in a year. Getting vaccinated upon arrival in Thailand, even if you plan to spend the winter, is a waste of time and money, because you can pay ~7,000 baht to doctors for services and a vaccine, and a week later get bitten by a stray mosquito in a nearby restaurant.

Secondly, even if you are willing to wait a year before flying to Thailand, such a vaccination is not given in Russia. Thirdly, the effectiveness of the vaccine depends on the strain (that is, it does not help against all serotypes equally) and on nuances such as age, serological status and some other scary words, from which I understood that this can be expressed as a percentage - on average 52%. That is, there is a 50/50 chance that the vaccine will work.

To summarize, the Dengue vaccination may only be of interest to Thais and foreigners whose residence period is one year or longer, which means they have a greater chance of contracting Dengue. Moreover, pick up how light form fever and hemorrhagic. IN the latter case Dengue fever vaccination greatly helps alleviate the complicated form, although the percentage also varies greatly.

Chance of getting sick

As a summary, I want to write you this: despite all of the above, you are less likely to get dengue in the most mosquito-infested place in Thailand than a Thai is to get the flu in a subway car in winter. Dengue is a virus that occurs without snot, coughing and is not transmitted by air, unlike the flu. That is, you do not need to isolate yourself from your family or hide from your sick spouse.

The risk of complications or death with influenza is no less likely than with Dengue. It’s just that the media (and that’s where all the concerns and fears are spread) don’t like to talk about Russian scourges like tuleremic mosquitoes or encephalitis tick, and influenza epidemics have not raised ratings for a long time as much as the exotic Dengue fever, which is “raging” in Southeast Asia. As soon as you come across another panic message about a mass disease in Thailand, wave your hand at it and don’t even think about returning your tickets.

According to the World Health Organization (WHO), cases of dengue fever were reported in only 9 countries before 1970. Currently, the number of states characterized by this disease has increased to 100. The most high level incidence is observed in South America, Southeast Asia and the Western Pacific. But every day the virus is spreading more and more actively, causing outbreaks in new territories. The trouble is that the overwhelming majority of children suffer from severe forms of fever.

Dangerous tropical fever

Dengue fever is an acute viral disease- transmissible zoonotic infection, accompanied by pyretic (over 39 ° C) temperature, severe intoxication, hypertonicity muscle cells, joint pain, skin rash, enlargement of regional lymph nodes. It is most widespread in tropical and subtropical climates.

The disease has several synonyms: joint fever, bone crusher fever, five-day fever, tropical fever, date disease and giraffe fever.

The cause of tropical fever is an arbovirus that is resistant to high temperatures, which reproduces its own kind while inside the cell. It can exist in blood serum at room temperature for up to 2 months, and in a dried state for up to 5 years.

The causative agent of Dengue fever belongs to viruses of the family Togaviridae of the genus Flavivirus (arbovirus of antigenic group B)

Children are more often diagnosed with a severe form of the pathology, sometimes leading to death. In adults, in 70% of cases a mild course of the disease is observed.

For pregnant women, the danger is an increased risk premature birth.

How to protect yourself from illness - video

Classification of the disease

There are two forms of fever:

1. Classical (bone breaking). Characterized by a mild course. It is observed in children of the local population and visitors of any age. It develops during the initial meeting of the body with the pathogen, that is, in the absence of immunity to the disease.
2. Hemorrhagic. It is characterized by the presence of pathology on the part of the blood coagulation system and an extremely severe course with a fatal outcome. This type of fever mainly affects children of two age groups: newborns and infants up to one year old with passive immunity, as well as children from two to three years old who have suffered the classic form of the disease.

Causes and factors of infection

The infectious yellow fever mosquito (Aedes aegypti) is the main vector of the virus. Its peculiarity is considered to be living mainly in urban conditions and eating in the morning and daytime, which contributes to the effective transmission of the pathogen. However, it is not the only cause of the disease. The second most important is the Asian tiger mosquito (Aedes albopictus), which is well adapted to the cold climate of Europe.

Upon inspection you can see:

• enlarged peripheral lymph nodes;
• rash on the mucous membrane of the soft palate;
• white coating on the tongue;
• hepatomegaly (liver enlargement);
• skin rashes resembling urticaria (often pinpointed with nodules), ending with severe peeling after 7–9 days.

The rash is accompanied by severe itching, its appearance has a certain sequence:

• rib cage;
• inner surface of the shoulders;
• stomach;
• arms and legs.

Dengue fever rash is accompanied by severe itching and leaves behind large areas of peeling

The average duration of classic dengue fever is 10 days.

Symptoms of hemorrhagic form in a child

In a typically occurring severe form The disease has symptoms such as:

• pyretic body temperature (39–41 °C);
• hemorrhages under the skin;
• liver enlargement;
• vascular and cardiac (heart) failure.

The onset of the disease is sudden, accompanied by chills. Pain in muscles and joints is usually absent. Puffiness and redness of the face and body are observed. A pinpoint rash appears with the formation of papules, which is localized on the bend of the elbows and knees. After 5 days it spreads throughout the body, face and limbs. As the fever progresses, the person falls into a state of depression and apathy.

After 7–8 days, the disease subsides - the temperature drops, the skin gradually clears, and recovery begins.

In severe cases, the patient’s condition deteriorates sharply, a sign of which is:

• poor circulation in the form of pale and bluish skin;
• abdominal pain;
• increased heart rate and breathing;
• pinpoint hemorrhages on the skin of the forehead, legs, arms;
• bloody vomiting, loose black stools, indicating gastric bleeding;
• central lesion nervous system: convulsions and depression of consciousness.

Classification of degrees clinical manifestations fever:

1. Nonspecific symptoms, minor bleeding.
2. Attachment of spontaneous bleeding, for example, from the gums, gastrointestinal tract.
3. Manifestations of 2 degrees and decreased blood pressure, cold damp skin, weak pulse, tachycardia.
4. State of shock.

If antishock therapy brought a positive result, the signs of hemorrhagic fever quickly disappear, the person recovers without any health consequences.

In cases where treatment is ineffective, death occurs within 24 hours.

Diagnostic measures

In addition to clinical manifestations, there are criteria that facilitate the diagnosis of hemorrhagic fever:

1. Decrease in the number of cells responsible for coagulation (platelets) in the peripheral blood.
2. Blood thickening is more than twenty percent compared to normal.

When diagnosing classic fever, the doctor relies on leading symptoms and laboratory tests. In addition, visiting places where cases of infection have been identified can lead to the correct diagnosis.

For staging final diagnosis It is necessary to carry out two main laboratory tests:

1. Virological - isolation of the virus, its identification, characterization of the basic biological properties. This requires a specialized laboratory. Most often, blood and swabs from the mucous membranes of the nasopharynx are used.
2. Serological - detection in serum of protective proteins (antibodies) against the causative agent of fever. A sign of the presence of the disease is an increase in the number of antibodies to the virus in the blood. Downside The test is a possible response to other viruses, so there is a possibility of a false positive reaction.

In laboratory conditions, the disease is confirmed by isolating the virus from the blood or based on an increase in antibody titer in paired sera

Differential diagnosis

Classic dengue fever is differentiated from influenza, measles, hemorrhagic fever - from meningococcemia, malaria, sepsis, yellow and mosquito fever, as well as other hemorrhagic fevers.

Only laboratory tests are decisive, since it is almost impossible to make an accurate diagnosis based on clinical signs alone.

Dengue fever treatment

On modern stage There are no medical developments or drugs aimed at eliminating the virus. Treatment is based on stabilizing the patient's condition by symptomatic therapy:

1. Prolonged high temperature contributes to the development of dehydration, so drinking plenty of fluids is necessary, which also helps reduce intoxication.
2. At temperatures above 38 °C It is recommended to take antipyretic drugs.
3. Painkillers are indicated for severe pain.

With a mild course of the disease, the classic form can be treated on an outpatient basis under the guidance of a doctor.

Hemorrhagic fever is an indication for hospitalization. Therapy is carried out only in a specialized closed hospital.

Prognosis, complications and consequences

If a viral infection is detected early and adequate symptomatic therapy is prescribed, the prognosis is favorable. When a severe form develops, it is also of paramount importance timely treatment, reducing mortality by 10%.

In case of complications (encephalitis,) the prognosis worsens.

In addition, after an infection, immunity lasts up to 2 years. The disease reoccurs in the local population and only in a dangerous hemorrhagic form (mortality rate up to 50%).

Vaccination and other preventive measures

The main measure to prevent viral infection is to control the pathogen vector. Recommended:

In 2015, a vaccine against dengue fever was developed, which World Organization Public Health suggests use in countries with periodic outbreaks of the disease. Its use is also advisable for tourists traveling on vacation to countries with a risk of infection.

Before visiting tropical countries where there are outbreaks of dangerous infections, it is recommended to increase your own immunity: consume fresh vegetables and fruits, play sports, be on fresh air at least 3 hours a day. And after returning home, be sure to see a doctor and get tested necessary tests to exclude the development of Dengue fever.

– natural focal infection, caused by arboviruses of the same name and occurring with influenza-like syndrome or hemorrhagic manifestations. Classic dengue fever is characterized by a two-wave rise in temperature, myalgia, arthralgia, lymphadenitis, exanthema, hemorrhagic - spontaneous bleeding. When diagnosing dengue fever, epidemiological and clinical data, virological and serological tests. Specific therapy and immunization have not been developed, so treatment of dengue fever is predominantly symptomatic.

General information

Dengue fever (bone disease, joint fever) – transmissible viral infection, flowing in two clinical forms– classical and hemorrhagic. Dengue fever is common in regions with tropical and subtropical climates: Southeast Asia, South America, Australia and Oceania, Mediterranean Sea etc. Every year, hundreds of thousands of cases of dengue fever are registered in endemic areas. Outside the area of ​​infection, imported cases of dengue fever occur, due to both the migration of infected individuals and the importation of infected mosquitoes. The classic form of dengue fever has a benign course, but the hemorrhagic form is characterized by high mortality.

Causes of dengue fever

Dengue virus (Dengue-virus) belongs to the arboviruses of antigenic group B, belonging to the genus Flavivirus, family Togaviridae. There are 4 known serovars of the pathogen (DEN-1, DEN-2, DEN-3, DEN-4), each of which is capable of causing both classical and hemorrhagic forms of dengue fever. After infection with one or another serotype of the virus, lifelong type-specific immunity remains, but this does not exclude the possibility of future infection with another serotype of the virus. Dengue-virus has single-stranded RNA, a bilayer lipid envelope, and the virion diameter is 40-45 nm. In its own way antigenic structure The dengue virus is close to the yellow fever, West Nile and Japanese mosquito encephalitis viruses. The dengue virus is resistant to freezing and drying, but is labile to heat, ultraviolet radiation, and proteolytic enzymes.

Reservoirs and sources of infection are sick people, monkeys, the bats, and the virus is transmitted by mosquitoes of the genus Aedes (A. albopictus and A. Aegypti, A. Polinesiensis, A. Cutellaris). Mosquitoes become infectious 8-12 days after bloodsucking and retain a lifelong ability to transmit the virus. Healthy people contract dengue fever through the bites of infected mosquitoes. Children under 2 years of age, elderly and frail people, as well as visitors, including tourists, are more susceptible to dengue fever. Local residents of endemic areas and visitors fall ill mainly with classic dengue fever. Children who have previously had classic dengue, caused by types 1, 3 or 4 viruses, are more likely to become infected with severe dengue hemorrhagic fever when infected with the second type of virus.

After a mosquito bite, the virus multiplies within 3-5 days in regional lymph nodes and vascular endothelium. After the period of primary replication, viral particles penetrate into the blood, causing the development of viremia, which is clinically manifested by febrile intoxication syndrome. The second wave of fever is associated with the penetration of viruses into organs and tissues. Cupping clinical symptoms occurs as virus-neutralizing and complement-binding antibodies accumulate in the blood. In the hemorrhagic form of dengue fever, the lesion occurs predominantly small vessels, violation state of aggregation blood with the development of multiple hemorrhages in the membranes of the heart, pleura, gastrointestinal mucosa, and brain.

Dengue fever symptoms

Dengue fever can occur in two clinical options: classic and hemorrhagic (without shock syndrome or with dengue shock syndrome). After incubation period(from 3 to 15 days after a mosquito bite) a short-term prodromal period begins, during which malaise, headache, signs of rhinitis and conjunctivitis are noted. Sometimes acute manifestations arise against the background of complete well-being without previous symptoms.

In the classic form of dengue fever, chills develop and a rapid increase in body temperature to 39-41°C. During this period, patients experience nausea, anorexia, arthralgia, ossalgia and myalgia, which impede movement. Typical objective signs are bradycardia, lymphadenitis, hyperemia of the pharynx, and injection of scleral vessels. After 3-4 days, body temperature drops sharply, and a short period of apyrexia occurs, lasting 1-3 days. Then a second wave of fever develops, accompanied by the same symptoms.

A typical symptom of classic dengue fever is exanthema, which appears during the first or second febrile wave. The rash is polymorphic, more often morbilliform, sometimes urticarial, scarlatiniform or petechial. Skin rashes abundant, localized on the trunk and limbs, accompanied by itching and peeling of the skin. Total duration acute period classic dengue fever is 7-9 days. The period of convalescence extends to 4-8 weeks, during which asthenia, insomnia, joint and muscle pain persist.

The hemorrhagic form of dengue fever, also known as Philippine, Singapore, and Thai hemorrhagic fever, has more severe course. IN initial period, just like in the classical form, there is an increase in temperature and intoxication. Pain in the joints and muscles occurs rarely, but severe abdominal pain and liver enlargement are common. On days 2-3, a petechial rash appears on the skin, severe cases spontaneous nasal, gingival, uterine, gastrointestinal bleeding, hemorrhage in the internal organs, hematuria. On days 3-5 from the onset of fever, dengue shock syndrome may develop, accompanied by tachycardia, arterial hypotension, oligoanuria, disseminated intravascular coagulation syndrome, cyanosis and convulsions.

To determine the severity of clinical manifestations and assess the prognosis, 4 degrees of dengue hemorrhagic fever are distinguished:

• I degree: Clinical signs- feverish-intoxication syndrome and “ positive test tourniquet"; laboratory tests - thrombocytopenia and hemoconcentration.
• II degree: clinical signs (optional) – bleeding (ecchymosis, from the nose, gums, genital tract, hematemesis, melena); laboratory signs– increase in thrombocytopenia and hemoconcentration.
• III degree: clinically – signs of circulatory failure, development of dengue shock; laboratory – increased thrombocytopenia and hemoconcentration.
• IV degree: dengue deep shock syndrome.

At hemorrhagic fever dengue deaths are registered in 5-20% of cases, mainly among children. In surviving patients, complications are possible in the form of polyneuritis, pneumonia, encephalitis, meningitis, mumps, otitis media, orchitis, thrombophlebitis, etc.

Diagnosis and treatment of dengue fever

The criteria developed by WHO allow one to suspect dengue fever in the event of the development of: a febrile syndrome that lasts 2-7 days; thrombohemorrhagic syndrome; thrombocytopenia (less than 100x109/l) and an increase in Ht by 20%; hepatomegaly and shock syndrome. The presence of epidemiological prerequisites (visits to endemic regions, mosquito bites, outbreaks of infection) and typical clinical symptoms(two-wave fever, arthralgia, myalgia, exanthema). An additional criterion can be a positive “tourniquet test” (intradermal hemorrhage after applying a tourniquet or cuff in the elbow area).

Laboratory confirmation of dengue fever is carried out by isolating the virus from the patient's blood PCR method and determining the increase in the titer of specific antibodies in paired sera over time using RSC, RNIF, RN, RTGA. Dengue fever should be differentiated from pappataci fever and chikungunya fever, yellow fever, malaria, meningococcal infection, sepsis; in children - from measles, scarlet fever, rubella.

There is no etiotropic therapy for dengue fever, therefore therapeutic measures are mainly symptomatic in nature (taking antipyretics, antihistamines, detoxification). For the hemorrhagic form of dengue fever, hemostatic and anti-shock therapy, correction of disseminated intravascular coagulation syndrome, transfusion of red blood cells and platelets, and blood plasma are carried out. Efficacy data available parenteral administration interferon in early stages diseases.

Prognosis and prevention of dengue fever

The classic form of dengue fever usually progresses favorably and ends with recovery. In the hemorrhagic form, the prognosis is serious, largely depending on the patient’s age, virus serotype, and timing of initiation of therapy. The highest mortality rate is observed among young children.

Experimental vaccines for dengue fever are currently in different stages clinical trials, so we can only talk about nonspecific prevention. To prevent infection in regions where dengue fever is endemic, it is necessary to use mosquito repellents, fumigators, and mosquito nets. Of particular relevance is the destruction of mosquitoes that carry the dengue virus, the use of insecticides, the fight against waterlogging and contamination of the territory, and the storage of water supplies in closed containers.

We all imagine life in Thailand as something connected with the sea, sun, fruits, but real life is fraught with some pitfalls that anyone who decides to stay longer in this exotic country should be aware of. Today you will learn about what it is Dengue fever how to treat it and preventive measures. Everything is based on personal experience.

Dengue fever- it's spicy viral disease transmitted to humans by mosquitoes. These creatures are black with white stripes. They bite very painfully. You will immediately understand the bite of such a mosquito.

There are 4 strains of this virus and two stages. We had the usual dengue fever. In Thailand, as in many Asian countries, it is quite widespread. The consequences for humans are not very terrible. Mortality rate is low. This probability is lower than from regular flu.

The second type of dengue fever is dengue hemorrhagic fever. Here things are more serious. Immediately requires hospitalization in a hospital on a drip. Various hemorrhages occur. The mortality rate is already higher, but mainly local residents or farangs, who have repeatedly suffered from the usual form of Dengue, suffer from this form of fever.

Dengue fever symptoms.

1. High unstable temperature. It can reach 39 degrees, and the next day drop to normal, then rise again.
2. Cough and sore throat. We didn't see any.
3. Aching bones, chills. We felt this to the fullest. My wife says it’s like she was at childbirth again. The pain in my back was very sharp and intense. It went easier for me. There was chills and aching bones. Feels like a big hangover :)
4. Rash all over the body. The creepiest topic in my opinion. Again, I was lucky and it didn’t hurt me too much, but my wife couldn’t sleep from the unbearable itching. It was impossible to even walk.
5. Headache. It bothered my wife a lot, but I had no problems with it.
6. Nausea and diarrhea. Again, my wife felt sick and had no appetite. On the contrary, I was constantly hungry :)
7. Inflammation of the lymph nodes. The situation is similar to a headache.

Dengue fever treatment.

There is no cure for Dengue fever. Only the symptoms that accompany it are treated. If you have a headache and fever, take paracetamol and antipyretics along with painkillers.

For nausea, vomiting and diarrhea, take appropriate medications.

Fenistil and Suprastin helped us with the rash.

All treatment boils down to the fact that the person is provided with rest and drinking plenty of fluids. A very sure sign that you are on the mend is a good appetite.

Prevention of Dengue fever.

Prevention of Dengue fever means avoiding mosquitoes. Necessary:

- install mosquito nets on windows

- use mosquito repellents in the room

- use anti-mosquito products.

Another very important advice. If a sick person is bitten by a mosquito, the same mosquito can infect others. Be very careful. If there is a patient with Dengue fever in the house, then you need to increase vigilance or send him for observation to a hospital.

How did we experience Dengue fever?

I’ll say right away that the course of the disease was different for me and my wife. My form was much lighter. Apparently the immunity is better or the mosquito with the virus turned out to be weaker.

The incubation period of the disease is 2-3 days. But we immediately felt after the bite that something wrong had happened.

I just felt lethargic and apathetic. I thought it was just tiredness. Since we caught the virus during our... It wasn't a very close journey. My wife immediately felt sharp pain in the back area. Then I got a headache and a fever. The aching in her bones was terrible, as if she was giving birth again.

Throughout my illness I felt weak and chilly. I didn't want to do anything. I just lay there.

An allergic rash covered my entire body. The unbearable itching did not allow me to sleep. Since the rash was even on the feet, it felt like you were walking on hot coals. It is simply impossible to sleep in this state.

After that, we decided to contact our insurance company. We are insured by IC Soglasie. There they talked to us and sent us letter of guarantee to Bangkok Hospital. This was already our second trip here. The hospital is very cool, and there is also a Russian-speaking translator, which was very cool with our not the best English.

When traveling to Samui, be sure to check whether your insurance company works with the ISOS assistance company. She is the one who works with Bangkok Hospital. In the usual place where we got Alina vaccinated, it would be difficult for us to explain everything, and the queues there are crazy.

In Bangkok, hospitals created a card for my wife and sent her for an appointment.

The doctor immediately assumed from our symptoms that it was Dengue fever. Thanks to the girl translator for explaining everything to us. Without her, we would have understood little.

Lena's blood samples were taken. I had to wait two hours for the result.

The analysis confirmed the doctor's assumption. Lena's diagnosis was confirmed. So I had a similar situation.

Next, we were offered to admit Lena to a hospital under the supervision of doctors. But since she felt relatively well, and the only treatment was an IV, we decided to give up and recover at home.

We were scheduled for a follow-up appointment the next day to see the progress. The insurance company also approved a second visit to the doctor because Dengue fever is an insurance event.

For the first appointment with tests, the insurance company paid 7,400 baht, of which 900 baht were medications that we paid for at our own expense. It’s true, it’s still not clear why? This is an insured event, which means everything must be paid for by the insurance company. We kept the receipt. When we have time, we’ll contact Soglasie in Novosibirsk. If you are aware of this issue with medications, write in the comments.

Here are the medications they prescribed for us.

This is for stomach problems.

This is due to temperature - our regular paracetamol.

It's for itching - I think it's just bottles of alcohol. Replace fenistil with gel and suprastin.

I think that if there are no Russian medicines, then you can look at pharmacies. It should be cheaper.

Repeated analysis confirmed that the wife is on the mend. Gradually we began to recover from the fever. We fully recovered in about two weeks.

Watch the video about my impressions after the illness.

Since I had to go out of order, I will have to adjust my goals for this month. The only point regarding income is that the plan has already been exceeded. Details in this month's report.

Subscribe to blog news. There is a lot of interesting things ahead. From now on, episodes will be published three times a week on Tuesdays, Thursdays and Saturdays.

In the comments, please write if Dengue fever has scared you? Have you changed your mind about flying to Thailand yet?

Dengue fever- This dangerous infection, transmitted through mosquito bites.

Dengue fever is common in tropical and subtropical regions of the planet. Light form infection causes rash, high fever, muscle and joint pain.

A severe form of the disease, called hemorrhagic fever, causes severe bleeding, shock due to blood loss, and even death.

Millions of cases of dengue fever are reported worldwide every year. This disease is most common in Southeast Asia and the islands of the Western Pacific.

However, in Latin America and the Caribbean islands there is also fast growth morbidity.

Researchers are working to develop a vaccine against dengue fever, but... the best way Prevention for now is to avoid places inhabited by mosquitoes, especially in disadvantaged regions.

Causes of Dengue Fever

When a mosquito bites an infected person, the Dengue virus enters the mosquito's body, where it can remain for a long time. With subsequent bites from this insect, the virus is transmitted to other people.

If a person has had dengue fever, then he remains immune to this type of virus, but not to the three other dengue viruses. The risk of developing severe hemorrhagic form fever increases if a person gets sick for the second or third time.

Risk Factors for Dengue Fever

1. Residence or travel to tropical regions, especially Southeast Asia(Thailand), Latin America(Panama) and the Caribbean islands.

2. Previous infection with Dengue virus. Previous infection increases the risk of severe fever if a person becomes infected in the future (with another type of dengue virus). This especially applies to children.

Dengue fever symptoms

Signs of Dengue fever include:

1. High temperature (up to 41C).
2. Headaches.
3. Muscle pain.
4. Joint pain.
5. Pain in the eyes.
6. Skin rashes.
7. Nausea and vomiting.
8. Bleeding.

With a mild form, most patients recover within a week. In some cases, symptoms worsen and the disease can be life-threatening. Blood vessels are damaged, the level of platelets, the elements responsible for blood clotting, drops sharply.

As a result, the following symptoms appear:

1. Bleeding from the nose, mouth, etc.
2. Constant vomiting, sometimes with blood.
3. Severe pain in a stomach.
4. Hemorrhages under the skin.
5. Problems with the lungs, liver and heart.

If a person has been to disadvantaged regions and soon after returning from cutting he has a fever, he should urgently seek medical help.

Diagnosis of Dengue fever

The doctor will definitely need a history of all trips and travels of the patient. It is important to accurately indicate the countries in which the patient has been, as well as the dates of all trips.

You can take blood tests to detect the Dengue virus, but this is not possible in all cases medical institutions. In addition, the test results will come too late to help the doctor decide on treatment.

Dengue Disease Treatment

Attention! If you have hemorrhagic fever, you should avoid antipyretics and painkillers such as acetylsalicylic acid(Aspirin, Upsarin), ibuprofen (Nurofen, Ibuprom), naproxen (Nalgesin) - these drugs can worsen bleeding!

A patient with severe dengue fever may need:

1. Intravenous infusion of fluids and electrolytes.
2. Blood transfusion for severe blood loss.
3. Monitoring of blood pressure and cardiac activity.

Complications of Dengue fever

Even with adequate treatment a small percentage of patients die.

Prevention of Dengue Fever

If a person travels to disadvantaged countries, then the following precautions must be taken:

1. Stay overnight only in hotels with air conditioning and tightly closed windows. This is necessary to avoid becoming a victim of mosquitoes at night.

2. Avoid walking after sunset and before dawn, when mosquitoes are most active. This is especially true for walks near bodies of water.

3. You must wear protective clothing - long pants, long sleeves, socks and closed shoes. Of course, you won't be able to wear these clothes all day on the beach in Thailand. But in the evening you should be careful.

4. Using mosquito repellent is an important preventative measure. You must remember to apply these products as often as required by the instructions. In addition, you can buy clothes that are already impregnated with an insecticidal agent - permethrin.

5. People who permanently live in the tropics need to make every effort to rid their yard and surrounding area of ​​standing water - a real breeding ground for mosquitoes, and a potential source of Dengue fever and other diseases.

Konstantin Mokanov