On December 16 BIMC General Manager, Cathy Bolwell, gave a talk for parents and teachers at the Bali Island School in Sanur on the topic of dengue fever.
Ms Bolwell explained that dengue fever is quite common in Bali. Dengue used to be prevalent during the rainy season that runs from October to April but in the past years the tendency is changing. You can get Dengue throughout the year as the season also cannot be predicted. She advised the group that anyone who is running a fever more than 2-3 days should seek medical consultation and do the blood test.
Fever, headaches, muscle and joint aches, are the most common symptoms and some people experience diarrhea, skin rash or itchiness after the fever is reduced says Ms Bolwell. “The fever is most severe for the first five days. Headaches are characterized with frontal throbbing around the eyes with non-specific muscle and joint aches and diarrhea and a skin rash usually develops on or about day five, at the same time when the antibody starts to develop.”
Doctors diagnose dengue fever through symptoms and travel history. Symptoms are not always straight forward especially if you are taking Panadol, ibuprofen, or steroids, which can mask the fever. Your doctor may order lab tests with two specific blood tests: NS1 antigen dengue, which is part of the virus protein, and IgM and IgG Anti dengue, which are the antibody against dengue. The NS1 antigen is checked between day one and day three, while the latter is ordered after day five of the disease.
Treatment of dengue requires a conservative approach, essentially plenty of fluid intake, either drinking or intravenous. During treatment your blood needs to be monitored for signs of low platelet and increasing concentration of red cells. When there are signs of bleeding, especially if associated with very low platelet, your doctor might need to give you a blood transfusion.
Those who have contracted dengue will typically suffer with fever for five days. By day six, the symptoms will begin to resolve and one will begin to slowly feel better. The blood test however will get worse by the fourth day with the lowest platelet count around day seven, then it will go up once again. By the 10th day, the disease will have resolved. Note: the course of the disease varies from person to person.
There is no prophylaxis medication or vaccine against the disease. There are however preventive measures for dengue such as keeping your household dry of still water especially in the bathroom and outside yard areas. If you have consistent flood pools of water in your yard, keep windows and sliding doors closed for most of the day and night. Remember to apply mosquito repellent, use bed netting, mosquito spray and anti-mosquito incense.
Unfortunately having had dengue in the past does not mean you are immune to the disease. There are numerous strains of dengue therefore it is best to err on the side of caution and be mindful during the rainy season with the preventative measures outlined in this article.