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dbratt@trinidad.net
Dengue
People
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People who suffer from dengue fever do not die, even
though they may feel like they are dying. It is those
who develop DHF or DSS who are at risk.
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You can get dengue four times as there are four types
of dengue viruses.
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Most people who have dengue have no symptoms or have them
very mildly.
Dengue
is a strange disease. Thirty years ago most Trinis had never
heard of dengue. It really is two diseases, just dengue,
and dengue haemorrhagic fever (DHF), the worst form of which
is dengue shock syndrome or DSS.
People who suffer from dengue fever do not die, even though
they may feel like they are dying. It is those who develop
DHF or DSS who are at risk.
To make things a bit more complicated, you can get dengue
four times. No wonder people are confused.
So when the Minister of Health says there is no dengue outbreak,
even though everybody and their nennen know of somebody
with dengue, and when the headlines in the newspapers proclaim
“Only autopsy can prove dengue” and doctors all
over the country are diagnosing dengue, that’s par
for the course in a country where everybody is already confused
by the bacchanal and bobol going on in, for example, sports
and politics, so why not health?
The Sports Minister claims his ministry is responsible for
our “success” at the Olympics. The “success”
is exclusively due to Richard Thompson and who knew anything
about Richard Thompson before the Olympics? And the usual
stupidness about what he’s going to get has broken
out? Car? Land? Medal? An alpagat and two zaboca? How
about a decent sports programme like the Jamaicans have?
We could put it in Tarouba. Whenever it’s finish building.
Or the probe into Udecott ends. Maybe we could get somebody
from UWI to find out if eating callaloo and doubles is as
good as yam?
Then you have the proposed political union with a set of
pretty, small-time islands that can’t even feed themselves,
one with a capital that has three streets, Front Street,
Middle Street and Back Street and you in country. What do
they bring to the table except more votes for a particular
political party? Look north, young man? No, look south where
the land is.
One of the long-term side effects of dengue is tiredness
and mental dullness. Could this be affecting all of us?
Before any American says getting dengue four times is voodoo
medicine, let me hasten to add that there are four types
of dengue viruses.
Each different virus type, and you can think of them like
the four members of the 100-metre relay team or any four
politicians that you choose, all quite the same but a bit
different, produces the same clinical manifestations.
The Venezuelans have a lovely name for dengue, they call
it fiebre de rompehuesos or “breakbone fever.”
Somehow the English does not have the impact that rompehuesos
has, like Rampanalgas or Rapunzel (Campunula rapunculus).
Perhaps it’s the “r’s.”
Dengue can hit you like the proverbial ton of bricks: sudden
onset of high fever (“burning up”) lasting five
to seven days, severe, severe headache, typically described
as behind the eyes, and real, real muscle and joint pains,
usually down your back, whence the name. A couple of days
into the fever you can get a rash, usually bright red or
purple spots on your legs and trunk.
To make things more difficult and for those who believe
in computer medicine, most people who have dengue either
do not have any symptoms or have them very mildly.
And to confuse you more, the fever may go after three or
four days and then return a day or two later, the “bi-phasic
or camelback fever pattern” beloved of professors of
medicine but remember it’s not an Arab camel but the
Asian one, the Bactrian camel, now found living only in
the Gobi desert, where there is no dengue.
Who thought this up is not known but this gives you some
idea of the imagination of doctors.
The most dangerous period is when the fever breaks, because
this is when you can develop DHF or DSS. The first signs
of this notorious disease are severe pain in the abdomen
and persistent vomiting accompanied or not by bleeding from
the gums or nose or passage of black tarry stools. Treatment
must be started when the pains and vomiting start. You wait
until bleeding and that is trouble.
No one can tell you if you are going to get DHF or DSS.
There is no relationship between the treatment you get early
on and whether you develop DHF or DSS. If it’s going
to happen, it’s going to happen.
There is no specific, curative treatment for either dengue,
DHF or DSS. Treatment for each is based on keeping the person
well hydrated, at home for dengue but in hospital for the
others and watching out for complications. Special
blood transfusions may be needed.
Finally a word about outbreaks. Yes, it is true that
the Government should be spraying mosquitoes but this comes
like the “gimme-gimme dependency syndrome” now
surrounding our Olympic medal winners.
It is our responsibility for making sure mosquitoes cannot
breed. Pardner, that means keeping your damm yard clean
or is you to ketch!
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