Dengue Fever

 

 

The dengue season runs from June to early December in Dhaka, but varies depending on the rains. Usually, we see most cases between July and early November but we have seen cases in the past as early as April.

 

There is no treatment for dengue fever, so PREVENTION is the most important step.

 

New arrivals to Dhaka often get caught out because the mosquitoes are not always evident. They do not fly in large clouds of insects - there may be only one - and they are very good at hiding in dark shady spots, under desks, around flowerpots, under car seats etc. Do not assume that because you cannot see them that they are not there. It only takes one bite....

 

Protect you & your family by taking the following simple measures:

 

 

LIMIT BREEDING

Female mosquitoes lay eggs indoors & outdoors, in tiny quantities of fresh or stagnant water. They especially favour fresh water in artificial clean containers such as pet bowls, flower pots, empty buckets and basins, vases, kids' toys that collect water, and old tyres. The eggs can survive for several months outside water, so make sure that you are rinsing containers well. The mosquitoes often collect in AC units because of the clean water pools, so spray car and house A-C units regularly.

During an epidemic, drain and rinse out containers at least every 5 days or so (the time it takes for the larvae to hatch) to break the hatching cycle.

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LIMIT BITING

Use bed nets.

Regularly apply insect repellant (see below), remembering that Aedes Aegypti mosquitoes bite during the day, especially in the morning & evening.

If you choose not to put repellants on the skin, then you must ensure that the skin is protected by some other means – protective long sleeves, trousers and socks, mosquito nets to cover buggies and beds etc - remembering that the mosquitoes can still bite through sheer fabrics. You might try spraying some DEET onto the material itself, rather than directly on the skin. 

Remember that using the air conditioner does not keep mosquitoes out of your house.

Check mosquito screens on doors & windows for holes.

Spray inside the house, car & office every morning before people enter. Follow safety precautions on the spray cans, since all of the commonly sold varieties are toxic.

If someone in your house is sick with dengue, take extra precautions to prevent mosquitoes from biting the patient then going on to bite others in the household.

 

 

MOSQUITO REPELLENTS

​I totally understand parents’ concerns about applying chemicals to their children’s skin, especially if their children have sensitive skins. However, dengue is a very serious and potentially fatal disease from which we must protect ourselves and our children.

 

ODOMOS cream (white and blue tube), available in local supermarkets and pharmacies, is the least “toxic” of the available repellents. It contains DEB, a close relative of DEET. Clinical trials have shown that it offers excellent protection if applied liberally and carefully to ALL exposed areas of skin. However, this protection only lasts for about 5-6 hours, so will wear off by lunchtime if applied in the morning. Older children should be encouraged to reapply their own Odomos at lunchtime and again after school if staying on for after-school activities. They also need to remember to reapply it after swimming and P.E. classes, and to pay special attention if jumping in and out of the swimming pool over a couple of hours, because the cream is NOT waterproof. For the little ones, the responsibility of reapplying repellent will eventually lie with the parents, house staff or teachers/teaching assistants caring for the children and must be discussed and agreed with them.

 

OFF spray (orange can) contains 15% DEET and offers a solid 8 hours of protection, if carefully applied to ALL exposed areas. In teens, adults and those who tend to attract mosquitoes, this might be a more convenient option than the Odomos.

 

DEET is best washed off the skin at the end of the day. It can be applied to children as young as 2 months old. DEET is also known to be safe in pregnancy and breastfeeding. “Jungle Formula” products containing 50-100% DEET are not required on the skin, but can be sprayed on clothes. Concentrations above 50% offer longer protection but not stronger protection.

 

Citronella ALONE is not sufficient.

 

Mosquito COILS are useful for open outdoor areas or for placing outside your front door where the mosquitoes often congregate.

 

There are other natural products on the market, including the Avon Skin So Soft "Bug Guard" range, but I am unsure whether there is any strong scientific evidence to confirm their effectiveness in preventing dengue.

 

Here are some links to some factual articles and information sheets about Odomos and DEET that you might find interesting to read:

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103177/

http://www.swmosquito.org/pdf/PROT_DEET%20Toxicity.pdf

http://www.cdc.gov/malaria/toolkit/DEET.pdf

 

 

THE SYMPTOMS

If you experience the following symptoms that fail to improve after a few days, please make an appointment to see one of our doctors:

 

• Fever

• Bone pain – dengue is also known as “break bone fever”

• Headache & pain behind the eyes.

 

If, in addition to the above, you experience any bleeding in your mouth, gums, urine or stool, excessive bruising or a rash that does not turn white when you apply pressure, please seek immediate medical help.