150 contract dengue fever a day in New Caledonia
Some 150 people contract dengue fever a day in New Caledonia at this time of year. So far the current dengue fever epidemic has seen 2 deaths (one of whom was 36 years old). We are constantly informed by billboards and newspaper articles that we need to empty gutters, pots and tires that may have water in them, that we need to wear insect repellent and that if we come down with dengue fever, we should consult a doctor. For dengue fever is spread by mosquitoes, and the local community needs to spray the area to get rid of the dastardly dengue-carrying insects.
The symptoms include body and joint pain (which can be so severe that the disease is nicknamed “breakbone fever”), headaches and high fever. As it is asymptomatic, you may not exhibit symptoms at all – and never knew you had it. Sudden fatigue, pain behind the eyes and vomiting can also consume you – along with a skin rash. Or nothing at all. The only way to know you have dengue fever is to take a blood test.
Back in December I felt very, very sick, but I didn’t want to bother a doctor with my symptoms as I only had a low-grade fever (and fatigue and muscle pain). About 10 days later our son was suddenly also sick – only much sicker (with a very high fever, non-stop vomiting, diarrhea and a skin rash). The doctor was unable to figure out what it was, but did not prescribe a blood test. Looking back, I probably should have requested one.
To this day, we choose to think we had had bizarre bugs and not dengue fever.
It turns out that catching 1 of the 4 forms of dengue fever generally immunizes the individual for life against the form he/she contracted, but the individual only has short-term immunity to the other forms. Subsequent infection with a different type increases the risk of severe complications.
Therein lies the importance of knowing whether or not you have contracted dengue fever. We have friends who developed eye complications from dengue fever – and temporarily lost their vision – a mother and son. The mother was unable to see very much at all for approximately 6 weeks and was homebound (with 4 children to tend to, get to school, etc.). When she started to recover her vision, her son came down with the virus and the same loss of vision. I’ve heard that of the 8 cases of this nature during the last epidemic, 7 recovered their vision and 1 did not.
Is dengue fever serious in New Caledonia? This year, it is. We’ve had the second worst epidemic the country has known since 1995 and there is a chance it will become the country’s worst. As of last Monday (1 April), we’d had 6,378 cases since September.
As you can see from the map, it is worse in urban areas. High-case areas include Robinson, Saint Michel, Koutio, Riviere Salé, Pot de Fer, Magenta, Vallée des Colons and Katiramona.
The dengue-carrying mosquito, the Aedes aegypti (also known as the yellow fever mosquito) is attracted to homes in cities – and is known to infect entire families. You can recognize it by white markings on its legs and a marking in the form of a lyre on its thorax. Flying soundlessly, it tends to sting its victims during the day, and principally around sunset.
We were pleased to find a very helpful brochure on dengue fever at the doctor’s office last week which fully explained how to recognise dengue fever, how to prevent it and what to do. If there are no complications, you are sent home and told to rest (once you’ve been diagnosed with a blood test). You are given an acetaminophen (Doliprane), and are told to just wait until it goes away (between 5 and 7 days). But complications (such as dengue hemorrhagic fever) can lead to death. The death rate is usually below 1% if patients get treated quickly, but can rise to 10% if not. So it’s not something to take lightly.
Is New Caledonia doing anything else about the epidemic? Two scientists are currently testing a new molecule (pyriproxyfen) that might block the development of the mosquito’s larvae. But their work is preliminary and will most certainly take time. Other labs have been investigating developing vaccines. A clinical trial on 4,000 children in Thailand showed only 30.2% success, as reported in September 2012. Another trial was announced in November 2012, to be carried out on 120 adults and children in India.
Meanwhile in the United States, hundreds of thousands of genetically modified mosquitoes were released into the Florida Keys in an experiment to fight dengue fever in December 2012. It is thought that the genetically modified non-biting male mosquitoes would pass along a birth defect killing their progeny before reaching maturity and that after a few generations the Aedes aegypti population would die off. But this is a trial and it may take years for the US Federal Drug Administration to approve it for wider use.
So until we have a larvae-blocking molecule, a vaccine or another solution, New Caledonia will have to remain vigilant. Residents will need to continue to make sure there is no standing water around or in their homes, tourists and residents will need to continue to use insect repellent. And everyone should consult a doctor if symptoms present themselves …