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Expert Explains Dengue Fever

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What Is Dengue Fever?

Where did dengue originate? The origin of dengue is unclear, but scientists have recently proposed that dengue originated in Asian forests in an infectious cycle involving mosquitoes and primates. As early as 992, a dengue-like outbreak in humans was recorded in a Chinese medical encyclopedia. Epidemics of dengue-like illnesses were reported in the French West Indies in 1635 and in Panama in 1699.

In 1771, Dr. Jose Sabater, a physician at the military hospital in San Juan, Puerto Rico, recommended treating dengue with small quantities of rum. At the time, the disease was called "break-bone fever." Where did this name come from? As you might guess, patients with the disease experienced a high fever accompanied by such severe bone and joint pains that they felt their bones were breaking.

In 1780, Dr. Benjamin Rush recorded an epidemic of the disease later known as dengue in Philadelphia, Pennsylvania. Rush described the symptoms of patients with the disease, which he called "bilious remitting fever." These symptoms included fever, joint and muscle pain, headache, rash, weakness, nausea, vomiting, and bleeding.

As early as 1801, people called the disease "dengue." In a letter written by Queen Luisa of Spain during her recovery from a dengue infection in 1801, she said, "I'm feeling better, because it has been the cold in fashion, that they call dengue, and since yesterday I've had some blood, which is what is making me uncomfortable, and after talking some time the throat hurts." What does dengue mean? The word dengue is Spanish for "affectation," "careful," or "fastidious." The term probably described the cautious, stiff movements of patients suffering from the muscle, bone, and joint pain caused by dengue fever. Some researchers believe that the name came from a Swahili phrase Ka dinga pepo, or a disease caused by an evil spirit.

In 1818, there was a serious dengue epidemic in Peru — 50,000 people were stricken with the illness. The first recorded dengue pandemic occurred between 1827 and 1828, and it affected the Virgin Islands, Jamaica, Cuba, Venezuela, the United States, and Mexico. Pandemics are epidemics that affect a very large region, multiple countries, or even the entire globe. Later in the 1800s, epidemics plagued Brazil, the southern United States, and the Caribbean. Dengue epidemics continued to occur more often through the first half of the 1900s. During World War II, dengue spread to new regions as large numbers of soldiers were stationed throughout the world. The first epidemic of severe dengue was reported in Manila, Philippines, in 1953, and the disease continued to spread in Southeast Asia during the next 20 years. Due to organized efforts to eliminate dengue in Central America and South America, fewer dengue epidemics occurred in these areas during the 1960s and 1970s, but when these efforts ended, dengue infections returned to these regions.

Dengue Is Back In Brazil And Northern Argentina

Thursday, February 18th 2010 - 23:24 UTC

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The Aedes Aegypti mosquito transmits the tropical disease also known as the "bone-crusher" because of its symptoms

Brazilian sanitary authorities confirmed the existence of a dengue epidemic in several counties of five states. They are Matto Grosso bordering with Bolivia; Matto Grosso do Sul next to Bolivia and Paraguay; Acre neighbouring with Peru and Bolivia; Roraima to the north next to Venezuela and Guyana and the state of Goias in the heart of Brazil.

"The risk that carnival celebrations might change the behaviour of the epidemic always exists", said Giovanini Evelim Coelho, coordinator of the National Program for Control of Dengue.

Dengue which is transmitted by the Aedes Aegypti mosquito becomes an epidemic when the number of confirmed cases reaches 300 per 100.000 of population.Dengue is considered one of the most extended diseases in the world and is endemic in the heartland of South America which includes northern Argentina, Brazil, Paraguay and Bolivia.

At the beginning of the month the Brazilian government alerted about the epidemic risk following the reappearance of the DEN-1 strain, with no cases registered in Brazil for the last ten years. Since January Brazilian sanitary officials have confirmed 12.666 cases in the country, five of them causing death.Although dengue cases have fallen overall 34.2% compared to last year, 298 Brazilian residents died of the most acute strain, and the Brazilian government has launched a massive information and prevention campaign.

In related news sanitary authorities from the Argentine northern province of Misiones, next to Paraguay, have confirmed 424 dengue cases since mid December. Most of the affected are back home and only 70 remain in hospitals or clinics.

However officials are on the alert because in the city of Port Iguazú, where the three countries meet (Paraguay, Argentina and Brazil) next to the world famous falls, a daily average of 60 people visits medical centres with possible symptoms of the disease.

Misiones was put on "yellow alert" last year following the epidemic in Paraguay.

Dengue is caused by four closely virus serotypes of the genus Flavivirus transmitted by mosquitoes. The disease manifests as a sudden onset of severe headache, muscle and joint pains, sever pains that gives it the nickname of break-bone fever or "bone-crusher", plus fever and rash. There may also be gastritis with some combination of associated abdominal pain, nausea, vomiting or diarrhoea.

The more dangerous strain is the dengue hemorrhagic fever which causes abdominal pain, haemorrhage and circulatory collapse. DHF starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Shock occurs after 2 to 6 days with sudden collapse, cool clammy extremities, weak pulse, and blueness around the mouth (cyanosis). Pneumonia and heart inflammation may be present. The mortality is appreciable ranging from 6 to 30%.

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