Mosquitoes are spreading dengue fever in more than 100 countries.
Mosquitoes are spreading dengue fever in more than 100 countries.
Copyright CDC/PHIL/Corbis

And Now, Something New To Worry About: Dengue Fever

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By Pamela Ferdinand
Special to The Washington Post
Sunday, May 6, 2007

One week I was lounging in paradise, snorkeling past giant clams and midnight blue starfish and eating freshly picked passion fruit and mangoes on a South Pacific beach with my fiance.

The next week I lay in torment at my home in Cambridge, Mass., alternately suffering chills and sweats with excruciating joint pain, bleeding under the skin and severe dehydration that landed me in the hospital for nearly a week.

Mark and I had chosen New Zealand over Thailand or Kenya for a month-long winter getaway, largely for its spectacular outdoors, where we could hike, kayak and scuba dive in remote and pristine wilderness. We also made the booking, after a year of family illnesses, because it promised a vacation free of political turmoil (no coups) and disease (no malaria shots).

The joke was on us.

When Air New Zealand offered a $100-per-person stopover at one of several island chains, including the Cook Islands, it seemed like a no-brainer: the perfect way to end our trip and an opportunity to see a place we might not otherwise visit. We opted to spend one night on Rarotonga and five on Aitutaki, the latter surrounded by an idyllic turquoise lagoon featured last year on the television reality show "Survivor."

Little did we know that our romantic detour had led us straight into a major disease outbreak striking hundreds of Cook Islanders and thousands of other people around the world. And, despite extensive trip homework and previous travels, we knew even less about the disease: dengue fever, a mosquito-borne virus also known as "break-bone fever."

When a fellow tourist came down with dengue, we figured: What are the odds of getting that?

As it turns out, pretty high.

* * *

Dengue fever (pronounced DENG-ee) is a common cause of illness in travelers returning to the United States from tropical areas, according to the Centers for Disease Control and Prevention. There is no vaccine, although clinical trials are underway, nor (unlike malaria) any preventive medication. Treatment involves close monitoring of vital signs, bed rest, fluids, and pain and fever relievers that do not encourage bleeding. Hospitalization can be required, especially for dengue hemorrhagic fever (DHF), a more severe and sometimes fatal form of the disease, but the good news is that dengue fever does not recur spontaneously, as does malaria.

The first reported dengue epidemics occurred in the late 18th century, and only nine countries experienced DHF epidemics before 1970. But scientists say the frequency and severity of outbreaks have increased in the past two decades -- particularly in the developing world -- due to climate change, increased air travel, uncontrolled urbanization with concurrent population growth, and failed or abandoned mosquito control efforts.

Now the disease is endemic in more than 100 countries in Africa, the Americas, Southeast Asia and the western Pacific, according to the World Health Organization. With one-third of the world's population at risk, there are an estimated 50 million to 100 million cases of dengue infection and 500,000 cases of DHF worldwide every year.

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© 2007 The Washington Post Company

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