Last year we looked at an innovative way in which the incidence of Dengue Fever has been reduced in Australia. It now looks like this is needed more than ever. A recent report from Nepal has highlighted a dramatic increase in cases. Since May 2019 more than 14,000 cases have been confirmed. Some say the real figure may be 10 times greater. This is extraordinary since the country's first reported case of Dengue Fever wasn't until 2004. Now, 67 out of 77 districts have confirmed cases.
According to the World Health Organisation (WHO), Dengue Fever is the fastest growing communicable disease in the world. It estimates that 390 million people were infected in 2018. Approximately half of the world's population are at risk. Symptoms develop within 14 days of being bitten by an infected Aedes mosquito and typically last for up to 7 days. Life threatening complications such as dengue hemorrhagic fever and dengue shock syndrome can occur in a small proportion of cases.
The cause of such an outbreak is unclear - the combination of a prolonged monsoon, the increasingly urbanised population of Nepal and growing geographic mobility are all thought to contribute. Climate change may also be playing its part. For the first time the Aedes mosquito has been found to flourish at an altitude of more than 2000m above sea level. As Jim Duff says,
It's now becoming blindingly obvious that global heating is causing disease vectors to move into previously healthy areas. For example malaria, Lyme and Dengue are all on the march. It will only get much worse, be prepared!
The rash seen in Dengue Fever is typically found on the face, chest and inner aspects of the arms and legs. Patches of skin are sometimes spared - these have been described as, "islands of white in a sea of red". The application of a tourniquet to an affected limb causes the rash to darken and give a "tourniquet positive test". A case study with photos of the rash can be found here.
Visitors to mountain regions such as Nepal are therefore encouraged to take precautions to prevent transmission. These simple steps may go a long way to preventing this unpleasant and sometimes fatal disease...
Wear loose fitting, long sleeve clothing
Treat clothes and exposed skin with repellant (containing 50% DEET)
Sleep under treated netting
Ensure windows and doors are closed whenever possible
Avoid areas with standing water - especially at dawn and dusk
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